Speech-Language Pathology

0 to 3 Months

Communication Development

Baby will:

• Coo and gurgle
• Coo vowels such as “ah,” “eee,” and “ooo”
• Use a strong cry
• Look at speaker’s eyes and mouth
• React to loud noises
• Become quiet in response to a smile and to a familiar, pleasant voice
• Make noises in response to parents’ smile and talk
• Smile in imitation
• Hold head up by self

Communication Activities

• Talk to your baby gently.  Use simple words and sentences.  Your baby will not understand what you say to him now, but will in time.
• Imitate any sounds the baby makes.  For example, if she says “aaah” then you say “aaah”.  This will encourage her to do more.  Imitation is the first way that children learn.
• Hum or sing softly to the child when you hold her.
• Hold or position your child so she can see your face.  Have her watch you as you talk.
• Hang a mobile over the baby’s crib so she can see it and you can talk about it.
• Play music at a quiet level (CD’s or tapes designed for young children) for the baby to listen to and enjoy.
• Call the baby’s name.  When she looks at you, pick her up, and reward her with smiles and affection for looking at you.
• Allow your child time to make noises alone; you don’t have to talk to her all the time.  Your baby needs some quiet time to enjoy and “experiment” with her own sound making.

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3 to 6 Months

Communication Development

Baby will:

• Turn to source of sound or voice
• Laugh out loud
• May use consonant and vowel sounds together such as “ba,” “ma,” or “ka.”
• Make protest sounds when a favorite toy or bottle is taken away
• Enjoy playing with sounds
• Know the difference between parents and strangers
• Rollover

Communication Activities

• Use expression in your voice. The tone of your voice will help your little one to learn the meanings of words. By varying the pitch and loudness of your voice, she will also pay more attention to you.
• Encourage babbling by imitating the sounds he makes.
• Imitate nonverbal speech (tongue clicks, bubble blowing) as well as sounds. When the child laughs and smiles, imitate what she’s doing.
• Let the child feel your mouth and throat when she makes sounds or when you talk. Also, place his hand on his own mouth and throat as he makes sounds.
• Increase your child’s awareness of environmental sounds. When your baby turns toward a sound such as a rattle and begins to reach for it, give the item to him to touch and explore.
• Use the child’s name often so that she learns her name.
• Place a mirror on the floor for your baby to see herself. This is an excellent way for her to become aware of her body and it will also encourage her to make sounds.

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6 to 9 Months

Communication Development

Baby will:

• Babble (Repeat a consonant and vowel sound together such as “bababa”)
• Look when name is called
• Listen to and imitate sounds you make (p, b, m, k, g, n, t, d)
• Use some gestures to communicate
• Search for objects that he doesn’t see
• Smile at and pat a mirror
• Play “patty-cake” and “peek-a-boo”
• Wave bye-bye
• Stand, holding on

Communication Activities

• The expression in your voice and on your face says so much to your child.  Use appropriate facial expressions.  For example, use a disappointing tone when your child misbehaves and a pleasant voice with a smile for good behavior.
• Likewise, use gestures as you talk.  For example, hold your hands out for “come,” wave for “bye-bye,” and shake your head for “no.”  This will help your child understand the meaning of words.
• Play games of “patty-cake” and “peek-a-boo.” At this age, the child will imitate the actions.  Imitation of actions is a readiness skill for the imitation of words.
• Play a game of “giving the child to family members.”  As the baby comes in contact with that person, say their name.  Use sentences such as “Mommy is picking you up” or “Here’s Daddy.”

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9 to 12 Months

Communication Development

Baby will:

• Say first meaningful word around first birthday
• Understand “no” when spoken
• Give toy or other object when asked
• Look when family members and pets are named
• Recognize the names of a few familiar objects
• “Talk” to himself and others
• Make faces at self in mirror
• Walk sideways while holding onto support
• Mark on paper with a crayon

Communication Activities

• Now is the time for your child to imitate you.  Hold him so that he can see your face and use sounds that he can make alone or in patterns such as “bababa” or “baga.”
• Do not teach your child “baby talk”.  When your baby begins to say words, do not imitate what she says (“wawa” for “water”), but say the word correctly for her.  (“Right.  That’s water.  Do you want a drink of water?”)
• Look at books that have simple pictures in them.  Take the child’s hand to touch the picture as you name it.
• Repeat simple directions many times.  For example, if you want your baby to give you a block, take his hand and show him what you want as you say, “Give me the block.”

