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