Growth & Development

Speech & Language

Healthy Child Development

There are several stages of healthy speech & language development that are marked by key abilities.  

By 3 months

  • Cries and grunts; has different cries for different needs

  • Makes a lot of “cooing” and “gooing” sounds

  • Responds to parent/caregiver voice (e.g.,, Watches your face as you talk)

By 6 months

  • Babbles using different sounds

  • Lets you know by voice sounds to do something again

  • Makes “gurgling” noises 

  • Understands some words (e.g., daddy, bye bye)

  • Smiles or laughs

  • Vocalizes pleasure and displeasure (e.g., squeals with excitement, grunts in anger)

  • Enjoys music, songs and rhymes

  • Brightens to sound, especially to people’s voices

  • Smiles and laughs in response to parent/ caregiver smiles and laughs

  • Imitates sounds in his/her repertoire (e.g., coughs or other sounds – ah, eh, buh)

By 12 months

  • Consistently uses three to five single words

  • Takes turns with sounds (e.g., Buh, animal sounds, car noises)

  • Waves hi/bye (emerging) and begins to use other gestures (e.g., hands up means pick me up)

  • Gives a few familiar objects on verbal request

  • Uses a variety of different voice sounds when playing (e.g., bababa, dadada, nanana)

  • Combines lots of sounds as though talking (e.g., abada, baduh, abee)

  • Tries to copy new sounds (e.g., ba, animal sounds, car noises)

  • Makes sounds to get attention, to make needs known, or to protest

  • Responds to hearing own name

  • Understands “no” and simple requests (e.g.,, Give it to mommy. Don’t touch. Where’s the ball?)

  • Plays social games with you (e.g., peek a boo)

  • Enjoys being around people

By 18 months

  • Tries to copy your sounds (sounds of our language)

  • Uses at least 20-50 words consistently; words do not have to be clear

  • Understands many more words than he can say

  • Understands simple directions or questions (e.g.,, Where is your nose? Get the ball.)

  • Demonstrates some pretend play with toys (e.g., give Teddy a drink)

  • Enjoys tickle, bounce and nursery rhymes

  • Makes at least four consonant sounds from p, b, m, n, d, t, w, h

  • Identifies pictures in a book (e.g., Show me the baby)

  • Enjoys being read to and looking at books

  • Points to familiar people and to some body parts when asked

  • Understands the concepts of in and out, off and on

By 2 years

  • Tries to copy your words

  • Uses a variety of words and gestures to communicate and ask for help (e.g., waving, pushing away, pointing)

  • Uses 100-150 words and combines 2 words (e.g., More juice. Want cookie.)

  • Follows two step instructions (e.g., go find your teddy bear and show it to Grandma)

  • Takes turns in a conversation □ Asks for something by pointing and using sounds or words

  • Begins to offer toys to peers and imitates other children’s actions and words

  • People can understand his/her words 50 to 60 per cent of the time

  • Uses many different speech sounds at beginning of words (p,b,m,t,d,n,h,w)

  • Enjoys being with other children

  • Learns and uses one or more new words a week; may only be understood by family

By 2½ years

  • Understands the concepts of size (big/little) and quantity (a lot, little, more)

  • Uses some correct grammar – “two cookies”; ‘bird flying”

  • Uses more than 350 words

  • Uses action words – run, fall

  • Begins taking turns with other children using both toys and words

  • Shows concern when another child is hurt or sad

  • Combines several actions in play –feeds dolls then puts him/her to sleep

  • Produces words with two or more syllables or beats: ba-na-na, com-pu-ter

By 3 years

  • Responds to simple questions or directions

  • Understands location words like in, on and under

  • Identifies some objects by their functions (e.g., What is a spoon for?)

  • Is understood by most people outside of the family most of the time

  • Uses long sentences, using 5-8 words, 

  • Uses pronouns: I, you, me and mine

  • Understands questions using who, what, why, when and where

  • Is learning the meaning of several new words every week (in spoken language)

  • Sings simple songs and familiar rhymes

  • Talks about past events

  • Tells simple stories

  • Shows affection for favourite playmates

  • Engages in multi step pretend play – cooking a meal, repairing a car

  • Shows ability to participate in routines

By 4 ½ years

  • Most of the time uses complete sentences with 4 or more words (e.g., I go home now.)

  • Uses correct grammar such as plural (e.g., books), past tense (e.g., walked) and pronouns (e.g., I, he, she, me, you)

  • Follows directions involving three or more steps “First get some paper, then draw a picture, last give it to mom”

  • Tells stories with clear beginning, middle and end

  • Talks to try to solve problems with adults and other children

  • Demonstrates increasingly complex imaginative play

  • Is understood by adults outside the family almost all the time

  • Is learning the meaning of and using several “new words” every week (in spoken language)

  • Recites nursery rhymes and sings familiar songs

  • Understands “just one”

  • Enjoys being read to

  • Can identify 4-6 colours by name

By 5 ½ years

  • Talks easily with other children and adults and is understood

  • Understands spatial relationships, on top of, under, behind, in front of, etc.

  • Explains concepts using words (e.g. ,What is a cup? What is a car?)

  • Understands many descriptive words (e.g., long/short, soft/hard)

  • Follows group directions “All the boys get a toy”

  • Understands directions involving e.g., “if…then” – “If you are wearing runners, then line up for gym”

  • Describes and can retell past, present, and future events in detail

  • Seeks to please his or her friends

  • Shows increasing independence in friendships

  • Uses almost all the sounds of his or her language with few to no errors

  • Uses complete sentences with good grammatical structure

  • Is learning the meaning of and is using several new words every week (in spoken language)

  • Can recall a brief story that has just been heard

... If a child is missing one or more of these expected age outcomes, consider this a red flag



... if a child is experiencing any of the following, consider this a red flag:

► Stumbling or getting stuck on words or sounds (stuttering)

► Ongoing hoarse voice

► Excessive drooling

► Problems with swallowing or chewing, or eating foods with certain textures (gagging).

► Lack of eye contact and poor social skills for age

► Frustrated when verbally communicating

These Practitioners and Agencies may be able to help

Having concerns about a child's development?

Having difficulty coping? Need some advice?

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