12 to 18 Months

Communication Development

Baby will:

• Point to objects when asked a question (“Where’s the kitty?”)
• Point to own body parts such as nose, eye, mouth, hair
• “Jabber” (appear as if “talking” without using true words)
• Understand many familiar words
• Imitate words
• Say “no”
• Use 5 to 10 words
• Follow simple directions (“Don’t touch.” “Come here.”)
• Walk alone

Communication Activities

• Talk to your child when you go for rides or walks, by pointing to and naming things you see.
• Encourage your child to repeat simple words like “ball,” “book,” “milk,” “cookie,” “bye-bye.” She won’t say them perfectly but praise her for an attempt.  Repeat the names of things several times for your child to learn.
• Have your baby find different family members by saying things such as “Where’s Mommy?” or “Go to Daddy.”
• Teach your child his body parts.  Name your body parts as you touch them and do the same with the child’s body.  Bathing and dressing are good times to point to and name body parts.
• Play with a ball.  Have her get the ball and then find the ball after you have hidden it.
• Help the child to become aware of sounds around him.  Make the sound of a truck, “bark” like a dog, “meow” like a cat, etc.
• Look at books and magazines with your child.  Talk to her in short simple sentences as you point out pictures.  (“Kitty.  That’s a kitty.  It says ‘meow.’  Here’s the kitty’s nose.  Here are the kitty’s eyes.”)
• Have your child listen to simple rhymes and songs.

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18 to 24 Months

Communication Development

Baby will:

• Start using words rather than gestures to express wants and needs.
• Put two words together (“Puppy gone.” “Daddy bye-bye.”)
• Bring familiar object upon request from another room (“Go get your shoes.”)
• Select the correct object from a group of three to five items
• Point to pictures in a book and also name some of them
• Indicate “yes” by word or gesture
• Point to body parts on a doll as well as himself
• Respond appropriately to simple action words such as “sit down” or “stand up”
• “Jabber” a great deal
• Understand personal pronouns:  me, you, him, her (“Bring it to me.”  “Give it to her.”)
• Begin dressing self with help

Communication Activities

• Have your child follow simple commands such as “Bring me the towel” or “Shut the door.”
• Play “Follow the Leader” to teach your child the meaning of action words.  For example have her imitate you as you “sit,” “stand,” “run,” “clap your hands,” etc.
• Once your child is able to identify body parts on himself and others, have him find body parts on a doll and in large pictures of people.
• Find large, colorful pictures in a book.  Have him point to and name the pictures when asked “What is that?”
• Encourage your child to repeat 2-word combinations such as “more milk” or “baby sleep.”
• Carry on a “conversation” with your child’s doll or stuffed animal.  Pretend to feed it, put it to bed, dress it, etc.  Tell the doll to do such things as “sit,” “stand,” or “walk.”
• Use pronouns with names so that your child will begin to understand the personal pronouns, “my,” “your,” “his,” and “her.”  For example, use: “This is Timmy’s shirt….this is your shirt.  Here’s Mommy’s shirt, my shirt.”

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2 to 2 1/2 Years

Communication Development

Child will:

• Use a variety of everyday words
• Have a vocabulary of 200-300 words
• Use two to three words in simple sentences (“Daddy go bye bye.”, “More milk.”, “Bobby fall down.”)
• Enjoy listening to a short story
• Start to use “me” for “I” (“Me want cookie.”)
• Add more action words to speaking vocabulary (“Sit down.”, “Run”, “Jump”)
• Follow simple commands without gestures from parent
• Understand the meaning of: in, out, on, off, up, down (“Put the block in.”, “Put your arm up.”)
• Identify actions in a picture (chooses correct picture when asked “Which one is eating, running, jumping?” etc.)

Communication Activities

• Add to your child’s words.  If she says “Puppy sleep,” extend her words by saying something such as “Right, the puppy is sleeping in her bed.”  Do not expect your child to imitate your sentence, but use this as a way to provide a good language example.  Use simple sentences.
• Plan a set time to read to your child.  Her attention span is now longer.  Select books with a simple story, not many words, and large colorful pictures.  Use short simple sentences to describe the pictures.  “The boy is riding his bike….Oh-oh, he fell down……See his bike….It’s down on the ground.”
• Point out your child in photographs and ask her to identify herself.  Do the same with familiar people.
• Ask your child to respond to “What is your name?”  Make a game having your toddler identify other family members by responding to “Who’s that?” or “What is her (his) name?”
• Let your child help set the table and have him repeat the names of things on the table.
• Have her name her clothes as she is dressing.
• Have your child put something in, on, or under.  Talk about where things are.  (I’m putting your shoes under the bed….You put the block in the can.”)

