Language Development

Language development is an important component of a child’s overall development. Speech and language development milestones start as early as the first three months of a child’s life. 

It is important to understand common speech and language development milestones so, as a parent, you will know when to be concerned about your child’s language skills and seek additional support. 

When a child isn’t reaching typical language development milestones, speech therapy can help. Speech therapy involves an array of activities and techniques that address a variety of language development disorders and delays, such as: 

• Expressive and receptive language delays
• Articulation issues
• Oral motor dysfunction
• Apraxia of speech
• Fluency (stuttering)
• Food and swallowing
• Social language delays
• Cognitive skill delays

Each child’s speech therapy activities are crafted to meet that child’s unique goals. Speech therapy can help with a range of different speech disorders and issues. Some children with neurological diversity, such as autism spectrum disorder (ASD), executive dysfunction issues, or social-emotional behavioral delays, can also benefit from speech therapy.

Speech-language therapy addresses both speech and language disorders.

A speech disorder is an issue with making specific sounds. Some of the top speech disorders include: 

• Articulation disorders: This is when children have issues with making sounds into syllables. This often looks like saying words incorrectly to the degree that the person listening can’t understand what is being said. 

• Fluency disorders: This includes issues with the flow of speech, most commonly seen as stuttering, where speech contains partial-word repetitions, prolonged sounds and syllables, and unusual stops. 
  
• Resonance and voice disorders: This includes issues with pitch, quality, and volume of one’s voice and can distract listeners. 

A language disorder occurs when one has a problem understanding and putting words together to express ideas. Language disorders can be either receptive or expressive. 

• Expressive disorders: This is an issue with putting words together and using language in a socially appropriate way. 

• Receptive disorders: This is an issue with processing and understanding language. 
• Cognitive-communication disorders: These are issues with communication skills that focus on attention, perception, organization, regulation, and problem-solving.

Feeding disorders are focused on the way one eats and drinks. This includes issues with coughing, gagging, chewing, and swallowing. 

Speech-language therapy is delivered by a speech-language pathologist (SLP), who is generally referred to as a speech therapist. 

An SLP has a master’s degree, a certification from the American Speech-Language-Hearing Association (ASHA), and a state certification or licensure in the field. 

With speech-language therapy, an SLP works in a variety of settings. They may work one-on-one with a child, in a small group, or in a classroom setting. SLP uses a variety of different strategies in their therapy sessions to address a child’s individual needs. 

• Language intervention activities are where the SLP interacts and plays with the child to stimulate language development, modeling correct vocabulary and grammar. 

• Articulation therapy involves exercises where the SLP models correct sounds and syllables in both words and sentences while engaging in play activities that are age-appropriate for the child.
• Oral-motor/feeding and swallowing therapy involves oral exercises, such as tongue, lip, and jaw exercises and facial massage, to strengthen the muscles needed for eating, drinking, and swallowing. 

Speech therapy can provide a child with many benefits that will positively impact their life, development, and relationships.

Communicating and expressing oneself is essential in one’s daily life. If a child is non-verbal, speech therapy can provide them with other means of communication, including: 

• Sign language
• Visual boards
• Low-tech communication devices
• High-tech communication devices
• Tablet and smartphone apps

Speech therapy is about ensuring all children have a way of expressing themselves through language.

Pragmatic language is the social language skill one uses in conversations with other people. Pragmatic language skills include: 

• Conversational skills
• Interpreting and expressing emotions
• Problem-solving
• Understanding non-literal language
• Using non-verbal communication skills 

If an individual has limited or no functional language skills, that can impact their social skills. Language development therapy can assist with learning important pragmatic language skills.

Speech delays result in issues with listening, reading, and writing. Both reading and literacy skills can impact one’s communication skills. Learning reading and literacy skills can assist with language development. 

Not effectively communicating one’s thoughts and feelings can be frustrating. Language development therapy can help children find means of communicating, which can help reduce frustrations in everyday life. 

Communication is about more than just words. Speech therapy can help children with neurodiversity learn other ways to communicate, such as through: 

• Facial expressions
• Gestures
• Eye contact
• Writing
• Sign language
• Approximations
• Vocalizations

Language development and speech therapy can enhance a child’s daily life. 

