It can be difficult as a parent to know when speech and language skills are considered truly delayed verses when they are simply different than those of other children. We have provided you with developmental guidelines in order to assist you in determining if your child’s speech and language skills may be disordered and require therapeutic intervention.


Your child should be able to demonstrate the following skills by corresponding ages. If your child is unable to do so, you should talk to your pediatrician regarding your concerns or call us directly to schedule an appointment for an evaluation.

Language Development Guidelines

The term of "language" refers to what a child is able to comprehend during conversation as well as what they are able to say independently. The following are guidelines only and are not meant alone for diagnosis.

hearing and understanding

Obeys simple commands like "Put the truck in the box." Can point to body parts like nose and mouth. Recognizes pictures of objects. Listens to rhymes and songs.

expressive language

Says first words and names objects. Repeats phrases like "all gone." Begins to use two-word sentences and questions ("Where's kitty?" and "What's that?").

hearing and understanding

Identifies objects by function (i.e., "Which one do you play with?") Understands prepositions and adjectives like in, on, big, little.

expressive language

Uses two to four word sentences. Vocabulary builds to around 900 words. Uses adjectives, prepositions, and pronouns.

hearing and understanding

Listens to stories. Follows two-step commands. Can match and sort objects. Remembers recent events.

expressive language

Asks a lot of questions. Speech is understandable. Tells stories, shares ideas. Vocabulary increases to 1500 words. Uses most parts of speech. Counts to three.

hearing and understanding

Comprehends 2500 words. Understands common opposites (hot-cold, in-out, etc.) Follows three-step commands. Likes books and tries to "read" them. Can retell a story using picture clues.

expressive language

Uses complete sentences. Produces "how" and "where" questions. Talks about imaginary things. Counts to ten. Can name items in a category (foods, animals, etc.) Has very few sound errors in speech.

hearing and understanding

Understands time concepts. Begins to differentiate between fact and fantasy. Understands humor, plot, and surprise. Can sequence four pictures to make a story. Comprehends 4,000 words.

expressive language

Tells several things about an object. Tells sequence of events. Uses imaginative language in play. Will usually talk willingly to adults. Like to pretend and act out stories. Uses possessives, negatives, conjunctions, irregular plurals, and complex sentences.

hearing and understanding

Understands riddles. Anticipates story endings. Is interested in current events. Wonders about abstract concepts, like how things work. Understands some figurative language.

expressive language

Gives short oral reports. Uses details in description. Uses most irregular verb forms. Creates conversation suggested by a picture. Names days, months, and numbers in serial order.


Every child we work with is a unique individual with specific needs based on their particular diagnosis. Based on the full range of these diagnoses, we would also like to provide you with definitions of speech and language diagnostic terms and provide you with appropriate links for additional information.

Term Definitions and Links


The sounds a child produces during expressive communication. These sounds develop in a traditional sequence based on a child’s chronological age.

These deficits involve the language a child is able to use spontaneously during conversation. Vocabulary production, sentence structure, and morphology skills are all considered a part of expressive language. These skills are developed based on developmental norms with skills being acquired in an expected sequence based on chronological age.

These deficits involve the language a child is able to understand during conversational interactions. Comprehension of questions, vocabulary and complete sentences are considered a part of receptive language. These skills are developed based on developmental norms with skills being acquired in an expected sequence based on chronological age. Auditory processing problems are also considered a part of receptive language.

The in-coordination of oral musculature in the presence of adequate strength resulting is extremely unintelligible speech and possibly severely reduced expressive language. Children with CAS typically are better able to produce simple terms than complex terms with variable phonemic errors obsevaable.

A neurological disorder which affects how a person interacts with their world. Some sensory deficits involving sight, sound, taste, smell, and touch will be involved in varying amounts. Receptive language and difficulties with social interaction exist as well for these children.

This refers to children who appear to be developing all skills that they should be acquiring but at a significantly reduced rate. For example a child with this type of delay may have a chronological age of 4 with all developmental milestones obtained that would be expected by the age of 2 years. A Global Developmental Delay refers to all aspects of development being delayed including speech, motor, and cognitive skills.

This refers to any amount of loss a child has involving the sensory system of hearing. Anytime a child demonstrates a measureable amount of hearing loss, speech and language skills can be dramatically affected. Higher degrees of loss result in the need for hearing aides and/or the usage of sign language for effective communication productions.

This disorder occurs during delivery based on decreased oxygen being given to the infant’s brain. Usually these children were considered developmentally normal when in utero. Severity of the disorder can range from mild to severe but always produce motor difficulties which may be spastic or flaccid in nature.

Disabilities attributed to the genetic make-up of a child which was present since the child began developing in utero. Genetic disorders include Downs Syndrome, Fragile X Syndrome, and Angelman Syndrome to name only a few.

This term refers to any uniqueness in cranium and/or facial structures. The most common anomalies are cleft palate and cleft lip. These structural deficits may not only affect how a person looks but can also impact their ability to speak with clarity as well as their abilities to eat and sometimes breath effectively.

This refers to the repetition of whole words, parts of words or complete phrases in an uncontrollable manner. Additional behaviors may be present in a person with severe fluency disorders such as facial grimaces and over usage of conversational fillers such as “um”. A psychological component may also be present in clients diagnosed with fluency deficits.

The fronting position of the tongue during speech sound productions, swallowing or while at rest. Phonemes usually distorted are the /s/ and /z/. The child may also demonstrate a reversed swallowing pattern. You may also notice that you can see your child’s tongue while they are at rest such as while watching TV or doing homework.

Children may have difficulties with their ability to orally process food and liquids without choking or aspirating. Difficulties in this area may be present at birth or as a result of an injury or trauma. Clients with feeding difficulties are commonly placed on an altered diet and may have a history of intubation or g-tube insertion.

Any alternative communication form other than vocal or sign language that a child uses to express themselves is considered augmentative. This may include picture exchange systems or computerized devices. These types of systems are predominantly used with children with cerebral palsy or autistic clients although other severe diagnoses may require this type of intervention to assist them in expressing their thoughts and desires to others.


If you have any specific concerns regarding diagnoses not described above, feel free to talk to your child's therapist or go to the “Ask Megan” portion of this website to request additional information.