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2 1/2 to 3 Years

Communication Development

Baby will:

• Speak in short simple sentences such as “Bear in my bed.” Or “Mommy daddy go work.”
• Know how simple objects are used (“Show me the one that we eat.”)
• Add more descriptive words to speaking vocabulary (hot, cold, big, little)
• Understand the meaning of: under, in front of, in back of, inside, outside
• Tell toilet needs
• Hold up fingers to show age
• Know difference between big and little
• Follow a two-step related command such as, “Get your coat and put it on the chair.”
• Continually ask questions beginning with “what” and “where”
• Count, “1,2,3″
• Match colors such as red, blue, and yellow

Communication Activities

• Talk about big and small things.  Point out differences in same objects such as a big ball and a little ball.  Use your shoes and your toddler’s shoes to point out the size difference.  “Mommy’s shoes are big….your shoes are little.”
• Try sorting big toys into one box and little toys into another box.  Do the same with other items such as big and little spoons, dishes, etc.
• Have your child join in with simple nursery rhymes and finger plays.  She may not be able to repeat the whole thing at this age, but she will enjoy filling in missing words and phrases.  Gradually leave out more words as your child becomes more familiar with the rhyme.  “The eency weency spider went up the __________.”  “The eency weency spider________________.”
• Play children’s records and sing along.  Play favorite ones over and over.
• Play “Follow the Leader” by asking your child to do different actions such as clapping hands, touching body and clothing parts, running, jumping, etc.  Talk about what you’re doing.  (“Now we’re walking.”) Then ask your child, “What are we doing?”  When he responds correctly, reward him with praise such as “Right, we’re walking.”
• Take common objects and ask your child to identify them by their use.  For example, show her an apple, cup, and shoe and ask questions such as “Which one do we eat, drink out of, or wear?”  Do the same with pictures.
• Practice having your child follow a two-step command such as “Put the ball away and go get your truck.”
• Help your child to understand the concept of “one” and “two.”  Ask your child to give you only one object out of several.
• Make a habit of counting things as you use them.  Have your child imitate each number after you.
• As he approaches his third birthday, encourage your child to give his whole name.  Write out his first and last name and show it to him.  Do not expect him to be able to print it.
• Give your child the opportunity to understand “wh” questions.  At this age, he should begin to answer “where,” “who,” and “What is the (person) doing?” questions.  Provide an example such as “I know what Daddy is doing…..He’s watching T.V.
• When looking at books, ask your child questions such as “Where is the girl?”, “Who is that?”, or What is she doing?”  Praise him

3 to 4 Years

Communication Development

Child will:

• Begin to use “I” instead of “me”
• May sometimes use “him” instead of “he”, “her” instead of “she”, “them” instead of “they.”  (“Him going to my house.”)
• Sometimes repeat or stumble over words
• Recite simple rhymes and songs
• Add “s” to words to form plurals (balls)
• Use the following sounds: b, p, m, w, h, t, d, n
• Follow an unrelated command such as “Turn on the T.V., then put your bike in the garage
• Name circle and square
• Identify at least 2 or 3 colors by name

