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Communication Red Flags
Every child is different and their development is different. We use the milestones and 'red flags' as one of many tools to determine if children need help with their speech and language skills.
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As your child progresses through the stages of development, you may notice their development does not happen in a straight line. It is completely normal for development and growth to have ebbs and flows for any child.
Speak with your pediatrician if you are concerned with your child's development and speak with a Speech-Language Pathologist if you are concerned about their communication development.
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At Any Age
Seems to have more trouble than most of their peers.
Is not generally progressing in terms of vocabulary, length of utterance, and ability to understand more complex language.
Does not seem to understand unless provided with a lot of repetition and gestures.
Displays frustration or reluctance to try to communicate.
Uses mostly vowel sounds.
Uses a 'lisp'.
Uses poor vocal quality or is monotone.
Vocal pitch is too high or low for age.
Is consistently nasal sounding or sounds like they have a stuffed nose.
By 4-6 Months
Does not laugh or squeal.
Does not look toward new sounds.
By 9 Months
Has limited or no babbling.
Does not indicate when happy or upset.
By 12 Months
Does not point to objects.
Does not use gestures (i.e. waving, shaking head 'no')
Does not engage in turn-taking activities (i.e. wait for another to respond to them)
Does not imitate vocalizations or gestures.
By 15 Months
Has not used first true word.
Does not respond to "no" by stopping at least temporarily.
Does not respond to "hi" or "bye-bye" with a wave or word.
By 18 Months
Does not use 6-10 words consistently.
Does not discriminate between sounds (i.e. cannot tell between "mama" and "papa")
Uses gestures or leading an adult as primary mode of communication.
Does not follow your pointing.
By 20 Months
Does not use at least 6 consonant sounds.
Does not follow simple directions (i.e. "sit down", "give me")
Does not look at you when talking or playing.
Does not play in close proximity to other children.
By 24 Months
Uses less than 50 words.
Does not put words together to form two-word phrases (i.e. "more milk")
Has decreased interest in social interactions.
Does not follow directions involving familiar objects (i.e. "Get the ball and give it to me")
Is not understood 50% of the time by adults and peers.
By 2-3 Years
Does not use simple three- and four-word sentences.
Cannot answer questions (i.e. "who is that?", "what do you want?", "where is your truck?")
Does not accurately answer Yes/No questions.
Is not understood 75% of the time by adults and peers.
Word endings are consistently missing (i.e. "do" for dog).