{Professional Insight} Speech and Language Developmental Milestones: When to Ask for Help

April 30, 2014
Hispanic Mom with Baby


The dreaded developmental milestones.  Before your child is enrolled in school, these milestones feel like benchmark testing or a report card to rate your child compared to the expectations of his or her chronologically same-aged peers.  As parents, I feel like we always have a desire to check each box the second it is expected or sooner!  Little Johnny turned 1 year old today, why isn’t he walking across the house?!  When in reality, developmental milestones should represent an age range where a specific set of skills might emerge.  Every child is different and will develop at their own rate.  This cannot be emphasized enough for a child born prematurely. 

When a baby is born prior to 40 weeks, their nervous system, along with the rest of their tiny body, has not had proper time to mature to prepare them for the outside world.  Therefore, the way they detect and respond to their environment will most likely be different than a full term baby.  The developmental expectations for an infant born prematurely will be adjusted according to their individual length of gestation for the first two years of their life (often called adjusted age).  Here are the speech, language, play, and communication developmental milestones for an infant born prematurely as outlined by Emory University School of Medicine (I like this list, in particular, because they also list possible complications that could impact a child’s mastery of a particular skill.  For example, if your child came home on oxygen.)

From 2 to 5 Months

  • smile and coo.
  • watch a person’s face intently.
  • follow people and objects with her eyes.
  • laugh out loud.
  • startle when she hears a loud sound. 

From 6 to 9 Months

  • babble and begin to combine vowel consonant sounds. For example, “dadadada.”
  • turn to locate the source of a sound.
  • respond to her name. 

From 10 to 12 Months

  • carry out a simple action on verbal request. For example, wave “bye” when she hears the word. She no longer has to see someone wave first.
  • purposefully say “mama” and/or “dada” as a greeting or to call a parent to her.
  • play with an object with both hands while sitting independently.
  • independently move herself across the floor to get a desired object.
  • try to communicate by pointing or reaching for what she wants.
  • turn the pages of a board or thick plastic book.
  • visually and manually explore toys, revealing a growing curiosity.
  • indicate recognition of familiar people by facial expression or by physically approaching the familiar person. 

From 13 to 18 Months

  • be able to scribble with a large crayon (if she can keep from putting it in her mouth).
  • use a vocabulary of four to ten words.
  • follow simple verbal directions to perform a single task. For example, “Give me the ball.”
  • coordinate the use of both hands well. For example, hold a container in one hand while putting something into it with the other.
  • respond to her name.
  • “talk” in long, jabbering sentences as if holding an understandable conversation with you.
  • point to at least two pictures on request.
  • use her thumb and first finger easily to pick up a very small object.
  • throw a ball easily. 

By two years of age, your baby should experience a burst of verbal language development.  They should demonstrate strong communicative intent to let you know what they want or need using a vocabulary between 50 and 250 words.

Your pediatrician can help you to determine if your child is meeting his or her communication developmental milestones.  If a concern is present, your pediatrician will likely refer you to a speech-language pathologist.  In addition, trust your “gut” and if you feel your child is behind for their age or is developing in an atypical manner, be persistent when talking with your child’s physician regarding a referral for a speech and language evaluation.  It can never hurt to learn more information about your child’s development or discover new strategies to help them grow their ability to communicate with you and the world.  If an issue is identified, early intervention offers the best prognosis for success!

Guest Blogger

Julie WahrenbergerJulie Wahrenberger, M.S., CCC-SLP owns and operates Spring Branch Speech Therapy. She is nationally accredited by the American Speech, Language, and Hearing Association (AHSA) and licensed by the Texas State Board of Examiners. Julie has practiced in a pediatric outpatient therapy setting for one of the nation’s premiere children’s hospitals. She has also served as an independent contractor at both the elementary and middle school levels for the second largest school district in Texas. Within these unique settings, Julie has had the pleasure of working with a diverse caseload of patients. She has served children with autism, receptive and expressive language disorders, articulation disorders, feeding problems, hearing impairments and cochlear implants, motor speech disorders, stuttering, craniofacial disorders, neurological impairments, and genetic disorders. Julie received her undergraduate degree from Texas A&M University with a major in Communications and a minor in Linguistics. She earned her Master’s of Science degree in Communication Disorders from the Callier Center at the University of Texas in Dallas. Write to Julie at Julie@springbranchspeech.com.