Speech and language therapy

Children vary in their development of speech and language. There is, however, a natural progression or “timetable” for mastery of these skills for each language. The milestones below are identifiable skills that can serve as a guide to normal development. Typically, simple skills need to be reached before the more complex skills can be learned. There is a general age and time when most children pass through these periods. These milestones help doctors and other health professionals determine when a child may need extra help to learn to speak or to use language. Following are age-related guidelines that can help you determine if your child’s speech and language skills are developing on schedule.

2-3 years old

  • Knows about 50 words at 24 months.
  • Knows some spatial concepts such as “in,” “on.”
  • Knows pronouns such as “you,” “me,” “her.”
  • Knows descriptive words such as “big,” “happy.”
  • Says around 40 words at 24 months.
  • Speech is becoming more accurate but may still leave off ending sounds. Strangers may not be able to understand much of what is said.
  • Answers simple questions.
  • Begins to use more pronouns such as “you,” “I.”
  • Speaks in two to three word phrases.
  • Uses question inflection to ask for something (e.g., “My ball?”).
  • Begins to use plurals such as “shoes” or “socks” and regular past tense verbs such as “jumped.”

3-4 years old

  • Groups objects such as foods, clothes, etc.
  • Identifies colors.
  • Uses most speech sounds but may distort some of the more difficult sounds such as l, r, s, sh, ch, y, v, z, th. These sounds may not be fully mastered until age 7 or 8.
  • Uses consonants in the beginning, middle, and ends of words. Some of the more difficult consonants may be distorted, but attempts to say them.
  • Strangers are able to understand much of what is said.
  • Able to describe the use of objects such as “fork,” “car,” etc.
  • Has fun with language. Enjoys poems and recognizes language absurdities such as, “Is that an elephant on your head?”
  • Expresses ideas and feelings rather than just talking about the world around him or her.
  • Uses verbs that end in “ing,” such as “walking,” “talking.”
  • Answers simple questions such as “What do you do when you are hungry?”
  • Repeats sentences.

4-5 years old

  • Understands spatial concepts such as “behind,” “next to.”
  • Understands complex questions.
  • Speech is understandable but makes mistakes pronouncing long, difficult, or complex words such as “hippopotamus.”
  • Says about 200-300 different words.
  • Uses some irregular past tense verbs such as “ran,” “fell.”
  • Describes how to do things such as painting a picture.
  • Defines words.
  • Lists items that belong in a category such as animals, vehicles, etc.
  • Answers “why” questions.

5-6 years old

  • Understands more than 2,000 words.
  • Understands time sequences (what happened first, second, third, etc.).
  • Carries out a series of three directions.
  • Understands rhyming.
  • Engages in conversation.
  • Sentences can be 8 or more words in length.
  • Uses compound and complex sentences.
  • Describes objects.
  • Uses imagination to create stories.

6-7 years old

  • The child is ready for school. He is sufficiently well developed, both physically and mentally. The most important thing, but it is not what your child knows or can, but this is how he uses to his skills.

Adapted from: The National Institute on Deafness and Other Communication Disorders. (2000). Speech and Language Developmental Milestones. NIH Publication No. 00-4781.

You should talk to your child’s doctor about anything that is checked “no.”

Treatment methods and services:

Assessment and evaluation of speech-language disorders
Consultation and advice about communication aids
Speech and language therapy
Articulation correction
Pictogram usage
Breathing exercises
Tongue exercises
Logopedic massage