


Please refer to the following comprehensive checklists as necessary:

The American Speech-Language-Hearing Association’s
Communication Milestones
Birth to 3 Months
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Alerts to sound.
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Quiets or smiles when you talk.
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Makes sounds back and forth with you.
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Makes sounds that differ depending on whether they are happy or upset.
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Coos, makes sounds like ooooo, aahh, and mmmmm.
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Recognizes loved ones and some common objects.
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Turns or looks toward voices or people talking.
4 to 6 Months
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Giggles and laughs.
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Responds to facial expressions.
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Looks at objects of interest and follows objects with their eyes.
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Reacts to toys that make sounds, like those with bells or music.
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Vocalizes during play or with objects in mouth.
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Vocalizes different vowel sounds—sometimes combined
with a consonant—like uuuuuummm, aaaaaaagoo, or daaaaaaaaaa. -
Blows “raspberries.”
​
7 to 9 Months
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Looks at you when you call their name.
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Stops for a moment when you say, “No.”
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Babbles long strings of sounds, like mamamama, upup, or babababa.
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Looks for loved ones when upset.
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Raises arms to be picked up.
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Recognizes the names of some people and objects.
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Pushes away unwanted objects.
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10 to 12 Months
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By age 10 months, reaches for objects.
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Points, waves, and shows or gives objects.
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Imitates and initiates gestures for engaging in social interactions and playing games, like blowing kisses or
playing peek-a-boo. -
Tries to copy sounds that you make.
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Enjoys dancing.
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Responds to simple words and phrases like “Go bye-bye”
and “Look at Mommy.” -
Says one or two words—like mama, dada, hi, and bye.
13 to 18 Months
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Looks around when asked “where” questions—like “Where’s your blanket?”
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Follows directions—like “Give me the ball,” “Hug the teddy bear,” “Come here,” or “Show me your nose.”
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Points to make requests, to comment, or to get information.
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Shakes head for “no” and nods head for “yes.”
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Understands and uses words for common objects, some actions, and people in their lives.
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Identifies one or more body parts.
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Uses gestures when excited, like clapping or giving a high-five, or when being silly, like sticking out their tongue or making funny faces.
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Uses a combination of long strings of sounds, syllables, and real words with speech-like inflection.
19 to 24 Months
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Uses and understands at least 50 different words for food, toys, animals, and body parts. Speech may not always be
clear—like du for “shoe” or dah for “dog.” -
Puts two or more words together—like more water or go outside.
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Follows two-step directions—like “Get the spoon, and put
it on the table.” -
Uses words like me, mine, and you.
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Uses words to ask for help.
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Uses possessives, like Daddy’s sock.
​
2 to 3 years
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Uses word combinations often but may occasionally repeat some words or phrases, like baby – baby – baby sit down
or I want – I want juice. -
Tries to get your attention by saying, Look at me!
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Says their name when asked.
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Uses some plural words like birds or toys.
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Uses –ing verbs like eating or running. Adds –ed to the end
of words to talk about past actions, like looked or played. -
Gives reasons for things and events, like saying that they
need a coat when it’s cold outside. -
Asks why and how.
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Answers questions like “What do you do when you are sleepy?” or “Which one can you wear?”
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Correctly produces p, b, m, h, w, d, and n in words.
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Correctly produces most vowels in words.
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Speech is becoming clearer but may not be understandable to unfamiliar listeners or to people who do not know your child.
3 to 4 years
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Compares things, with words like bigger or shorter.
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Tells you a story from a book or a video.
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Understands and uses more location words, like inside, on, and under.
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Uses words like a or the when talking, like a book or the dog.
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Pretends to read alone or with others.
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Recognizes signs and logos like STOP.
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Pretends to write or spell and can write some letters.
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Correctly produces t, k, g, f, y, and –ing in words.
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Says all the syllables in a word.
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Says the sounds at the beginning, middle, and end of words.
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By age 4 years, your child talks smoothly. Does not repeat sounds, words, or phrases most of the time.
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By age 4 years, your child speaks so that people can understand most of what they say. Child may make mistakes on sounds that are later to develop—like l, j, r, sh, ch, s, v, z, and th.
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By age 4 years, your child says all sounds in a consonant cluster containing two or more consonants in a row—like
the tw in tweet or the –nd in sand. May not produce all sounds correctly—for example, spway for “spray.”
4 to 5 years
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Produces grammatically correct sentences. Sentences are longer and more complex.
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Includes (1) main characters, settings, and words like and to connect information and (2) ideas to tell stories.
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Uses at least one irregular plural form, like feet or men.
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Understands and uses location words, like behind, beside,
and between. -
Uses more words for time—like yesterday and tomorrow—correctly.
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Follows simple directions and rules to play games.
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Locates the front of a book and its title.
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Recognizes and names 10 or more letters and can usually write their own name.
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Imitates reading and writing from left to right.
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Blends word parts, like cup + cake = cupcake. Identifies
some rhyming words, like cat and hat. -
Produces most consonants correctly, and speech is understandable in conversation.
​
Source: www.asha.org
The American Speech-Language-Hearing Association’s
Feeding and Swallowing Milestones
Birth to 3 Months
What can my baby do?
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Holds head up when supported.
