We were at a birthday party last weekend. Chocolate cake with sprinkles and games galore. A happy chaotic scene with mixed ages running around. Incessant chatting, lots of laughter and the mandatory tearful toddler when a balloon left her fingers and floated upwards. Amidst the streamers and treats, a concerned parent approached me. “Jonah is the sweetest little boy, he adores his little sister and loves playing with his friends. But something doesn’t feel right. He just started school. We understand him at home but he has a hard time expressing himself outside the house with new people. I don’t know where to start”
As a speech-language pathologist, I have seen different scenarios of this story. Sometimes it’s a toddler who has not yet said her first word. Or a preschooler who is communicating with basic phrases and limited vocabulary. The parent worries that the child isn’t speaking as clearly or as often as they expected by now. The other kids just seem to be more verbal, talkative, or engaging. Quite often, it’s a first-grader who had undetected language delays all along and is only being identified now when they are starting to have difficulties learning to read.
So what should children be saying at specific ages? What is the typical age and sequence of sound acquisition and development of language? As parents, we want the best for our kids. We compare and we worry, often because we’re not sure what to expect.
Every child is different
Before we talk about developmental milestones, I have to emphasize that every child is different, and that each child will develop at their own pace. The milestones are also different for monolingual and bilingual children. There are also different language acquisition frameworks - Gestalt language processing versus Analytic language processing (AKA Natural language acquisition v/s Typical language acquisition). More on that in a future blog post. The point is that our children’s capabilities are not measured by their milestones. Each child is truly unique.
Milestones
Milestones are provided as a guide to support families, teachers, doctors, and other professionals in monitoring any potential delays in speech and language development.
Being aware of milestones can be a game changer for families and professionals, because it helps identify a possible need for evaluation and support. It is a starting point to have a conversation about development.
A milestone occurs when 90% of children have mastered a particular skill. However, when a child is not meeting a milestone, it means that they are not meeting the bare minimum developmental expectation at that age level for that skill. 10% of children do not meet their milestones. A child should master the skills listed by the time they reach the top of the age range. Missing one skill in the age range does not mean they have a problem. However, many out of this 10% of children will need to see a speech-language pathologist to catch up, and some may have more significant needs that require ongoing speech therapy.
When to seek Help
Missing milestones is your first clue that something MIGHT be going on with your child’s development. It is worthy of a discussion with your doctor or speech therapist/ SLP. Although many children who miss milestones catch up and it doesn’t necessarily mean that they will need intervention, a specialist can determine if there is a need for intervention or monitoring of speech development.
Family doctors and pediatricians may differ in their opinions on how early to get help when a child is missing their milestones. This is one situation where I don’t recommend a “wait and watch” approach, where they monitor the child and refer after a year or two without improvement. Timely intervention has tremendous benefits and can guide families in the right direction in this development journey.
Let's take this example of Milestones versus Average development- At age 3 (for children who are analytic language processors i.e who Typical language acquisition patterns), the expressive language milestone is a vocabulary of 250 words. This is the bare minimum expectation. However, on an average, 3 year olds are at 1000+ words and combine 3 words into utterances. At this age, the average number of words expected versus the milestone number is a huge gap. If a child is falling behind this learning curve, it affects their abilities to express themselves, develop social relationships, develop literacy, and cause frustration and other behavioral issues.
Here are a few handy milestone infographics for 1-2 years, 2-3 years, 3-4 years and 4-5 years. The American Speech Language Hearing association is another great resource website with lots of detailed information.
If parents have concerns, they should be heard and validated. Also please bear in mind that speech and language development is more than number of words and how much is understood- so if the child is meeting these milestones on the surface but there are other underlying concerns or a gut feeling about development, trust your parental instincts. No other person knows your child better than you. Be informed and empowered. Celebrate their individuality.
Resources: