Does my child need Speech and Language Therapy?
It’s natural for parents and carers to feel concerned or unsure about whether their child may need speech and language support. When signs aren’t always obvious, or you’re uncertain what’s typical at their age, we can use developmental milestones as a guide.
Developmental milestones refer to the key skills most children are expected to achieve by specific ages. These include significant moments such as taking their first steps, smiling for the first time, and waving “bye-bye.” Milestones encompass a range of developmental areas, including play, learning, communication, social interaction, and motor skills. While each child develops at their own pace, understanding developmental milestones can provide valuable insights to help determine if they might benefit from additional support. Here are the developmental milestones in speech, language and communication:
Understanding Words
By 12-15 months, most children can understand basic instructions in context and with cues (e.g., “get your shoes” whilst pointing to their shoes near them)
By 18 months, most children can understand basic instructions without context and cues (e.g., “get your shoes” without pointing, and they are in another room). They can also understand simple questions like “Where’s Mummy?”
By 2 years, most children can understand instructions with two information-carrying words, i.e., words that carry meaning (e.g., “Pass me the green grape” when the child has a red and green grape, red and green apple in front of them). They can understand prepositions, such as in, on, and under, and simple directional terms like up and down. They can understand another, as in “Can I have another?”
By age 3, most children can understand instructions with three information-carrying words. They can understand the prepositions in, off, on, under, out of, together, and away from. They can understand size differences and time concepts such as wait, soon, and later. They can understand simple WH questions (what, who, and where).
By 4 years, most children can understand instructions with four information-carrying words. They can understand the prepositions behind, in front, around, beside, next to and between. They can identify colours. They can understand more complex WH questions (how, when and why) and object-function questions, e.g., “What are fridges for?” (to keep food cold). They can answer ‘how many’ questions, when the number doesn’t exceed 4.
By 5-6 years, most children can understand and follow more complex instructions with multi-steps and information-carrying words. They can understand prepositions like nearest and through, corner and middle, know their left and right and understand opposite concepts. They can understand time concepts such as yesterday, today, tomorrow, first, then and the days of the week.
Using Words
By 12-15 months, most children have between 2-10 recognisable words. This includes symbolic words, e.g., “woof woof” for ‘dog’.
By 18 months, most children have around 20 recognisable words, but on average, 50 words. This includes symbolic words, e.g., “nee naw” for ‘ambulance’.
By 2 years, most children use at least 50 words, but on average, between 200-300. They can use simple two-word phrases, e.g., “More milk”. They can use the pronouns ‘I’ and ‘it’.
By age 3, on average, children use around 1000 words and phrases with at least three words, e.g., “Teddy wants kisses”. They can ask simple, ‘where’, ‘what’ and ‘what… doing?’ questions. They can use the pronouns you, me, my, mine, your, yours, he, she and we.
By age 4, on average, children have 1,600 words and use what, where, when, how, whose and how when asking questions. They can ask one-word why questions and ask is questions, e.g., “Is Mummy going to work?” They can use the pronouns they, them, their, theirs, us, his, her, hers, its, our, ours, him and myself.
For older children, the average 5-year-old has 2200-2500 words, and the average 6-year-old has 2600-7000 words. At this age, they learn several new words a day (the number increases gradually with age), and the average 12-year-old has a vocabulary of 50,000 words.
Speech Sounds
Most 2-3-year olds can make the p, b, m, n, t, d, k, g, ‘ng’ (e.g., 'sing’), w, h, y, f sounds
Most 4-year-olds can make the l, j, ch, s, v, sh, z sounds
Most 5-year-olds can make the r, ‘zh’ (e.g., ‘treasure’), voiced ‘th’ (e.g., ‘the’) sounds
Most 6-year-olds can make the voiceless ‘th’ sound (e.g., ‘thought’)
Speech Intelligibility
By 18 months, 25% of speech is intelligible
By 2 years of age, 50-75% of speech is intelligible (50% intelligible to unfamiliar listeners)
By 3 years of age, 75-100% of speech is intelligible (75% intelligible to unfamiliar listeners)
By 4 years of age, 100% of speech is intelligible to unfamiliar listeners
If your child is not meeting their communication milestones, Speech and Language Therapy can support them to reach their communication potential.
References;
Lanza, J., & Flahive, L. (2012). Guide to communication milestones. East Moline, IL: LinguiSystems.
Nicolosi, L., Harryman, E., & Kresheck, J. (2004). Terminology of communication disorders (4th edition) Baltimore, MD: Williams and Wilkins.
McLeod, S., & Crowe, K. (2018). Children's consonant acquisition in 27 languages: A cross-linguistic review. American Journal of Speech-Language Pathology, 27(4), 1546–1571.
Owens, R. E. (1996) Language Development: An Introduction. Boston: Allyn & Bacon.
Tuohy, J., Brown, J., & Mercer-Moseley, C. (2001). St. Gabriel’s curriculum for the development of audition, language, speech, cognition. Castle Hill, Australia: St. Gabriel’s.