Warning signs

If any of the following are observed, speech-language screening is recommended.

These are “red flags” for a speech and/or language disorder.

12 Months

  • Does not point

  • Does not gesture – such as waving or clapping

  • Has limited or no babbling

18 Months

  • Does not respond to “no” or “bye-bye”

  • Does not use at least 10 words consistently

  • Does not discriminate between sounds well – such as ball/doll

24 Months

  • Less than 50% intelligible

  • Does not use at least six consonant sounds

  • Does not follow simple directions

  • Does not imitate names of familiar objects

  • Has a vocabulary of less than 50 words

  • Relies on gestures and grunting to communicate

  • No two-word meaningful phrases

36 Months

  • Deleting consonants at the end of words and/or beginning of words

  • Less than 75% intelligible – strangers can’t understand child

  • Has not mastered the following sounds: p, m, h, n, and w

  • Not using three-word phrases

  • Difficulty understanding and therefore answering a variety of questions

48 Months

  • Less than 100% intelligible

  • Has not mastered the following sounds: b, k, g, d, f, and y

  • Does not answer “wh” questions

  • Not using complete sentences and/or able to carry on simple conversations

Other Behaviors to Consider

  • Picky eater and/or gags on certain foods

  • Has difficulty with transitions

  • Demonstrates repetitive and/or odd behaviors

  • Shows no interest in communicating

  • Drools excessively

  • Stutters more consistently and for more than six months

  • Limited eye contact

  • Skips a major milestone

  • Doesn’t appear to hear and/or understand

  • Limited body awareness