Waiting for Your Child’s First Words: When to Worry and Why

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Childhood is filled with milestones, and the first three years of a child’s life are prime learning opportunities for speech-language development.

Developing language is a life-changing thing. Societies communicate in a variety of ways every day. My name is Faith Hudnall and I’m a pediatric speech-language pathologist (SLP) at Riley Hospital for Children at Indiana University Health. For over 14 years, I have practiced as a clinician, helping babies and toddlers better communicate.

Childhood is filled with milestones, and the first three years of a child’s life are prime learning opportunities for speech-language development.  Over the years, as a clinician, I’ve often encountered questions from families relating to how much a child should talk as well as how clearly they should speak and when. To aid concerned parents, I’d like to address what is considered a typically developing timeline and when to see your doctor.

Birth to 3 months:

  • Increases or decreases sucking behavior in response to sound
  • Makes pleasure sounds (cooing, gooing)
  • Cries differently for different needs

4 to 6 months:

  • Babbling sounds more speech-like with many different vowel sounds and consonant sounds p, b, m
  • Chuckles and laughs
  • Vocalizes excitement and displeasure
  • Makes sounds when left alone and when playing with others

7 to 12 months:

  • Recognizes words for common items like “cup,” “shoe,” “book,” or “spoon”
  • Begins to respond to requests like “Come here” or “Want up?”
  • Babbling has both long and short groups of sounds such as “tata, memu, bobobo”
  • Uses speech or non-crying sounds to get and keep attention
  • Imitates different speech sounds
  • Has one to a few words (hi, dog, dada, mama, ball) around first birthday although sounds may not be clear

1 to 2 years:

  • Uses an increasing amount of words every month
  • Uses some one- or two-word questions (“Where daddy?” “Go out?” “What’s that?”)
  • Puts two words together (“More cookies,” “No juice,” “Mommy book”)    
  • Uses many different consonant sounds at the beginning of words

2 to 3 years:

  • Understands differences in meaning (“Go-stop,” “In-on,” “Big-little,” Up-down”)
  • Has a word for almost everything
  • Uses two- and three-word combinations to talk about and ask for things
  • Uses k, g, f, t, d, and n sounds
  • Speech is understood by familiar listeners most of the time
  • Asks why
  • May stutter on words or sounds

If you think your child has a speech, hearing, or language problem, I encourage you to take those concerns seriously.  The timeline I’ve provided gives you an idea of when to be concerned if speech-language milestones are going unmet.  The first person to speak with should be your child’s physician. Come to the appointment with specific details about why you’re concerned. 

If your doctor does not share these apprehensions, I empower you to say that you’d still like a referral for a speech-language evaluation. Peace of mind does not have a price tag.  In my professional experience, when parents have had a concern, it has overwhelmingly been a legitimate concern. 

Suggestions for how to facilitate some of the milestones mentioned here can be found at www.asha.org (The American Speech-Language-Hearing Association).  Additionally, we are lucky enough to live in a society where a variety of early intervention services exist for babies and toddlers that are experiencing developmental delays or disabilities. The early intervention program, known as First Steps in Indiana, can be incredibly beneficial. Your child’s pediatrician can offer additional details.  

Getting help early can stop later problems with learning, literacy, social relationships, and unwanted behaviors.  The team of SLPs at Riley is committed to providing support for speech-language development in addition to other components within our specialized training (e.g., feeding and swallowing disorders).  For more information about our services, click here.

-- By Faith Hudnall, MS, CCC-SLP

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