Speech and language milestones
Language refers to set of socially shared rules. Language skills include ability to use words to express meaning, join words together meaningfully and grammatically in a sentence, usage of appropriate words in a specific situation. Receptive language relates to understanding others and expressive refers to using language to convey ones feeling, thoughts or to share information. Speech is the verbal expression of language and consists of voice, articulation and fluency. Vocal folds convert the airflow from lungs into voice. Articulators like tongue, lips, palate etc convert this voice into varieties of sounds and this process is called articulation. Fluency refers to the flow and rhythm of the speech. Different aspects of speech and language can be delayed or develop in a deviant manner leading to varieties of speech and language difficulties.
Language development is a process in which children learn to use and understand more complex and varied language. Stages of language development are universal and do not vary significantly across languages used. These stages are described below:
Recognizes parents voices, calmed by known voices, watches faces when talked to, babbles (strings of consonants and vowels like baba) while playing, makes other vocal noises, makes sounds when spoken to.
Understands frequently used words like bye, come here; responds to name call, understands simple sentences when accompanied by gestures and facial expressions, uses babbling to communicate, uses gestures like waving bye-bye, starts using true words by the end of the first year.
Understands more words and simple sentences, recognize names of common objects and people, points to common objects, uses about 20 common words, words are usually not clear, starts pretend play like putting a doll to sleep.
Understands 200-500 words, Uses 50 or more common words, puts together short simple sentences like “mommy go”, understands simple questions and instructions.
Understands longer sentences, uses up to 300 words, variety of vocabulary increases with nouns, verbs, adjectives being used; makes 4-5 word sentences, speech clarity improves.
Asks a lot of questions, answers variety of questions, makes longer connected sentences, listens to longer stories, understands and uses words related to colors, number and time.
Makes longer conversations, takes turns, vocabulary keeps increasing, uses most of the speech sounds clearly, re-tells stories, understands and uses sequential information.
Articulatory development (usage of speech sounds/pronunciation) is complete in most children by 8 years. In 90% of the children most of the speech sounds are established by 6 years of age. It is common for young children to say e.g tat for cat as they learn to master sounds of their language. However if the sounds are not acquired post their average age of acquisition, it could be misarticulation. Children are not very clear as they start speaking and they become clearer with age. Clarity of speech increases from 75% at age 3 to 90% at age 5. Misarticulations could be a result of some structural deviation in the mouth, tongue, lips or palate. However in most of the children they are developmental in nature and can be corrected after a speech therapy.
Red signs for speech and language development
All the children develop at different rates and achieve speech and language milestones at varied ages. However following are some of the warning signs for speech and language development. In case you notice these in your child consult a speech and language therapist.
Absence of babbling (continuously saying strings of syllables like baba) by 8-9 months
Lack of interest in social games like peek-a-boo by 8 months
Absence of gestures for communication at 1 year of age
Absence of single meaningful word like papa, mama by 1 year of age
Inability to imitate by 2 years
Inability to follow directions by 2 years
Sudden reduction in babbling or vocal play on its own or after a severe illness like brain fever
Lack of verbal communication by 2 years
Poor eye contact by 3 years
Absence of language expansion or burst by 30 months
Limited vocabulary at 3 years
Absence of 2 word simple sentences by 3 years
Limited or inconsistent response to questions or directions by 4 years
Limited variety of consonants in speech by 4 years
Highly unclear speech at 4 years
Poor imitation skills at 4 years
Lack of speech fluency, repeats part of word while speaking, accompanied by high anxiety by 5 years of age
Difficulty eating or swallowing food
Rough or raspy voice
Increased nasal quality to the voice