Starting at birth, a child will move through a range of speech and language milestones essential to their overall development. Speech and language skills help prepare children for success in school and daily life. 

As a parent or caregiver, it is important to be aware of speech and language development milestones and when to be concerned so you can get the appropriate care for your child.

• Baby is startled by loud noises.
• Baby is soothed by calm and gentle voices.
• Baby may cry, gurgle, grunt, or say, “ah.”
• Baby can suck and swallow well.

Parents should take note if the baby shows no reaction to sound. Or if they are not sucking and swallowing correctly, and it impacts feeding.

• Baby tries to “talk” by cooing and babbling.
• Baby enjoys smiling back at the family.
• Baby coos and squeals for attention and has a unique cry when hungry.
• Baby starts to watch an adult’s face when they talk.

Parents should take note if the baby shows an absence of these behaviors. 

• Child understands common words with gestures, such as “up,” “bye-bye,” and their own name. 
• Child starts to say sounds and words, such as “na, na.” 
• Child tries to make sounds when listening to songs and the radio.
• Child laughs.
• Child imitates sounds.

Parents should take note if the child gets frequent ear infections or seems to babble or play less than other babies around the same age. 

• Child understands simple statements, such as “Give me.” 
• Child nods head “yes” and shakes head for “no.” 
• Child likes to “dance” to music.
• Child babbles and strings multiple sounds together.
• Child starts to say a few words, although not clearly.

Parents should be concerned if the child doesn’t use any words or doesn’t seem to be sociable with their environment. 

• Child uses 2-word sentences, such as “Me up” or “All gone.”
• Child understands simple one-step directions, such as “Grab your jacket.”
• Child understands more words than they can speak.
• Child asks for things they want, like “More milk” or a toy.

Parents should be concerned if the child depends on gestures more than words to express themselves. It is also important to take note if the child doesn’t seem to understand what is said to them. 

• Child uses 2-3 word sentences.
• Child follows simple two-step directions, like “Put your shoes by the door.”
• Child answers simple questions. 
• Child understands how to put an object in, on, or under something.
• Child sits with a book for a few minutes.

Parents should be concerned if the child’s speech continues to be difficult to understand, if the child can’t make 2-word sentences, or gets frustrated when they try to talk.

• Child follows 2-step directions that are related to one another. 
• Child says their first and last name. 
• Child understands questions related to a picture story.
• Child tells a short story.
• Child starts to develop sentences that are 3 to 4 words long.
• Child gives others directions.
• Child starts to ask questions that start with “what,” “why,” and “where.”

Parents should be concerned if the child has difficulty engaging in imaginary games and playing with others, and if their speech is difficult for strangers or their peers to understand. 

• Child follows directions with three related steps.
• Child makes sounds accurately, except for “l, r, th, ch, sh.”
• Child starts to answer and ask more deep reasoning questions.
• Child describes their day in detail.
• Child understands concepts like top and bottom.
• Child understands and identifies several different colors.
• Child explains what things mean.

• Child should be able to communicate with adults and other children easily
• Child should be able to say most sounds correctly
• Child should use sentences with details and be able to tell stories
• Child should use rhyming words and adult grammer

Parents should be concerned if the child doesn’t understand or use complete sentences, can't follow directions, or stutters.

With language development, early detection of any difficulties is essential. Early detection and intervention can make it easier for your child to learn to talk and communicate with others. 

Children with neurodiversity often experience more language development challenges, making access to speech and language therapy crucial. 

As children enter elementary school, communication milestones become more complex, encompassing listening, speaking, reading, and writing skills.

• Child should be able to follow one to two simple directions in a row, listen to and understand stories, and follow a simple conversation. 
• Child should be able to speak clearly enough that most people understand what they are saying, answer simple yes/no questions, answer questions like “What did you eat for breakfast today?,  retell a story, take turns talking, and show interest in and start conversations. 
• Child should understand how a book works, understand that sounds make up works, pick out rhyming words, tell the first sound in words, and recognize some words by sight.
• Child should be able to write their first name, draw a picture that tells a story, and write in upper and lowercase letters. 