Communication Activities

• Teach your child the relationship between words, objects and ideas.  Talk about how they are alike and different.  Here are examples:  “This block is bigger than that one.  Here are two pencils; the yellow one is skinny and the green one is fat.”
• Take turns naming things you see.  Name things your child sees and encourage her to do the same.  Ask your child the names of familiar objects.  Don’t criticize her if she misses a name.  For example, if your child says the following about a match, “That’s a fire,” you can respond, “Yes, it makes fire, it’s called a match.”
• Let your child participate in household activities.  He can help wash windows, set the table, dust, sweep, or wipe unbreakable dishes.  Take these opportunities to talk to your child to increase his vocabulary.  For example:  “This plate is round.”  “The knife is next to the spoon.”   “The napkin goes under the silverware.”  “Wash the top (bottom) of the window.”
• Help your child learn correct grammar by using the words that she has said incorrectly and repeating or rephrasing them in your own speech with the error corrected.  For example, if your child says “Me no want that,” or “Her is pretty,” you can respond with “You don’t want that….I don’t want that either,” or “Yes, she is pretty.”
• Give your child practice in sorting things.  Let her sort silverware by putting it back in the drawer and point out to her that the forks, knives, and spoons go together.  Sorting laundry also offers many opportunities for grouping things into piles such as whites and colors, towels and socks, etc.  Be sure to explain to your child what you are doing.  Other categories include:
• Color:  buttons, blocks
• Size:   Daddy’s socks and child’s socks
• Appearance: different types of noodles
• Allow your child to wear old clothes and play “grown-up.”  This is a good way to encourage imaginative play skills.
• Point out to your child things that are the same and different.  Be specific when describing what is the same.  For example, say “These shirts are the same color” or “These are the same size.”
• This is the age when many stuttering-like behaviors occur.  DON’T PANIC.  Many nonfluencies are normal, some are not.  The two most important things you can do are 1) listen to your child; 2) observe when and where the stuttering is worse.  If you have questions, or if the stuttering continues, you may wish to contact a speech-language pathologist in your area.
• Good health is very important, even for speech.  Make sure your child is eating properly and getting enough rest.
• Accept your child’s nonfluencies.  Do not criticize or imply that you think her “stuttering” is wrong or just a bad habit.
• Encourage your child to be independent and carry out her own ideas.
• Provide an effective model.  You can speak more calmly, slowly, simply, and rhythmically yourself.
• Give your child time to talk.  Listen to him.  Let him complete his thoughts.  Don’t fill in words for him – – give him the chance.
• Let your actions help provide a tension-free, relaxed setting.  If you are rushing around the house, cooking, cleaning, and setting the table, you are not providing a relaxed atmosphere.  Try to stop your activity and listen.
• Although it is positive to reward your child for fluent speech, be careful not to punish her for difficult moments.
• Recognize tensions and stress situations which make fluent speech difficult for your child.  Do not force your child to talk in these situations, but give her the opportunity to talk if she wants.  For example, it may be very stressful for your child to talk to new adults, so don’t force her to “show off” by speaking or reciting.
• Care about what your child says.

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4 to 5 Years

Communication Development

Child will:

• Answer simple “when” and “why” questions correctly (“When do you eat breakfast?”  “Why do you wear your coat?”)
• Tell about a recent experience
• Sort objects by shape, color, and function (things we eat, wear, play with)
• Verbalize opposites (hot, cold) and comparatives (big, bigger, biggest)
• Understand yesterday, today and tomorrow
• Be understood most of the time by strangers
• Understand most of what the parent says
• Begin to self-correct when sounds are mispronounced
• Sometimes have difficulty with the following sounds: ch, f, j, l, r, s, sh, th, and v

Communication Activities

• Take a “talk-walk” to help your child learn how to put words together correctly in sentences.  Describe and tell all you know about the things around you:  “I see a big tree.  Look, it has a rough, brown trunk.  This is called bark.  See, there’s a nest way up there on that branch.”  Encourage your child to describe what he sees.
• Put a few small toys in small bag or box.  Have your child remove a toy and tell him where to place it.  Use words that describe WHERE such as:  under, over, in, out, around, through, between, beside, behind, above, below.  When he understands the words and can follow the directions correctly, then you place the toy somewhere and ask him to tell you where it is.
• To help your child understand the order of things happening, look through pictures in children’s books.  Talk about what happens first, next, and last.  Discuss action that has taken place and what might happen next.  Let your child retell the story to you.
• Look through magazines with your child and cut out pictures that are related, such as baby and mother, fork and plate, cow and barn, comb and brush.  Spread the pictures on a table, pick one up and ask, “Can you find a picture that goes with this one?”  Then talk about why they go together.  “Why does the hammer go with the nail?  Right.  You use the hammer to pound in the nail.”
• Help your child understand numbers by counting anything she sees around her: people, cars, chairs, etc.  Number recognition can be improved by calling her attention to numbers on houses, road signs, price signs at stores and license plates
• Help your child learn to count objects by stringing Cheerios or Fruit Loops.  Choose a number from 1-10 and ask your child to string a certain number of cereal pieces, (“Put on five Cheerios.”)  Help her to count them out correctly.
• Give your child a box of crayons and see how many colors he can identify by name.  Have him pick out objects or pieces of clothing to match a color.  Help him find all the things in the room that are red, blue, etc.
• Assemble a “junk box.” Blindfold your child and have him take one object out of the box.  While still blindfolded, have him describe how the object feels (hard-soft, rough-smooth, round-sharp).  See if he can guess what it is.  Then remove the blindfold and ask him to tell you how the object looks (color, size, shape), what it is used for, where you would buy it, what it is made of, etc.
• Additional activities include blindfolding your child and asking him how food tastes or smells.  See if he can guess what it is.  Other suggestions for smelling include lemon juice, perfume, paint, magic markers, onions, oranges, coffee.
• Ask your child to think of things people can wear, eat, drink, play with or drive.
• Point out opposite concepts to your child.  For example:  “The refrigerator is cold, the stove is hot.”  “This man is short, that one is tall.”
• Point out comparisons to your child such as big, bigger, biggest or soft, softer, softest.
• Make your child aware of why things are done.  Examples of questions and answers that may be discussed include:  “Why do we wear coats?  We have coats to keep us warm.  When it’s cold outside, we put them on.”
• Provide a good model when your child mispronounces a word.  Do not imply that he is doing anything wrong, but say the word correctly for him.  Exaggerate the error sound correctly.  Child:  “I hurt my fum” Parent:  “You hurt your thumb.”  Praise your child for an attempt to say the word correctly.
• Help your child to understand the time concepts of yesterday, today, and tomorrow.  Talk about things you did yesterday, are doing today, and will be doing tomorrow.

