QK Parents


Most people do not realize that an incredible foundation of language skills begins at birth. Communication begins at birth such as your child crying when he/she is hungry. We are often contacted by parents who call the clinic with a feeling that something is not right with their child’s speech & language development. It could be the obvious signs such as a child not talking or a child is hard to understand, but the warning signs of a speech-language concern could also be less obvious such as a child who avoids eye contact or a child who has difficulty putting sentences together in the correct order. Your child’s doctor can refer you to a speech-language pathologist for an evaluation. It is important to note that most often parent concerns are justified; therefore, never assume your child will “outgrow” anything, it is always better to be safe than sorry. Because the acquisition of speech depends on hearing acuity, it is also important to rule out a hearing problem first. Frequent ear infections and the presence of otitis media (fluid in the middle ear) can significantly impact speech-language skills. If a professional determines that your child has difficulties with his/her speech or language skills, studies have demonstrated the advantage of beginning intervention as early as possible (McLean & Woods 1997). Treatment plays a critical role in helping children learn to speak, listen, read, and write (ASHA 2001)


At Quotable Kids, we thought it would be helpful to give you some of the warning signs and speech milestones that will give parents an idea of what are some signs that warrant an evaluation. As parents, if you observe differences in your child’s speech, language, and listening skills, compared to his/her peers, you may want to seek a professional’s opinion. Your child’s doctor can refer you for a professional screening or assessment from a licensed speech-language pathologist (SLP).
Expressive Language Warning Signs
  • Child is not talking or talking very little (limited vocabulary)
  • Child does not copy you or imitate your actions/sounds/words (i.e, blowing raspberries back & forth)
  • Child does not gesture (point) to indicate his wants and needs by 15 months
  • Saying a word once and does not use it again
  • Child does not use words to tell you what he/she wants
  • Not changing or increasing vocabulary month to month
  • Child is not combining words into phrases and sentences (i.e., 2-3 word sentences such as “hi mom” and “more please” by 24 months, 3-4 word sentences by 36 months of age, 4-5 word sentences by 4 years of age)
  • Child has regressed or lost words at any point in his/her development
  • Child does not ask questions (by 24 months of age, i.e., “Where’s daddy?”)
  • Child does not use past tense correctly by age 4
  • Child has difficulty with pronouns (i.e, “Her did it”)
  • Child does not tell stories in correct order by age 5
Receptive Language Warning Signs
  • Child does not respond to his/her name
  • Child does not turn to respond to sounds
  • Child does not follow directions (i.e, come here, give it to me, get your book)
  • Child does not go get a familiar object from another room when asked (by 18 months)
  • Not pointing to objects or people in books (ie, Show me the dog)
  • Does not answer questions reliably or repeats the question without producing an answer (i.e, You ask, “Do you want milk or juice?” child answers “Want milk or juice?” making it difficult to tell if he/she comprehends the question)
  • Child does not listen and follow directions compared to other children his/her age
  • Does not understand basic concepts (i.e., prepositions, size, gender)
  • Does not exercise good auditory skills and memory
  • Child does not understand the plot of a story
Speech Warning Signs
  • Mispronouncing vowels such as saying “baba” for “baby”
  • Talking using mostly vowels, omiting consonant sounds (i.e, “oo” for “two”)
  • Child is hard to understand (understood at least 50% of the time by 24 months of age, 75% of the time by 30 months of age, and 80% of the time by 36 months of age)
  • Child omits the initial sound of most words (i.e., “og” for “dog”)
  • Child does not have correct articulation of most speech sounds by age 5
  • Child has stuttered for more than six months
Social/Pragmatic Warning Signs
  • Child does not gesture or reference his/her wants (often by pointing)
  • Child avoids eye contact
  • Child does not take turns (i.e, rolling a ball back and forth, taking turns making sounds)
  • Child has difficulty with transitions
  • Child does not initiate conversations with you
  • Child prefers to play alone rather than seek interactions with peers
Early Literacy Warning Signs
  • Does not point to objects or people in books by 18 months of age
  • Child does not listen to a story and actively participate in book reading
  • By age 6, child does not recognize that individual letters in words represent different sounds that form words (i.e, c-a-t for “cat”).
Other warning signs that may warrent an evaluation
  • Child gets frustrated when he/she is not understood
  • Child is a picky eater and does not eat a wide variety of foods (eats less than 10 foods)
  • Child drools excessively
  • Child demonstrates repetitive behaviors (i.e, insists on opening and closing the door)
 If you notice any of the warning signs detailed above, you may be observing the presence of a possible speech, language, or listening problem or disorder. Parents know their children best. Get your child the help he/she needs today. Research tells us that “early identification of language delays will give children a better chance of developing pre-reading and academic skills” (Spivey 2013). With the guidance of an SLP, parents can learn how to help their children develop age-appropriate speech, language and listening skills.