• Child should be able to remember what they hear and follow two-to-three-step directions in a row.
• They should be able to speak clearly enough so that most people can understand them, answer harder yes/no questions, tell and retell stories in a way that makes sense, share ideas using complete sentences, use most parts of speech or grammar correctly, ask and answer who, what, when, where and why questions. 
• Child should be able to stay on topic and take turns in conversation, give directions, and start conversations.
• Child should be able to say words that rhyme, name all sounds in short words, put sounds together to make new words, match spoken words with written words, point to letters, words, and sentences, sound out words when reading, and read grade-level books.
• Child should be able to write for their ideas, print clearly, and spell word that they use a lot. 
• Child should be able to write about their ideas, print clearly, spell words they use a lot, and begin written sentences with capital letters and sentences with periods or question marks. Child should be able to write stories, notes, and journal entries. 

• Child should be able to follow three to four directions in a row, understand words about place and time, and answer questions about a grade-level story.
• They should be able to speak clearly, answer harder yes/no questions and ask and answer who, what, when, where, and why questions.
• Child should be able to use more complex sentences, explain words and ideas, give directions with three to four steps, and use words to inform, persuade and entertain.
• Child should be able to stay on topic, take turns and keep eye contact during conversation, and start and end conversations appropriately. 
• Child knows how letters make sounds in words, recognizes many words by sight, rereads and self-corrects when necessary, explains important parts of a story, predict what happens in stories, and read and retells a story in the correct order. 
• Child should be able to write clearly, use different sentence structures to write different types of content, use basic punctuation and capitalization, and organize writing with a beginning, middle and end. They should spell words they frequently use correctly.

• Child should be able to pay attention in groups and understand grade-level information. 
• Child should be able to speak clearly and know when to talk with a soft or loud voice, ask and answer questions, and be a part of conversations and group discussions. 
• Child should be able to use words related to school subjects such as math, science, or history. 
• Child should be able to stay on topic, use eye contact, and take turns in conversation. 
• Child while reading, can understand phonics, use word analysis skills, use clues from a story, predict and explain what happens when reading, and ask and answer questions about what they read.
• Child while writing can plan, organize, review and edit, write stories, letters, and short reports; use details in writing, spell simple words correctly, and correct most spelling mistakes. 

• Child could listen to and understand information, form options based on what they hear, and listen for specific reasons, such as to learn, enjoy or convince. 
• Child should be able to speak in a conversational manner correctly; use language for asking questions, arguing, and joking, understand some figurative language, take part in group discussions, give correct directions to others, summarize the idea in their own words, organize information, so it is clear and give clear speeches. 
• Child while reading, should be able to read grade-level books smoothly with few mistakes, use what they know to understand new material, follow written directions, take brief notes, link what they learn in one subject to another, and use reference materials.
• Child while reading should be able to read and understand different types of writing, make inferences from texts, talks about what she reads in their own words, and paraphrase things. 
• Child should be able to write stories and explain with many paragraphs about the same topic, develop a plan for writing that includes a beginning, middle and end, organize writing around the main idea and edit the final copy of the written text for grammar, punctuation, and spelling. 

• Child can listen and make conclusions about different subjects like math, science, and social studies. They can understand what’s taught in class. 
• Child can make planned speeches and deliver a speech while making eye contact, using gestures and a loud voice. Child can participate in class discussions, summarize main points, and report information from group activities. 
• Child while reading, can read grade-level books, learn meanings of new words, read different types of text, describe how a character and plot develops, talk about poetry, and use reference materials.
• Child while writing can write for a variety of reasons, use different words and varying sentence structures.

Your child’s listening, speaking, reading and writing skills are all part of their language development and will continue through middle school and high school.

If at any time your child’s language development doesn’t mirror or keep up with that of their peers, you can get language development help for your child. Language development is crucial for

Does your child show language development concerns? Award Behavioral Health can help arrange for language development therapy through Medicaid’s Home and Community-Based Service (HCBS) program. 

Early intervention is crucial for proper language development, although language development services can be used throughout a child’s life to provide your child with the support they need. 

If your child and family need support, please contact Award Behavioral Health for a consultation. 

To know more about our program and for appointments, please call us at (800) 249-9569 or contact us online.