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How Important Are Speech and Language Milestones?

Mom reads to her baby to help develop speech

Every child develops at their own pace and while some speak early and often, others may take longer to develop their speech and language skills. Being aware of common speech and language milestones can help caregivers advocate for their child if they need some extra support.

“Speech milestones are important from a perspective that it gives us a way to track a child’s progress,” said Bernadette Palmese AuD, program manager, Pediatric Audiology, Yale New Haven Children’s Hospital. “But there are some grey areas. Not every child is going to fall on the specific goals as they’re written.”

Speech milestones by age

Like milestones for other developmental markers, speech and language milestones are measured by age.

Birth to 3 months: At this stage, newborns should start to turn to sounds and have preferences for voices (typically a parent). They may also show interest in faces.

4 to 6 months: Start to coo, giggle or laugh. At this age, babies will also start to express themselves with different cries, for example a cry for hunger may sound different than a cry for discomfort.

7 to 9 months: Babies at this age may recognize their name and imitate sounds. They can gesture for communication, like raising hands to be picked up.

10-12 months: Playing peekaboo, blowing kisses and raspberries. Babies may say their first word at this age such as ‘Mama,’ or ‘Dada.’

13-18 months: Starting to follow directions. At this age their vocabulary is slowly increasing in both words and gestures as they show a stronger and more diverse intent to communicate (and showing an intent to communicate). For example, they may shake their head for no or nod for yes. They can identify body parts, clap hands and respond to gestures in songs.

19-24 months: They are now developing a vocabulary of words at a rapid pace and starting to string two or more word phrases together. For example, ‘Mommy up,’ or ‘more water.’

Getting help for a speech and language delay

There are many reasons why a child may not be meeting their milestones, including developmental delays, genetics or hearing loss. A universal hearing screening at birth is designed to catch anything greater than mild hearing loss. At around 12 to 18 months, hearing loss can be evaluated in a sound booth.

“If there is hearing loss of any type, we would want that hearing loss to be addressed as soon as possible,” said Palmese. “For example, if there’s fluid in the child’s ears for a long period of time, that’s potentially going to impact speech and language development.”

Treatments for hearing loss can vary. For example, children with recurring ear infections may benefit from ear tubes which help drain fluid from the ear and improve hearing while more pronounced hearing loss will need to be addressed with amplification.

Once hearing has been ruled out as a factor, other interventions such as therapy with a speech language pathologist can help children improve their communication skills.

“Parents will sometimes say, ‘Oh, my child’s just a late talker.’ I hesitate to use that phrase because yes, they could be slower to develop, or there could be another reason such as hearing loss, apraxia of speech or autism. So, it’s always great to seek an evaluation from a licensed SLP if you are at all concerned that your child is behind,” said Yale New Haven Hospital Speech Language Pathologist Emily Chapman, MS CCC-SLP.

Chapman says when she’s working with patients, she’s not just counting how many words a child is or isn’t saying. Instead, she’s looking at a child’s desire to communicate. Are they making eye contact? Are they participating in back and forth play or following directions? Picking up on those communication cues is more important than hitting a specific milestone at a certain age and gives experts clues into how best to support that child’s needs.

Encouraging speech and language at home

So, what can parents do at home to encourage their child’s speech and language development? Constant interaction since birth can make a big difference. It may feel silly, but Chapman recommends caregivers talk to their baby about what they’re doing in that moment. At mealtime, you can explain, “Now daddy is cooking dinner. Look, he’s chopping vegetables!” During a bath, explain that you are washing their face and cleaning their hands. Reading books and using the real words for everyday items can be helpful but it really boils down to simple interactions on a consistent basis.

“Constantly talk throughout your day,” said Chapman. “Narratives provide lots of examples and moments for increased communication skills.”