Pediatric Speech & Language

Development Guide
Normal Expressive Language
Development:
Children typically develop speech in a
fairly standard way. Expressive language
is the way your child communicates to you.
Does your child babble? Talk? Use
pointing and other gestures? This is all
expressive communication.
Preparing for language:
Sucking is one of the first steps in the
development of expressive language
1 month: Vowel-like sounds and crying
emerge
2 months: A baby is able to produce
different kinds of cries
3 months: A baby begins using m, p, and
b, which are made with the lips and are
easy to see/imitate. Babies also learn over
the next few months to vary their tone to
express different feelings. Now, the baby
begins to stop making sounds while being
addressed by an adult. Your child is really
listening to you.
6 months: May spend long periods of time
making sounds in isolation or with an adult.
Begin producing simple syllables, such as
“ma” and “pa”. This vocal play is very
important for spoken language.
The Beginnings of language:
7 months: Begins to put two syllables
together while babbling. Some sounds
begin to sound almost like real words.
9 months: May “sing along” with music
and has probably learned to play “peek-a-
boo” or “pat-a-cake”. Asks for toys or food
by pointing and making sounds.
10 -12 months: Usually says first words.
May talk to family members without using
true words. May make sounds as if singing
along with music and may wave “bye-bye”
when asked to.
1 year: Normally will use from 5 -10
spoken words. Likes to make sounds of
familiar animals and things; laughs a great
deal, and will indicate want by pointing.
12 – 18 months: Most children will learn
50 new words, simple turn-taking rules, and
really converse with adults. Knows some
body parts. Indicates yes or no, & sings
simple tunes.
18 months: Toddler repeats overheard
words and tries to communicate using real
words. They have approximately 75 true
words, and may begin phrases linking
together words with long pauses:
“Mommy…Cookie!” “Doggie...Go” “All
gone…Milk”
2 years: Most children use two word
phrases, and pauses between words
decrease. The child begins making phrases
to talk about objects, locations, & actions.
Words will be used to control adults
behavior, request/reject toys, food, or a wet
washcloth. 300 word vocabulary with 75%
intelligibility with unknown context.
Begins using negatives and plurals.
2-1/2 to 3 years: short phrases are used
more often, even stringing 3-4 words
together. Will sit; repeat names of objects
& make appropriate noises; frequently talks
to him/herself. More turn-taking is evident
in conversation.
3 years: The three-year-old is rapidly
mastering grammatical skills and have
approximately 1000 words in their
vocabulary & are approx. 90% intelligible
with unknown context. Good usage and
understanding of questions.
Normal Development of Receptive
Language:
Normal Development of
Receptive language is defined as the receptive/expressive language for
cognition or understanding of language. older children:
Does your child understand what you say to
him? Can your child follow directions? 3.5 – 4 years: Understands up to 1500
words; can recall 3 – 4 digits in a sequence;
Points in the sequence of understanding Can follow commands with modifiers (e.g.
language in early years: Walk slowly to the ____); Uses requests;
1 year: Recognizes names of objects, Answers questions logically; can relate
1 month: Responds to voice people, pets, and action verbs. Comes events and experiences.
2 months: Eyes follow movement when called, and understands pointing. 4 -5 years: Places simple pictures in
3 months: Coos in response to pleasant 1.5 -2 years: Understands some new words sequence; Understands time concepts; Able
voice each week. Identifies pictures in a book, a to group items by Category; Describes
4 months: Turns head to source of sound few new body parts and some common Similarities and differences; Verbal
5 months: Responds to own name objects. Carries out 2 consecutive reasoning skills including, what is silly or
6 months: Appears to recognize words like directions (i.e kiss the ball). Recognizes wrong with this?
daddy, bye-bye, mamma and pets. many common objects and pictures when 5.5-6 years: Carries out complex commands; likes
7 months: Shows interest in sounds and named. Understands possession “where’s silly words and riddles; expressive vocabulary of
objects mama’s shoe?”. Understands yes/no 1500-2000 words; uses conjunctions and auxiliary
8 months: Recognizes names of common questions, and grasps cause/effect verbs; can tell stories and articulate with 90%
objects sentences (i.e when we go to the store, I’ll accuracy; egocentric speech is decreasing and
9 months: Follows simple directions like get you an ice cream cone) social speech emerges; uses 6 -8 word sentences, &
“find the ball” and “give me the ball” will 2.5 – 3 years: Understands the use of understands approximately 4000 words.
sustain interest in activity for up to one objects and prepositions (in, on, off, out of,
minute. up, down) & understands simple questions.
10 months: Understands no and stop. Understands pronouns (I, me, my, mine)
Understands simple commands like “come and categories. Matches familiar activities,
here” and “give it to me” and can stay on an activity for about 10
11 months: Appears to understand simple minutes.
questions like “where is the ball?”
Chart illustrates average upper age limits of customary consonant production. The solid bar corresponds to the age when a child
masters each sound. It starts at the median age of customary articulation and stops at the age level when 90% of all children are
producing the sound. For example, 90% of children have learned the "d" sound by the time they are 4 years old. The information
contained in this chart illustrates a general range of development and should be used only as a guideline. Data taken from Templin,
1957, Wellman et al. 1931, Sander 1972 Journal of Speech and Hearing Disorders.
What if my child appears to be behind in their speech development?
-Go to www.speechtails.com/assessment and take the free speech assessment.
-Sign-up for the SpeechTails speech newsletter which is filled with facts and tips about speech development.
-Ask a licensed speech pathologist a question at SpeechTails.com
-Check medical insurance to see if your child’s speech therapy is covered.
-Discuss with your child’s pediatrician
-Discuss with school based speech pathologist
-Seek an ASHA certified speech-language pathologist. This specialist will determine whether your child needs additional help and
will recommend an individual program of activities and provide therapy if appropriate.

About SpeechTails Founder:

Amy Reno – M.S., CCC, SLP has a Bachelor of Arts degree from Ball State University and a Masters of Science degree from
Marquette University. She has a Certificate of Clinical Competence in Speech Language Pathology and holds a license to practice in
the State of Wisconsin. Experience includes more than fifteen years of working in private practice, birth to three, elementary school,
local children’s hospital settings and rehab center. Her particular interests are working with children with various difficulties
including: feeding and swallowing difficulties, oral motor impairments, neurological impairments (developmental and acquired),
developmental speech and language difficulties (including apraxia of speech and autism spectrum disorder), and expressive/receptive
language delays. She realized early in her career that those who need speech therapy don’t always receive it and this fact became the
driving force behind her founding SpeechTails.com

About SpeechTails.com:
SpeechTails is a step-by-step self-directed alternative to traditional speech therapy. The online program is aimed at helping children
in three groups:
-To help all children learn speech properly from the beginning.
-To help the many children who do not qualify for formal speech therapy due to the problem deemed “not serious” enough.
-To help facilitate homework outside of the speech therapy session for those who are able to qualify for traditional speech services.
Some of the attributes of SpeechTails are:
-Cost effective, unlimited use for $25/month
-Convenient, access anytime, anywhere the internet is available.
-Step-by-Step, self-directed, fun, facilitates practice