Healthy Child Development

There are several stages of healthy hearing development that are marked by key abilities.  

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0-3 months

• Makes cooing sounds

• Increases or decreases sucking behaviour in response to sound

• Startles, blinks, cries, quiets or changes breathing rate in response to a sound

• Startles in response to sudden, loud noises

• Stirs or awakens when sleeping quietly and someone talks or there is a sudden noise

• Moves head, eyes, arms and legs in response to a noise or voice

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

• Makes different cries for different needs–such as hungry, tired

• Recognizes familiar voices and quiets when spoken to

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4-6 months

• Responds to changes in the tone of parent/caregiver voice

• Turns head toward voices and interesting sounds

• Enjoys musical toys or toys that make noise

• Begins to imitate coughs and other sounds as well as make speech-like sounds e.g., ah, eh, buh, ma

• Babbles for attention and uses vocal play

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6-9 months

• Responds to their name

• Responds to the telephone ringing or a knock at the door

• Responds to the word “no”

• Gets what they want through sounds and gestures, such as reaching to be picked up

• Babbles and repeats sounds in a series e.g. babababa, duhduhduh

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9-12 months

• Localizes correctly to sound by turning head toward the sound

• Follows simple one-step directions, for example “sit down”

• Looks across the room to something you point to

• Recognizes words for common items like “mom”, “cup”, “shoe”, “book” or “juice”

• Uses three or more words

• Uses gestures to communicate, for example waves “bye bye”, shakes head “no”

• Pays attention when spoken to

• Gets parent/caregiver’s attention using sounds, gestures and pointing while looking at their eyes

• “Performs” for attention and praise

• Combines lots of sounds as though talking — abada baduh abee

• Shows interest in simple picture books

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12 months -18 months

• Sometimes startles to sudden loud noises

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

• Points to several body parts when asked

• Uses at least 20 words

• Starts to put words together

• Responds with words or gestures to simple questions — “Where’s teddy?”, “What’s that?”

• Looks at your face when talking to you

• Makes at least four different consonant sounds — b, n, d, g, w, h

• Enjoys being read to and looking at simple books with you

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18 months -2 years

• Follows two-step directions, for example “Go find your teddy bear and show it to Grandma”

• Uses 100 or more words

• Understands more words than they can say

• Uses at least two pronouns, e.g. “you”, “me”, “mine”

• Uses own name

• Consistently combines two or more words in short phrases - “daddy hat”, “truck go down”

• Asks simple questions, for example “What’s that?”

• Enjoys being with other children

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

• People can understand their words 50 to 60 per cent of the time

• Takes turns in a conversation

• Forms words and sounds easily and effortlessly

• “Reads” to stuffed animals or toys

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2-3 years

• Is alert to environmental sounds

• Responds to someone talking out-of-view (particularly when there are no distractions)

• Responds to voices on the telephone

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

• Uses some adult grammar — “two cookies”, “bird flying”, “I jumped”

• Uses more than 350 words

• Uses action words, for example “run”, “spill”, “fall”

• Uses sentences of three or more words most of the time

• Answers simple questions, for example “Where is the car?”

• Participates in short conversations

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

• Puts sounds at the start of most words

• Produces words with two or more syllables or beats, for example “ba-na-na”, “com-pu-ter”, “a-pple”

• Listens to and enjoys hearing stories for longer periods of time

• Remembers and understands familiar stories

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3-4 years

• Tells a short story or talks about daily activities

• Talk in sentences with adult-like grammar

• Generally speaks clearly so people understand

• Hears you when you call from another room

• Listens to television at the same volume as others

• Answers a variety of questions

• Understands words for some colours, like red, blue and green

• Understands words for some shapes, like circle and square

• Understands words for family, like brother, grandmother and aunt

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4-5 years

• Pronounces most speech sounds correctly

• Participates in and understand conversations even in the presence of background noise

• Recognizes familiar signs, for example stop sign

• Makes up rhymes

• Hears and understands most of what is said at home and school

• Listens to and retells a story and asks and answers questions about a story

• Understands words for order like first, next and last

• Understands words for time like yesterday, today and tomorrow

• Follows longer directions like “Put your pajamas on, brush your teeth and then pick out  a book”

• Follows classroom directions like “Draw a circle on your paper around something you eat”

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