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Turns head towards nipple and opens mouth.
How does my baby eat and drink?
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Latches to nipple.
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Sucks and swallows.
What should my baby be eating and drinking?
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Human milk and/or formula (IDDSI Level 0).
​
4 to 6 Months
What can my baby do?
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Brings hands to the breast or bottle.
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Pats breast or bottle.
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Brings hands or toys to mouth.
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Starts to sit up in cradle position and holds breast or bottle during feeding.
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Sits supported in highchair with straps and when reclined.
How does my baby eat and drink?
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Opens mouth for spoon.
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Uses tongue to move food to back of mouth for swallowing.
What should my baby be eating and drinking?
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Human milk and/or formula (IDDSI Level 0).
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Infant cereal mixed with breast milk or formula*
(IDDSI Level 3) -
Smooth baby foods (purees) with no lumps or chunks.
(IDDSI Level 4)
​
*Consult with pediatrician regarding appropriate infant cereals.
6 to 9 Months
What can my baby do?
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Holds head up when sitting upright.
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Leans forward to receive foods.
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Still needs support from highchair around waist and legs, including footrest.
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Reaches for toys and food.
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Picks up food with fingers.
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Brings foods to mouth with hands and starts to feed self.
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Tries to hold spoon.
How does my baby eat and drink?
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Starts to drink from a cup, but may bite cup edge or straw; some liquid spills out of mouth.
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Drools less.
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Moves food around mouth using tongue.
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Munches.
What should my baby be eating and drinking?
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Human milk and/or formula; may start drinking small amounts of water (IDDSI Level 0).
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Smooth baby foods (purees) with some lumps (minced and moist) like mashed potatoes, applesauce, oatmeal, or
pudding (IDDSI Level 5). -
Soft, chewable, solid foods cut into strips like a pancake,
toast, or cheese (IDDSI Level 6).
9 to 12 Months
What can my baby do?
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Holds bottle or sippy cup with both hands.
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Sits upright in highchair with minimal assistance.
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Holds spoon during meal.
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Feeds self with fingers.
How does my baby eat and drink?
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Takes a small bite from a larger piece of food.
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Begins chewing food on both sides of mouth (called “rotary chewing").
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Closes lips during swallow.
What should my baby be eating and drinking?
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Soft, bite-sized foods like sliced banana, cheese cubes, or pasta (IDDSI Level 6).
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Human milk and/or formula; may drink small amounts of water (IDDSI Level 0).
​
12-18 Months
What can my child do?
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Sits upright with feet on floor or on a flat surface (can sit in highchair, booster seat, on floor, etc.).
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Feeds self with utensils or fingers.
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Drinks from a sippy cup without help; can drink from an
open cup with some spilling.
How does my child eat and drink?
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Uses tongue to move food from side to side in mouth.
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Drinks from straw without help and without spilling.
What types of food should my child be eating and drinking?
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Foods made of mixed consistencies (IDDSI Level 7).
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Human milk, water
​
18-24 Months
What can my child do?
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Sits without support.
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Feeds self with fingers or utensils.
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Drinks from a small cup with hands and has minimal spilling.
How does my child eat and drink?
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Consistently chews food on both sides of mouth.
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Moves food around mouth, chews, and swallows without spilling.
What types of food should my child be eating and drinking?
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Foods that require a lot of chewing, like chicken breast.
Child still requires adult to cut more challenging foods into smaller pieces to prevent choking (IDDSI Level 7). -
Human milk, water
​
2 to 3 Years
What should my child be able to do?
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Feeds self with fork and spoon, although often still uses fingers.
How does my child eat and drink?
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Drinks from an open cup without spilling.
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Chews all foods, including those with tougher textures, without gagging or choking.
What types of food should my child be eating and drinking?
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Most crunchy, hard, or mixed food textures, but parents should avoid offering foods that carry a choking risk—like popcorn, hotdogs, or grapes. Child still requires adult to cut more challenging foods into smaller pieces to prevent choking (IDDSI Level 7).
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Human milk, water
​
Source: www.asha.org





Know the Signs of Speech and Language Disorders
Children: Signs of a Language Disorder
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Does not smile or interact with others (birth and older)
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Does not babble (4–6 months)
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Makes only a few sounds or gestures, like reaching (7–9 months)
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Does not understand what others say (10 months – 2 years)
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Says only a few words (19 months – 2 years)
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Does not put words together to make sentences (19 months – 3 years)
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Speaks using words that are not easily understood by others (3–4 years)
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Has trouble with early reading skills, like pretending to read or finding the front of a book (4–5 years)
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Children: Signs of a Speech Sound Disorder
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Says p, b, m, h, and w incorrectly in words (2–3 years)
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Says k, g, f, t, d, and n incorrectly in words (3–4 years)
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Produces speech that is unclear, even to familiar people (2–3 years)
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Children: Signs of Stuttering (Disfluency)
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Repeats first sounds of words—“b-b-b-ball” for “ball”
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Stretches sounds out—“ffffff-farm” for “farm”
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Shows frustration when trying to get words out
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Children: Signs of a Voice Disorder
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Loss of voice
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Uses a hoarse or breathy voice
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Speaks with strain and effort
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Source: identifythesigns.org
