Every parent waits anxiously for their baby’s first word, and every child will speak that first word on their own unique schedule. There are some milestones, however, that can serve as a general guide to healthy development and can help parents and healthcare providers detect any problems.

Speech and language milestones

(source: The Mayo Clinic)

By the end of 3 months, your child might:

• Smile when you appear
• Make "cooing" sounds
• Quiet or smile when spoken to
• Seem to recognize your voice
• Cry differently for different needs

By the end of 6 months, your child might:

• Make gurgling sounds when playing with you or left alone
• Babble and make a variety of sounds
• Use his or her voice to express pleasure and displeasure
• Move his or her eyes in the direction of sounds
• Respond to changes in the tone of your voice
• Notice that some toys make sounds
• Pay attention to music

By the end of 12 months, your child might:

• Try imitating speech sounds
• Say a few words, such as "dada," "mama," and "uh-oh"
• Understand simple instructions, such as "Come here"
• Recognize words for common items, such as "shoe"
• Turn and look in the direction of sounds

By the end of 18 months, your child might:

• Recognize names of familiar people, objects and body parts
• Follow simple directions accompanied by gestures
• Say as many as eight to 10 words
• By the end of 24 months

By 2 years of age, your child might:

• Use simple phrases, such as “more milk”
• Ask one- to two-word questions, such as “Go bye-bye?”
• Follow simple commands and understand simple questions
• Speak at least 50 words

Between 2 and 3 years, vocabulary continues to build and comprehension also increases.

By 3 years of age, your child should be able to:

• speak in three-word sentences
• have a vocabulary of 200 words or more (basically, more than you can count)
• be understood 75% of the time
• understand prepositions (such as, “put it on the table” or “put it under the bed”)
• use pronouns (“me,” “you,” “it”)

By 4 years of age, your child should be able to:

• talk about activities at school or at friends' homes
• talk about what happened during the day and can use about four sentences at a time
• usually be understood when speaking to people outside the family
• answer simple “who,” “what,” and “where” questions
• ask when and how questions
• say rhyming words, like hat-cat
• use pronouns, like I, you, me, we, and they
• use some plural words, like toys, birds, and buses
• use a lot of sentences that have four or more words
• usually talk easily without repeating syllables or words

By 5 years of age, your child should be able to:

• say all speech sounds in words; may make mistakes on sounds that are harder to say, like l, s, r, v, z, ch, sh, th
• respond to “what did you say?”
• talk without repeating sounds or words most of the time
• name letters and numbers
• use sentences that have more than one action word, like jump, play, and get; may make some mistakes, like “Zach got 2 video games, but I got one”
• tell a short story
• keep a conversation going
• talk in different ways depending on the listener and place, such as short sentences with younger children or talk louder outside than inside

Expressive language delays

Is your toddler a “late talker?” Taking a wait-and-see approach can be detrimental to the child that truly needs therapy to develop normal, healthy language skills. Language-based learning disabilities are caused by a difference in brain structure that is present at birth, are often hereditary, and are often related to specific language problems.

Expressive language delays can manifest in a number of ways. According to the American Speech-Language Hearing Association (ASHA), children with an expressive language delay may have trouble:

• Asking questions
• Naming objects
• Using gestures
• Putting words together into sentences
• Learning songs and rhymes
• Using correct pronouns, like “he” or “they”
• Knowing how to start a conversation and keep it going 

Some children also have trouble with early reading and writing, such as:

• Holding a book right side up
• Looking at pictures in a book and turning pages
• Telling a story with a beginning, a middle, and an end
• Naming letters and numbers
• Learning the alphabet

Written language delays

According to ASHA, language-based learning disabilities are problems with age-appropriate reading, spelling, and/or writing. This disorder is not about how smart a person is. Most people diagnosed with learning disabilities have average to superior intelligence.

The learning problem related specifically to reading is known as dyslexia. Dyslexia can also occur, however, as part of a larger language disability involving trouble with both the written and spoken word.

Children with written language delays may have difficulty:

• Expressing ideas clearly
• Learning new vocabulary that the child hears and/or reads
• Understanding questions and following directions that are heard and/or read
• Recalling numbers in sequence (telephone numbers and addresses)
• Understanding and recalling details of a story or classroom lecture
• Reading and comprehending material
• Learning words to songs and rhymes
• Telling left from right
• Letters and numbers
• Learning the alphabet
• Identifying the sounds that correspond to letters
• Mixing up the order of letters in words while writing
• Mixing up the order of numbers that are a part of math calculations
• Spelling
• Memorizing the times tables
• Telling time

Expressive language disorders in adults

Adults can also experience problems with expressive language. Social anxiety or stuttering, and conditions such as Asperger syndrome or Tourette syndrome can affect an individual’s ability to speak and interact socially.

 Speech-language therapy for language disorders

If you are concerned about your child’s spoken or written language progress, or if you are experiencing a language disorder as an adult, an assessment by a speech-language pathologist is crucial. Individualized treatment with a speech-language pathologist will focus on supporting strengths and implementing strategies for growth. Therapy goals for expressive language delays include:

• Develop the use of language by learning about word meanings, making comparisons and associations, and exploring categorizations.
• Expand vocabulary by identifying synonyms, attributes, and functions.
• Use analogies to develop word relationships.
• Discover how words and word order can change the meaning of a sentence.
• Use signal, quantity, place, and time-order words.
• Talk about cause and effect.
• Identify the relevant details, key words, main ideas, characters, and problems in literature and nonfiction.
• Increase the use of tense markers, pronouns, plurals, possessives, articles, negatives, and questions.

Therapy goals for written language delays:

• Increase the ability to use conventions of spelling, capitalization, and punctuation.
• Expand the use of syntactical forms of modifiers, phrases, and various sentence structures.
• Explore meaningful communication with appropriate content, detail, coherence, and organization.
• Expand comprehension and critical analysis of text for improved classroom or vocational performance. 

Language is powerful. It is how humans communicate our beliefs, feelings, thoughts, and desires. It is the way we connect with and comprehend each other.

A language disorder means there is an impairment in an individual’s ability to express or understand language and words. This type of problem, which affects children and adults in different ways, is estimated to affect between 6 and 8 million Americans. A language disorder can seriously affect quality of life for you or your child.