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Ear, nose and throat program

Age-appropriate speech and language milestones

Hearing problems may be suspected in children who are not responding to sounds or who are not developing their language skills appropriately. The following are some age-related guidelines that may help to decide if your child is having hearing problems. It is important to remember that not every child is the same and children reach milestones at different ages. Consult your child's physician if you are suspicious that your child is not developing speech and language skills correctly. The National Institute on Deafness and Other Communication Disorders (NIDCD) and other experts list the following age-appropriate speech and language milestones.

Milestones related to speech and language:

Birth to 5 months
  • Coos
  • Vocalizes pleasure and displeasure sounds (laughs, giggles, cries or fusses)
  • Makes noise when talked to
6 to 11 months
  • Understands "no-no"
  • Babbles (says "ba-ba-ba)
  • Says ma-ma or da-da without meaning
  • Tries to communicate by actions or gestures
  • Tries to repeat your sounds
  • Says first word
12 to 17 months
  • Answers simple questions nonverbally
  • Says two to three words to label a person or object (pronunciation may not be clear)
  • Tries to imitate simple words
  • Vocabulary of four to six words
18 to 23 months
  • Correctly pronounces most vowels and n, m, p, h, especially in the beginning of syllables and short words - also begins to use other speech sounds
  • Vocabulary of 50 words, pronunciation is often unclear
  • Asks for common foods by name
  • Makes animal sounds such as "moo" 
  • Starting to combine words such as "more milk"
  • Begins to use pronouns such as "mine"
  • Uses two word phrases
2 to 3 years
  • Knows some spatial concepts such as "in", "on"
  • Knows pronouns such as "you," "me," "her"
  • Knows descriptive words such as "big," "happy"
  • Vocabulary of 250 to 900 words
  • Uses three word sentences
  • Knows 50-100 words
  • Speech is becoming more accurate but may still leave off ending sounds - strangers may not be able to understand much of what is said
  • Answers simple questions
  • Begins to use more pronouns such as "you," "I"
  • Uses question inflection to ask for something such as "my ball?"
  • Begins to use plurals such as "shoes" or "socks" and regular past tense verbs such as "jumped"
3 to 4 years 
  • Groups objects such as foods, clothes, etc.
  • Identifies colors
  • Uses most speech sounds but may distort some of the more difficult sounds such as l, r, s, sh, ch, y, v, z, th - these sounds may not be fully mastered until age 7 or 8
  • Uses consonants in the beginning, middle and ends of words - some of the more difficult consonants may be distorted, but attempts to say them
  • Strangers are able to understand much of what is said
  • Able to describe the use of objects such as "fork," "car," etc.
  • Has fun with language - enjoys poems and recognizes language absurdities such as, "is that an elephant on your head?"
  • Expresses ideas and feelings rather than just talking about the world around them
  • Uses verbs that end in "ing," such as "walking" and "talking"
  • Answers simple questions such as "What do you do when you are hungry?"
  • Repeats sentences
4 to 5 years
  • Understands spatial concepts such as "behind," "next to"
  • Understands complex questions
  • Speech is understandable but makes mistakes pronouncing long, difficult or complex words such as "hippopotamus"
  • Vocabulary of about 1500 words
  • Uses some irregular past tense verbs such as "ran," "fell"
  • Describes how to do things such as painting a picture
  • Defines words
  • Lists items that belong in a category such as animals, vehicles, etc.
  • Answers "why" questions
5 years
  • Understands more than 2,000 words
  • Understands time sequences (what happened first, second, third, etc.)
  • Carries out a series of three directions
  • Understands rhyming
  • Engages in conversation
  • Sentences can be eight or more words in length
  • Uses compound and complex sentences
  • Describes objects
  • Uses imagination to create stories
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