Red Flags/When to Call/Speech and Language Milestones
12 Months
Limited or no babbling
Does not gesture – such as waving or clapping
Does not respond to name
Not pointing at objects of interest
Does not understanding common words such as mama, dada, milk
No back and forth sharing of sounds and smiles
18 Months
Does not respond to “no” or “bye-bye”
Does not use at least 8-10 words meaningfully
Does not follow simple commands, such as "give me the ball"
Is not playing pretend with items, such as a phone
By Age Two
Less than 50% intelligible
Does not use at least six consonant sounds
Does not follow two step directions
Cannot point to pictures of items in books when asked
Has a vocabulary of less than 50 words
Relies on gestures and grunting to communicate
No two-word meaningful phrases
By Age Three
Deleting consonants at the end of words and/or beginning of words
Less than 75% intelligible – strangers can’t understand child
Has not mastered the following sounds: p, m, h, n, and w
Not using three-word phrases
Difficulty understanding and therefore answering a variety of questions
By Age Four-Five
Is not 90-100% understandable to strangers despite age appropriate articulation errors (may not be able to say /r, sh, ch, l, or th yet)
Is not asking a variety of questions to gain information (who, what, where, why and when)
difficulty with grammar or pronoun use
Cannot tell a simple story on topic
Has difficulty answering simple who, what, where and why questions
Is not yet able to name a few letters, numbers, and rhyming words
My Child Benefit From Therapy if...
Not meeting the expected developmental milestones during the first 15-24 months of life (i.e., cooing, babbling, producing first word(s)
Difficulty coordinating and planning oral motor movements (tongue, lips) to formulate sounds/ syllables or have weak oral motor movements (i.e., weak jaw and/or tongue strength)
Not putting two words together to produce phrases and short sentences
Articulation difficulties where their speech consists of substitutions ( i.e., “f ” for “th,” “w” for “l”), distortions (i.e., the “s” sound may be a lisp or sounds messy), omissions (i.e., the word “cat” is produced “ca.”)
Weaknesses in receptive language skills or the ability to understand Language. (includes following simple directions, identifying spatial and temporal concepts, understanding prepositions, identifying antonyms, synonyms, multiple meaning words, etc.)
Weaknesses in expressive language skills or the ability to communicate through words, facial expressions, gestures, or other nonverbal forms
Difficulties in social situations, such as appropriate turn-taking skills, eye-contact, understanding a communication partner’s feelings, introducing and maintaining a topic, etc.
Limited food repertoire or have a food repertoire that is limited to certain textures, such as puree
Numerous disfluencies where they may repeat a sound, word, or phrase before completing a sentence
