Communication Milestones: Ages Ranges

Board takeaway

• Purpose: Use communication milestones to recognize concerns and tailor the visit to the child's abilities.
• Assess: Assess hearing, receptive and expressive language, speech, and social communication together; normal development varies, including between siblings.
• Refer: Missing many milestones in an age range warrants assessment by an ASHA-certified audiologist or speech-language pathologist (SLP), available through ASHA ProFind.
• Limit: The checklist supports referral and counseling rather than making a diagnosis.

Compare expectations without turning ranges into deadlines

Assess hearing, receptive/expressive language, speech, and social communication together. Missing many milestones warrants audiology/SLP assessment; a checklist alone is not a diagnosis. Retain multilingual counseling and caregiver supports below.

Birth through 12 months

Birth–3 months

• Responds to sound and voices.
• Settles or smiles with speech.
• Exchanges vocalizations, coos, and changes sounds with mood.
• Recognizes familiar people and some objects.

4–6 months

• Laughs.
• Responds to facial expressions.
• Visually tracks interesting objects.
• Reacts to sound-making toys.
• Vocalizes during play or mouthing objects.
• Varies vowels, sometimes adding consonants.
• Makes raspberries.

7–9 months

• Responds to name.
• Briefly pauses at a verbal prohibition.
• Produces repeated babble.
• Recognizes some names.
• Seeks familiar people when distressed, raises arms for pickup, and rejects unwanted objects.

10–12 months

• Reaches for objects by 10 months.
• Points, waves, and shares objects.
• Initiates or copies social gestures and games.
• Imitates sounds, enjoys dancing, understands simple phrases, and says one or two words.

Caregiver support across this age range

• Respond and imitate.
• Model gestures and turn-taking.
• Describe routines and outings.
• Teach animal sounds.
• Read, sing, and tell stories daily.
• Hearing safety: observe responses to noises and speech. Ear pulling with crying may indicate ear trouble; consult the child's doctor when concerned.

13–24 months

13–18 months

• Responds to location questions and simple directions.
• Points to request, comment, or inquire.
• Gestures yes/no.
• Understands and uses familiar words for people, objects, and some actions.
• Identifies at least one body part.
• Uses expressive gestures and mixes babble with words and speech-like intonation.

19–24 months

• Understands and uses at least 50 words.
• Combines two or more words.
• Follows two-step directions.
• Uses personal pronouns, possessives, and words to request help. Pronunciation may remain unclear.

Caregiver support across this age range

• Imitate environmental sounds.
• Name and describe everyday objects.
• Practice two-step requests.
• Expand the child's words into short sentences.
• Read picture books daily and invite pointing or naming.

2–3 years

• Frequently combines words; occasional repetition of words or phrases may occur.
• Requests attention, states own name, uses some plurals and present-progressive/past-tense endings.
• Explains reasons, asks why/how, and answers simple functional questions.
• Produces p, b, m, h, w, d, n and most vowels correctly in words; unfamiliar listeners may still have difficulty understanding.

Caregiver support

• Speak clearly and expand utterances.
• Request clarification when needed.
• Teach descriptive words, synonyms, counting, and categories.
• Discuss pictures and label them in writing.
• Offer choices and wait for answers.
• Use songs, rhymes, and finger games.

3–4 years

• Uses comparisons, location words, and articles; retells stories; pretends to read/write, recognizes signs, and writes some letters.
• Produces t, k, g, f, y, and the sound represented by -ing correctly; includes all syllables and sounds across word positions.
• By 4: generally fluent, with repetitions absent most of the time; most speech is understandable. Errors may remain on l, j, r, sh, ch, s, v, z, th.
• By 4: includes every sound position in consonant clusters, although individual sounds may still be substituted.

Caregiver support

• Discuss funny pictures, categories, and rhymes.
• Retell or act out stories.
• Ask playful questions.
• Use familiar daily activities in role-play to practice social communication.

4–5 years

• Uses longer, grammatically correct sentences; tells connected stories with characters and settings; uses at least one irregular plural.
• Understands and uses more advanced location and time words; follows simple game instructions and rules.
• Identifies a book's front/title; names 10 or more letters; usually writes own name; imitates left-to-right reading/writing; joins word parts and recognizes some rhymes.
• Produces most consonants correctly; conversation is understandable.

Caregiver support

• Discuss position, opposites, categories, similarities, and differences.
• Define new vocabulary and encourage questions.
• Allow conversational turns.
• Act out and predict stories.
• Use descriptive guessing games.
• Record dictated stories.
• Involve the child in games, planning, and choices.

Multilingual counseling

• Caregivers should use languages they speak comfortably, with daily opportunities to hear, practice, and read them.
• Learning multiple languages does not cause speech/language problems or prevent later English learning.
• Mixing languages within a conversation can be a normal part of multilingual development.

Common board traps

Answer aloud

What referral is appropriate when a 23-month-old misses many communication milestones?

Arrange assessment by an ASHA-certified audiologist or speech-language pathologist.

• Assess hearing, receptive/expressive language, gestures, and communication across settings.
• The 19–24-month range includes at least 50 words, combinations of two or more words, and two-step directions.
• Milestones identify concern; the checklist alone does not establish a diagnosis.

A 4-year-old is understandable but substitutes a sound in a consonant cluster. Is that necessarily abnormal?

No. By four, all cluster positions should be represented, but substitutions and later-developing sound errors may persist.

• Distinguish a substituted sound from an omitted position.
• Consider the wider communication pattern; missing many milestones warrants specialist assessment.

Parents want to stop their home language to improve speech. How do you counsel?

Support the languages the family uses comfortably; multilingual learning itself does not cause speech/language problems.

• Provide daily conversation, practice, and reading in those languages.
• Mixing languages can be normal multilingual development.
• Assess genuine communication/hearing concerns rather than attribute them to multilingual exposure.