How vital are Speech and Language Milestones? And what are they?

February 28, 2021 Dr.Srinivas Gada 0 comment

How vital are Speech and Language Milestones? And what are they?

Among millions of species that have inhabited our planet, the human species have evolved and emerged as the most dominant of all. The most critical reason for this is our ability to communicate with each other using speech and language. Communication with other human beings facilitated our ability to share information about threats, helped us decide, plan, cooperate, and coordinate a response against our enemies and threats. Consequently, our ability to communicate has allowed us to adapt, survive and thrive on this planet earth. One does not need to go back to the history books to look for evidence of this. Just look at the current threat from the COVID-19 pandemic and the subsequent successful response with coordinated lockdowns and vaccines’ development. Homo sapiens have endured many such perils, big and small, over the past 200,000 years by their ability to communicate to ensure safety and survival.

Our ability to use language to communicate has evolved over the past tens of thousands of years. It is still changing as I write this article, and it will continue to do so. Just think of all the electronic forms of communication such as emails, texts, and photo sharing, unheard of only a couple of decades ago. So, communication comes in various forms such as using signs, symbols, pictures, gestures, eye gaze, facial expressions, body language, tone of voice, speech sounds, verbal and written language.

‘Speech’ is our ability to produce recognisable sounds using coordinated actions of muscles present in our vocal cords, palate, tongue, lips, and jaw. ‘Language’ is a communication system or a set of shared rules by which people express and share their ideas meaningfully. A delay or disorder of language could involve difficulty understanding what others are saying (receptive language) or problem sharing one’s intention and thoughts using the spoken form (expressive language).

As one can appreciate, the delays and difficulties in speech and language impact a child’s ability to share and express ideas, socially interact with their peers, participate in play, and learn. Moreover, language delay during preschool years has been shown to affect confidence, cause low self-esteem, disengagement from learning, and even have a long-term impact on the individual’s health, well-being, and learning. Additionally, speech and language development follows a well-established natural course. Consequently, knowledge of speech and language milestones can help parents and professionals identify delays and difficulties early so that effective interventions to address them can be instituted promptly.

In this article, I have covered ‘Speech and Language milestones’ in a typically developing child. But a note of caution before you read further. While each milestone listed below is vital, missing a single milestone in the absence of anything else may not be significant. Nevertheless, a delay in developing several of these milestones in a child deserves prompt attention and a thorough neurodevelopmental assessment.

0 – 3 months

Crying for food, comfort, and company
Listens to bell
One syllable cooing
Searching for sound with head movements
Can make 2 different kinds of sounds
He/she can laugh

3 – 6 months

Cooing and gurgling
Can make 4 different kinds of sounds
Develops 2 syllable babble
Could respond when called
Can shout for attention
They can listen to conversations

6 – 9 months

Can have singing tones
They like jingles and rhymes
May have developed at least one word that is meaningful, e.g., dada, mama
4+ syllable babbled phrases
Knows own name and responds on calling
Can shake head for ‘no’
Can wave and clap

9 – 12 months

Can have a babbled monologue when on their own
Most of them can now use 2-3 definite words meaningfully
Can have babbled conversations
Can respond to ‘no’
Many develop a context-dependent understanding of language
Their comprehension of everyday words is increasing

12 – 18 months

He/she can have long babbled sentences with some clear words
They can use up to 12 words in context with meaning
They can identify 4-6 objects and name a couple of them
Can obey simple requests, e.g., give me the spoon
Can understand simple questions, e.g., where is your cup?
Can know 3-6 body parts and can point to them
They enjoy picture book with simple stories, rhymes, and songs

18 – 24 months

Can point to pictures in a book when named
They can understand many single words, nouns, and verbs
They are learning new words regularly and can have up to 50words
Can put two-words together, e.g., daddy come, more drink
They can listen to stories
Can identify several objects and name some of them

2 years

Can now use 2–3-word phrase to talk or ask for things
Can use words that contain k, g, m, p, b, t, d, and n, sounds
Often word endings are omitted
But family and friends can understand their speech
Can name several objects and can ask for them by name
Can define a couple of objects by use, e.g., what is a cup for? They can say ‘drink.’

2.6 years

Their speech has lots of sound simplifications
Hence, speech is understood by familiar adults
Can use words with ‘f’ ‘s’ ‘sh’ ‘ch’ sounds
Can use sentences of 5-6 words
They have begun to use some pronouns (me, he, she)
They can understand basic concepts such as big/little, on/under

3 years

Increasing clarity in speech and language
Hence, they can be understood most of the time by strangers
They begin to ask ‘why’ questions
Can tell a story
Can have a vocabulary of 500+ words
They have a word for most things
Beginning to understand ‘yesterday/tomorrow.’

4 years

Can speak in fluent sentences
Many can converse and explain at a simple level
Can talk about things they have done & will do
Can tell stories in their play
Can answer simple questions, e.g., who, what, and where
Can still make errors, especially with the past tense, e.g., falled
Can understand more’ time’ words (morning, evening)
Their speech is intelligible but may have errors with blending consonants (sp, bl, gr) and sh/ch

5 years

Can pay close attention to a story and answer questions relating to it
Understands most of what is said at school and at home
Can communicate readily with peers and adults
Many have full adult grammar
Can have a good reciprocal conversation and clear speech
Most speech is correct, with only some minor errors that do not affect intelligibility
Can still have difficulties with speech sounds ‘th’, ‘r’, ‘s’ or ‘z’

6 years

Can answer comprehension questions such as ‘what should you do if…?’
They know 8-10 colours
Know 20+ capital letters
Can use the preposition ‘above’
He/she begins to master exceptions to grammatical rules
They can understand passive tense
They can give directions
Can ask/answer factual & inferential questions
Answers complex how, who, why, when questions
They can take turns in conversations
Can listen for sustained periods of time

7 years

They can follow a series of instructions without the need for repetition
They can use language to problem solve and talk about their feelings
Can rephrase a statement if not understood
Can ask for clarification if you do not understand
They know their full address
Can know their birthday
Most have one special school friend

8 years

They begin to understand and use idioms
They can use clear and subject-related vocabulary
Can explain what has been learned
Can repeat a 16-syllable sentence
Can describe a picture with many descriptive words
They can use personal pronouns correctly
They begin to understand jokes and riddles

To Conclude,

Failure to acquire the speech and language milestones as above-mentioned can occur in several neurodevelopmental disorders such as Global Developmental Delay, isolated Speech/Language Delay, Learning Disabilities, Autism Spectrum Disorder, Ex-Prematurity, Hearing impairment, Speech Dyspraxia and Cerebral Palsy. Delay in Speech and language could also accompany conditions such as ASD (Autism Spectrum Disorder), DCD (Developmental Coordination Disorder) or ADHD (Attention Deficit Hyperactivity Disorder).

If screening identifies any delays or concerns, then a prompt neurodevelopmental assessment is warranted. As identifying and addressing these delays earlier can prevent secondary consequences for the child, such as disengagement from learning, low self-esteem, anxiety, and poor psychological health, thus leading to a long-term impact on their health, well-being, and education. Moreover, earlier identification and effective interventions can help the child acquire useful qualifications, gain employment, and have a fulfilling life.