Communication Milestones
Did you know, 1 in 12 children ages 3-17 have a disorder related to voice, speech, oral language, written language, or swallowing (NIDCD, 2023)?
Did you know, more than 3 million Americans stutter (NIDCD, 2023)?
Did you know, nearly half of U.S. children ages 3-17 with a voice, speech, oral language, written language, or swallowing disorder have not received intervention services in the past year (NIDCD, 2023)?
Do you know what type of professional referral you should seek out if you believe your child has voice, speech, oral language, written language or swallowing deficits? Although most believe the answer is your child’s pediatrician, the answer is actually a Speech-Language Pathologist (SLP). You might need a referral from your child’s pediatrician; however, the referral you will want to ask for (if not already recommended) is for an evaluation by a licensed Speech-Language Pathologist.
A Speech-Language Pathologist works to prevent, assess, diagnose and treat speech, language, social communication, cognitive communication, and swallowing in children and adults (ASHA, 2023). Speech-Language Pathologists use the “evaluation and see” approach, while pediatricians sometimes use the “wait and see” approach. Don’t get me wrong, we love and value a good pediatrician; however, they aren’t experts on communication - and that is why we respect the pediatricians that refer their patients, who have even small delays, to an SLP to assess whether or not intervention services are warranted.
That brings me to introducing myself - my name is Marissa Kile, and I am a licensed SLP in Pana, Illinois. I have my own private practice, Impressive Speech Services. I see clients in my clinic as well as contract to school districts in order to assess and treat school-aged children (3-22 years). I started my private practice to help meet the needs in my community and surrounding communities that have an ongoing waitlist for children of all ages. I also had parents coming to me in tears and frustration, who after waiting months to be taken off a waitlist, were met with insurance issues and more red tape. I wanted to provide help to these children who desperately needed services. I wanted to provide services to my community that required no insurance, red tape, no waitlists, and 1 on 1 individualized services to obtain best results. That’s how Impressive Speech Services was founded. I continue to provide resources to our communities, regardless if my direct services are utilized or not, so I can help children expand their speech and language skills no matter their circumstances! With that in mind, I wanted to provide some information to help caregivers advocate for their children in all areas. In this blog, I will share: 1) how to get your child referred for an evaluation, 2) milestones for speech/language skills, and lastly, 3) tips you can do to increase speech and language growth at home.
First, the referral process - it can feel like you’re jumping through hoops at times, but hopefully with the information I provide, it will make the process a little less challenging. If you have concerns about your child’s development, the first step you will want to do is talk to your child’s pediatrician about your concerns. Documented concerns can help speed up the referral process. Next, you can ask your child’s pediatrician directly for a speech therapy evaluation referral. Depending on your child’s pediatrician, they might refer immediately or wait for the next wellness visit. I recommend you let your pediatrician know you want the referral as soon as possible to prevent the delay from growing. Your child’s pediatrician will likely refer you to an SLP in their facility. If your child is between the ages of 0-3, you can ask your pediatrician for a referral to the early intervention services your state provides (Illinois - Child and Family Connections) or call your nearest DHS office to refer your child yourself (phone # to locate your nearest DHS office: 1-800-843-6154). Early intervention programs can have long waitlists which is when you would want a referral to an outpatient speech therapy program or private practice. If you want to avoid referrals, waitlists, and insurance red tape, reach out to Impressive Speech Services and I will help you!
Secondly, let’s talk about communication milestones. I’ll briefly outline the American Speech Language Hearing Association’s milestones for 0-5 year olds. Children start to communicate the moment they are born via crying. As they age, they expand that communication more. So, here is what your littles should be doing based on their age:
For 0-3 month olds, babies should be alert to sounds, make different sounds for happy vs. upset, look towards voices of people talking, and make some vowel babble sounds (e.g., ooooo, ahhhh).
For 4-6 month olds, babies should start to laugh/smile at loved ones, respond to facial expressions, look at objects of interest, vocalize during play, and may even blow raspberries.
For 7-9 month olds, babies should look at you when you call their name, babble strings of consonants and vowels (e.g., ma ma ma, dadada, ba ba ba), look for loved ones when upset, raise arms to be lifted up, push away unwanted objects and more.
For 10-12 month olds, babies should be reaching for items, pointing, waving, imitating gestures, trying to copy sounds you make, responding to simple words like “look at mommy” or “go bye bye”, and should be saying 1-2 words (mama, dada, hi, bye).
For 13-18 month olds, babies should be looking around when asked “where” questions, follow simple directives, such as “give me ball”, point to make requests, identify one or more body parts, shake head no, and use several gestures + some words.
For 19-24 month olds, babies should use and understand 50 words, start to put 2 words together, follow 1-2 step directions, use words like me, mine, you, use words to ask for help and start to use possessives (e.g., daddy’s sock).
For ages 2-3 years old, toddlers should use word combinations, try to get adults’ attention, use plurals, say their name when asked, use -ing word endings, ask why and how, correctly produce p, b, m, h, w, d, n in words and make 2-3 word sentences.
For 3-4 year olds, toddlers should compare things like bigger and shorter, tell a story from a book, understand location words (e.g., in, on, under), pretend to read alone or with others, correctly produce t, k, g, f, y, say all syllables in words, and is understood by most of the people they talk to.
For 4-5 year olds, children should produce grammatically correct sentences, use time words (yesterday, tomorrow), recognize and name 10 or more letters and can usually write them independently, produce most consonants correctly and be understandable in conversation.
There are many reasons your child might not be reaching their milestones, including hearing loss, middle ear infections, developmental delay, or undiagnosed underlying disorders. If you feel like your child is not easily understood, has limited vocabulary or is not meeting their communication milestones, seek out a speech/language evaluation to determine if their errors are age-level or not.
Last, but not least, if you made it this far in the blog, I’ll share some tips to help promote speech and language growth at home. I’ll provide three tips, but if you’d like more, please reach out. I have so many tips and techniques, I could probably write a book on them to elicit speech and language growth.
Tip 1 is repetition. Children hear sounds and words THOUSANDS of times before attempting imitation. The more repetitions and models of a word you provide, the more likely they will imitate it.
Tip 2 is self-talk. Self-talk is narrating what you are doing during daily routines and activities. Research shows a strong correlation between increased language acquisition in children whose parents frequently use self-talk
Tip 3 is parallel talk. Parallel talk is narrating what your child is doing during daily routines and play activities. Research also shows a strong correlation between increased language acquisition and parents who use parallel talk.
I’m very passionate about helping others communicate, advocating for those who struggle to communicate, and being a resource for parents. I am here to support you mommas (or other caregivers) no matter what step of the journey you are on. If you, or someone you know has communication concerns, please reach out and I will help in any way I can. And, if you read this blog entirely, thank you for sticking it out. I hope you learned something new!
Marissa Kile
M.S., CCC-SLP
Speech Language Pathologist
Owner of Impressive Speech Services