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5 to 6 Years

Communication Development

Child will:

• Say sentences that are usually correct except for irregular parts of speech (“bited” for “bit,” “mouses” for “mice”)
• Know concept of time: before, after, now, later, yesterday, today, tomorrow
• Give a simple definition of a word
• Know right and left
• Remember and tell main ideas in short stories
• Follow a 3-part command such as “Close the door, pick up the ball, and sit down.”
• Count out 10 objects
• Name 8 colors
• Sometimes still experience difficulty with the following sounds:  ch, j, l, r, s, sh, th, v

Communication Activities

• Ask your child to “read” a familiar story to you.  See if he can tell you the story by looking at the pictures.  Also look at the comic strips in the newspaper and ask him to tell you what happened in each picture.
• See if your child knows the following body parts:  eyebrow, eyelid, chin, shoulder, wrist, palm, waist, ankle, heel, chest, jaw, hip.
• Teach your child her right hand from her left hand.  Put a small mark or tie a string on her right hand.  Show the child her right and left leg, eyes, ears, and other body parts.
• Ask your child to help you set the table.  Point out such things as:  “The knife is on the right side of the plate.  The fork is on the left.  The spoon is next to the knife.  You sit between Mom and Dad.  Your glass is full of milk.  My glass is almost empty.  Whose glass has more milk in it?  Who ate the most French fries?  Which food is hot (or cold)?”
• Play “remembering” games such as:  “Get your pencil, put it on the table, and sit down.  Please put plates on the table, then knives, then spoons.”
• Play “Simon Says” or try using a different title such as “The Clown Says”.
• Help your child to recognize written numbers.  Make number cards from recipe cards by printing one number from 1-10 on each card.  Once she learns to recognize them, mix the cards and ask for them out of order.
• Ask your child to find certain numbers on the clock, turn the television to a certain channel, point to numbers on the telephone dial, etc.
• Teach your child to recognize his name.  Use recipe cards to print the letters of your child’s name, writing one letter on each card.  See if he can arrange the letter cards in correct order to spell his name.
• Draw a clock and talk about the numbers on it and how the hands move as time goes by.  Discuss some of the things that she does “by the clock,” such as what time she gets up, what time she watches Sesame Street, what time Daddy or Mommy comes home from work etc.  Talk about typical morning, afternoon, and night time activities such as eating breakfast in the morning or sleeping at night.
• Pantomime several different actions and ask your child to guess what you are doing.  These are suggestions:  combing hair, jumping rope, driving a car, eating an ice cream cone, riding a bike, using a telephone, drinking from a glass.  Also ask your child to act out different things.  She may need some help.
• Play a game in which your child is to anticipate the opposite concept.  “I want you to stand up.  Now I want you to _____________________.”  “Run fast, now run______________________.”  Other possibilities include: clap softly-loudly, push the chair-pull, touch something big little, and open your eyes close.
• Your child can learn to group things into categories by letting him sort your canned food in as many different ways as he can.  First suggest some ways to sort them, then let him figure out other ways if he can.  Possible groupings:
• Size: small, medium, large
• Color:  yellow, red, green, etc.
• Kind:    fruit, vegetable
• Weight: light, heavy
• Teach your child her address and mother and father’s name.  Teach your child her full name.

The following materials can be used by parents and caregivers to encourage language development in infants and young children.  If you have questions,  contact a speech-language pathologist that serves your local school building.

Name	Description
Effects of Recurrent Otitis Media	How middle ear infections can affect a child’s communication skill development.
Information Talk/Let’s Talk	How to model and encourage communication with a young child.
Top Ten	Suggestions for Parents and Caregivers
Word Production List	A tool for documenting new vocabulary.
Word Production List (Spanish)	A tool for documenting new vocabulary