I am an in-home child care provider and I wanted to know at what age should I be concerned about the speech of a child?



Speech and language development begins long before a child starts talking. A child’s rate of speech development is as unique as he or she is and can vary. Knowing some general milestones of speech and language development can be helpful in determining when to be concerned about a child. Also keep in mind that communication involves more than just saying words. Eye contact, comprehension, how the child plays, socializes, imitates and gestures are all important considerations as well.

Listed below are a few general guidelines for speech and language development:

By age 12 months, a child should be progressing from babbling to making intentional sounds and a few word approximations (although words may not be clear), should be reaching for objects and using gestures to communicate, should enjoy games like “peek-a-boo” and “patty-cake, and should begin to respond to simple requests/questions like “come here” and “want more?”.

Between one to two years, children should begin to point to body parts when asked, listen to simple stories, rhymes and songs, point to pictures or objects when named, follow simple commands, learn new words on a regular basis, put 2 words together (like “more cookie” “no juice”), use different consonant sounds at the beginning of words, and ask 1-2 word questions (like “where kitty?” or “go bye-bye?”).

The causes of speech and language delays are often unknown. Children who may be at risk for communication delays include those who are born prematurely, children who have frequent ear infections, children who do not exhibit much eye contact, or children who display developmental delays in other domains. Parents and caregivers should be concerned when children exhibit little or no response when others initiate communication (gestures, etc.), children do not react to loud noises or speech of others, children do not walk or use single words by 15 to 18 months, children do not use at least 50 words and some two-word combinations at age 2, or children who seem to be behind their peers with regard to speech-sound development (unclear speech, struggles to form words, or can only produce a limited range of sounds).

When a caregiver has concerns about a child’s speech and language development, he or she should discuss their concerns as soon as possible with the child’s parent and encourage them to talk with the child’s health care provider. Advise the parents to ask their child’s health care provider for a referral for a speech and language evaluation. If the health care provider does not provide a referral and the parent is still concerned, they may seek an evaluation on their own from their state’s early intervention program or a speech-language pathologist in their area.

Child care providers and caregivers can learn more about speech and language development by visiting www.asha.org or by visiting www.scpitc.org and referring to the South Carolina Infant Toddler Guidelines.