From the Guidelines
Speech milestones in children should be monitored closely, with regular surveillance of developmental milestones, auditory skills, parental concerns, and middle-ear status, and objective standardized screening of global development at 9,18, and 24 to 30 months of age, as recommended by the American Academy of Pediatrics 1.
Key Speech Milestones
- By 3 months, babies typically coo and make vowel sounds.
- Around 6 months, they begin babbling with consonant sounds like "ba" or "da."
- Between 9-12 months, first words usually emerge, often "mama" or "dada."
- By 18 months, children typically have 5-20 words and understand simple commands.
- Two-year-olds generally use 50+ words and begin forming two-word phrases like "more milk."
- By age 3, children usually speak in short sentences of 3-4 words and strangers can understand about 75% of their speech.
- Four-year-olds typically use complete sentences and tell simple stories, while five-year-olds generally speak clearly with adult-like grammar, though some speech sounds may still develop.
Importance of Early Intervention
Early intervention is crucial for children with hearing loss or speech delays, as it can significantly improve outcomes in vocabulary development, receptive and expressive language, syntax, speech production, and social-emotional development 1.
Recommendations for Parents
Parents should talk, read, and sing to children regularly to support speech development. Significant delays warrant discussion with a pediatrician, as early intervention with speech therapy can be highly effective for addressing developmental concerns.
Surveillance and Screening
Regular surveillance and screening can help identify potential issues early on, allowing for timely intervention and support. This is particularly important for children with hearing loss, as early intervention can help them achieve language development within the typical range of children with normal hearing 1.
From the Research
Speech Milestones in Children by Age
- By 30-31 months, children typically experience the steepest growth in single-word and multiword intelligibility 2
- By 31-47 months, 50% of children achieve single-word intelligibility, while 75% achieve it by 49-87 months, and 90% by 83-120+ months 2
- For multiword intelligibility, the age ranges are 34-46 months for 50%, 46-61 months for 75%, and 62-87 months for 90% 2
- Children should be at least 50% intelligible by 48 months, with intelligibility growth continuing through 9 years for those in median and lower percentiles 2
- Between 30 and 47 months, typically developing children exhibit steady linear change in intelligibility development, with multiword intelligibility growing at a faster rate than single-word intelligibility 3
- By 41 months of age, multiword productions become more intelligible than single words, with boys and girls showing no significant differences in intelligibility development 3
Language Development Milestones
- A set of 26 clear and distinctive milestones has been identified to reflect language development in children aged 1 to 6 years, covering vocabulary, grammar, and communication 4
- These milestones can be used as an instrument to monitor language development in young children, with an item ordering that holds for all children 4
Clinical Decision Making for Speech and Language Development
- Speech-language pathologists (SLPs) use research to inform clinical decision making for children with specific language impairment (SLI), with assessment standard scores and percentiles strongly associated with SLP service recommendation 5
- SLPs recommended services for individuals with SLI at higher rates than in actual practice, with variation across the clinical decision-making process occurring due to child characteristics rather than practitioner characteristics 5