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Language Development and Possible Causes for Concern

Baby talkingHow should your child's language development be progressing? Marin Speech Pathologist Cydney Doerres, MS, CCC, fills us in on children's important developmental milestones and potential causes for concern in this guest article.

Do you recall how excited you were when your child said his first word? Talking and walking are two of the most important developmental milestones in a child’s and a parent’s life. We, as parents, often gage our children’s overall development based on the language that he understands and is producing. Catching a speech or language delay early is important as the ability to communicate helps your child to develop learning, play and social skills in preschool and earlier.

As a Speech and Language Pathologist/Therapist the most frequent question I hear from professionals, family, friends and parents is “Is my child talking at the right level for his/her age?” If I feel that I have observed the child well enough, then I can provide a confident answer, however, I have often only just met the child!

Here are some common signs to look for that tell you whether or not you should take a closer look at your child’s speech and language development. The following is an adaptation of a chart found in the book The Late Talker: What to Do If Your Child Isn't Talking Yet by Marilyn C. Agin, M.D., Lisa F. Geng, and Malcolm J. Nicholl (St. Martin’s Press, 2003).

How speech and language typically develop:

  • 12–15 months: child should start saying first real words such as mama, dada, up and more.
  • 18 months: child should be adding new words rapidly; up to 10 or more words a day.
  • 20 months: child may begin saying 2 words together in simple phrases.
  • 2 years: child may have the ability to state needs more effectively and may be using an increasing number of 2 and 3 word phrases.
  • 30 months: Child should show a spike in vocabulary produced that is proportionately greater than at any other time in life. The number of words used may jump from around 200 words to over 1000.
  • 3 years: Children begin to pick up grammatical rules and may use regular plurals, regular verb tenses, and sentence structures become more adult like.
  • 3–5 years: Children are usually able to hold conversations using increasingly complex language and sentences that may be 8 or more words long.

Possible causes of concern:

  • 9 months: No babbling or babbling with few or no consonants
  • 12 months: May be easily upset by sounds, may look at a desired object but does not let you know clearly that he wants it, a lack of consistent patterns of babbling (bababa, mamama, etc.), does not respond to words or hand gestures, or has difficulty understanding language when he cannot see what is being talked about.
  • 18 months: Does not gesture to communicate, does not attempt to imitate or spontaneously say single words with meaning, doesn’t keep trying to communicate when not understood, understands fewer than 50 words or gestures without cues, speaks fewer than 10 words, lack of growth in vocabulary over time.
  • 24 months: Mostly uses gestures without words, speaks fewer than 50 words, does not produce any two-word combinations, produces a limited number of consonants, speech is largely unintelligible, tends to label objects instead of commenting or requesting, demonstrates a regression in language development or stops talking, echoes phrases, or language doesn’t match the environment.
  • 36 months: Words are limited to single syllables with the last consonants omitted, does not demand a response from listeners, does not ask questions, speech intelligibility is poor, has frequent tantrums when not understood, echoing speech without the intent to communicate, having difficulty understanding language unless it is simple, slow and includes gestures.
  • 48 months: Frequently says “huh?” or “What?”, needs repetition of directions, speaks in a simplistic style using immature grammar, demonstrates frequent frustration in communicating, substitutes common pronouns such as me/I, him/he, her/she, or speaks little during pretend play.
  • 60 months: Demonstrates difficulty with word finding in describing use of objects, difficulty in retelling stories or recent events, sentences seem unorganized and awkward with difficulty getting to the point.

If, after reading this information, you feel concerned about your child’s development in the areas of speech and language, the best thing to do is to talk to you pediatrician first. He/She can make an initial assessment and refer you to a speech pathologist if necessary.

Cydney Doerres, MS, CCC, has been working with children in Marin County since 1998. She specializes in pediatrics with emphasis on early intervention, developmental apraxia of speech (dyspraxia), school age language, auditory processing, and reading (dyslexia). She strives to provide language therapy in a nurturing, supportive environment in which the children have fun.

Cydney has completed continued education in areas including the Kaufman Program for Dyspraxia; the Lindamood Bell Reading Program with Phillis Lindamood; the Phonographix Reading Program; autism with Bryna Siegel, PhD; sensory integration, social thinking with Michelle Garcia Winner, Playing to Learn with Barbara Kalmanson, PhD and Charla Cunningham, RDT, MFA, MFTI; and Neuro-developmental Disorders.

To find out more about Cydney Doerres and her services, contact her at (415) 457-7745 or visit cydspeech.com.