A baby's first words are music to a parent's ears. But how can you tell if your child's speech and language development is on track?
While every child learns to speak at his or her own pace, general milestones can serve as a guide to normal speech and language development. These milestones help doctors and other health care providers determine when a child might need extra help.
By the end of three months, your child might:
- Smile when you appear
- Make cooing sounds
- Quiet or smile when spoken to
- Seem to recognize your voice
- Cry differently for different needs
By the end of six months, your child might:
- Make gurgling sounds when playing with you or left alone
- Babble and make a variety of sounds
- Use his or her voice to express pleasure and displeasure
- Move his or her eyes in the direction of sounds
- Respond to changes in the tone of your voice
- Notice that some toys make sounds
- Pay attention to music
By the end of 12 months, your child might:
- Try imitating speech sounds
- Say a few words, such as "dada," "mama" and "uh-oh"
- Understand simple instructions, such as "Come here"
- Recognize words for common items, such as "shoe"
- Turn and look in the direction of sounds
By the end of 18 months, your child might:
- Recognize names of familiar people, objects and body parts
- Follow simple directions accompanied by gestures
- Say as many as 10 words
By the end of 24 months, your child might:
- Use simple phrases, such as "more milk"
- Ask one- to two-word questions, such as "Go bye-bye?"
- Follow simple commands and understand simple questions
- Speak about 50 or more words
- Speak well enough to be understood at least half the time by you or other primary caregivers
Talk to your child's doctor if your child hasn't mastered most of the speech and language development milestones for his or her age or you're concerned about your child's development. Speech delays occur for many reasons, including hearing loss and developmental disorders. Depending on the circumstances, your child's doctor might refer your child to a hearing specialist (audiologist) or a speech-language pathologist.
In the meantime, talk to your child about what you're doing and where you're going. Sing songs and read together. Teach your child to imitate actions, such as clapping, and to say animal sounds. Practice counting. Show your child that you're pleased when he or she speaks. Listen to your child's sounds and repeat them back to him or her. Some affectionate "baby talk" to your child is OK, but remember that your child learns to speak by imitating you. These steps can encourage your child's speech and language development.
March 25, 2021
- Kliegman RM, et al. Language development and communication disorders. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Feb. 14, 2019.
- Birth to one year: What should my child be able to do? American Speech-Language-Hearing Association. http://www.asha.org/public/speech/development/01.htm. Accessed Feb. 14, 2019.
- Kliegman RM, et al. The second year. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Feb. 14, 2019.
- One to two years: What should my child be able to do? American Speech-Language-Hearing Association. http://www.asha.org/public/speech/development/12.htm. Accessed Feb. 14, 2019.
- Speech and language developmental milestones. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/pages/speechandlanguage.aspx. Accessed Feb. 14, 2019.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 22, 2019.