When my first child was born, I was surprised by the frequency of her pediatric appointments. The nurses would draw lines on the medical table paper above her head and below her toes to track her length, then set her diaper-free body on a miniature scale to record her weight. The doctor would gently squeeze her abdomen to check her organs, look at her eyes, ears and mouth. These procedures were followed up by a barrage of questions: How long are her sleep stretches? How many ounces of milk is she drinking? How many wet diapers does she have a day?
I was flustered. I hadn’t counted diapers and I didn’t have any idea how much milk my baby got when nursing. I was hardly sleeping myself. My mind felt like scrambled eggs, my body like broken eggshells. But as the weeks and months passed and I slowly began to come back online as the self I recognized, I appreciated all the milestones that medical experts watch for as a child grows — patterns that help doctors and families better support kids when a need arises.
Like weight and height, language develops in an expected, patterned way — with a bit of range at any given stage. But your child’s language development might not be something you think about much. It’s more abstract than milestones we measure physically, and if you’re a first-time parent, you have no other child to which to compare your baby.
Despite how nebulous early language development might seem, there are concrete measures. I spoke to experts in the field to create this primer on language development in children.
What to know: typical speech milestones
Bielca Sosa, a bilingual pediatric speech-language pathologist, works with children of all ages, through her private practice, Let’s Talk Speech in L.A., as well as with students in local charter schools. According to Sosa, the following milestones are great for parents to be aware of so that they can seek evaluation and support for their child if needed. These milestones cover major aspects of language development, including speech articulation and receptive, expressive and social language.
6 months: Responds to sounds by making sounds; strings vowels together when babbling; likes taking turns making sounds with parent; makes sounds to show joy and displeasure; starts to say consonant sounds.
1 year: Responds to simple spoken requests; uses simple gestures (shaking head “no,” waving “bye”); says “mama,” “dada” and exclamations like “uh-oh;” tries to repeat words you say; repeats sounds or actions to get attention.
18 months: Says several single words; points to what they want; knows what ordinary things are for (milk, ball, spoon); points to get the attention of others; shows interest in a doll or stuffed animal, pretending to feed it, for example; follows one-step verbal commands (e.g., sits when you say “Sit down.”).
2 years: Gets excited when with other children; knows names of familiar people and body parts; says sentences with two to four words (e.g., big bubble,” “car go beep”); follows simple instructions; points to things in a book and names them (cat, bird).
3 years: Takes turns in games; follows two- and three-step instructions; can name most familiar things; says first name and age; talks well enough for strangers to understand; carries on a conversation using two to three sentences.
4 years: Is increasingly creative with make-believe play; talks about interests; follows some basic rules of grammar; sings a song from memory and tells stories.
5 years: Can tell what’s real and what’s make-believe; speaks very clearly; tells a simple story using full sentences; uses future tense (e.g., “Grandma will be here soon.”); knows about things used every day, such as money and food.
What to do if you’re concerned
If you believe your child needs language support, your next steps might depend on your child’s age. If they are an infant or toddler and not yet in school, your nearest regional center is an incredible resource. There are seven state-funded regional centers in Los Angeles County, and each one stands ready to assess, diagnose and support your child. Most services are free, regardless of family income. Since early intervention is beneficial, gathering more information via assessment can only help.
If your child is already in public school, be it preschool or higher, your school is now a great resource, says Kortney Spencer, a speech-language pathologist who has worked in Culver City Unified School District for eight years. Parents can request that a teacher have a child assessed, though usually it’s a teacher who flags a child for support in this setting. Over the course of their career, a teacher works with hundreds of children, and this often gives them a wide perspective on developmental stages and needs.
Once a school refers a child to Spencer, she seeks permission from parents to informally assess the child. If she feels there’s a language deficit to address, she conducts formal testing, determines a diagnosis, then supports the child on her way to meeting targeted speech and language goals. To qualify for free services through public school, Spencer says, a child’s disability must impact their academic performance. For example, if they mispronounce their “r” sound, but can read the sound and write the sound appropriately, they may not qualify for on-campus support.
If your child isn’t eligible, but you still believe they need services, going to a private practice is another option. Michelle Aylon is a speech-language pathologist who works at private practice Nikki Rubin Speech Therapy in West Los Angeles.
When she’s not providing services on campus, she partners with caregivers who want services despite their child’s ineligibility via the school process. Also, sometimes a child sees a pathologist at school, but the family wants additional support after school hours. Aylon notes that services at a private practice are fee-based. Coverage for services can vary depending on your insurance company.
Dispelling misconceptions around speech and language is part of the work that speech pathologists do. A common one revolves around speaking two or more languages in the home. If a student is an English-language learner and is diagnosed with a language deficit, parents sometimes assume that speaking two languages might be confusing a child and/or that they should cease speaking another language at home.
“The data shows that this is not the case at all,” says Sosa of Let’s Talk Speech. “If a child has a true speech delay or disorder, it will be in both languages. So, if you take one away, you’re just taking away the cultural connection that comes with that language — and [the child’s ability] to connect with family members who speak it.”
Pamela Wiley, president of L.A. Speech and Language Therapy Center, says the “wait and see” approach is another misconception. Her center has operated for more than 40 years and works with children as young as 18 months old and adults, offering comprehensive services for an array of learning needs. No matter your child’s age, Wiley says do not wait to get help.
“If you think there’s a problem, you’re the parent, you know,” Wiley says. “The sooner you get services, the better the outcome. Seek out support, be persistent and be your child’s best advocate.”
Chelsee Lowe is a writer and mom in L.A. who writes about food, culture and travel.