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Developmental Milestones

Speech and Hearing at a Glance
Birth - 6 Months 
  • Startles or cries in response to loud sounds
  • Stirs or awakens when sleeping quietly and someone makes a loud sound
  • Makes “coo” or “aaah” sounds
  • Repeats the same sounds frequently and babbles

6-9 Months

  • Notices and turns head toward the side and source of new sounds
  • Responds to “no” and his/her name
  • Babbling increases.  Begins to use 2-syllable babbling
  • Makes many different sounds

9-15 Months

  • Turns head in any direction to find an interesting sound
  • Responds to name when spoken softly
  • Uses his/her voice to get attention
  • Begins to use single words
  • Gives toys to parents on verbal request

15-24 Months

  • Follows simple two-part requests (i.e., “Get your coat and put it on.”)
  • Uses about 15-20 words or more
  • Imitates words
  • Puts two words together (i.e., “more milk”)

2-3 Years

  • Notices different sounds, such as a dog barking or someone at the door
  • At two years has an expressive vocabulary of 50-250 words
  • At three years has a vocabulary of over 1000 words
  • Asks questions
  • Uses pronouns (i.e., “I”, “you”, etc.)
  • Uses two or three word sentences

3-4 Years

  • Understands conversation easily
  • Beginning to say many sounds correctly
  • Uses plurals (i.e. “toys”)
  • Uses four or five word sentences
  • Talks about experiences from recent past.
  • Speaks so that others (i.e. other than caregiver) can understand.  May speak with some disfluency such as whole word repetitions

4-5 Years

  • Hears and understands most speech, even when spoken quietly
  • Uses most sounds correctly, except possibly /th/, /r/, /l/, /ch/, and /sh/
  • Can define common words and explain how they are used (e.g. fork, scarf, etc.)


  • Your baby must hear well to learn to talk
  • No child is too young to have a hearing test
  • Your child will likely make some speech mistakes as he/she learns to talk
  • Contact your physician, an audiologist, or a speech-language pathologist if you are concerned about your child’s hearing or speech

Prepared for the Child Welfare Committee of the Ontario Medical Association
When does a child need a referral to a speech-language pathologist?

Seek answers if your child:

  • Shows no reaction to sound in the first three months of life
  • Is not babbling and making sounds by 10 months
  • Doesn’t gesture, show, give or point to get something by 12 months
  • Doesn’t pretend play (like feeding a stuffed toy) by 18 months
  • Is not using single words by 18 months
  • Doesn’t understand a variety of simple concepts like “big-little, up-down” by 24 or 30 months
  • Is not joining two words by 28 months
  • Shows other communication problems, or you have a sense that something is just not quite right with the child’s way of communicating or interactions
  • Shows signs of difficulty with feeding, chewing and/or swallowing development

Speech-language pathologists are in a number of programs and divisions across the city hospitals.  To find out more information on how to make a referral for a child, please call the Janeway at 777-4957 (Development Team) or 777-4804 (Rehabilitation Team). Referrals to speech-language pathology can be made by a parent, physician or other health care provider.




Updated Jun 27, 2012