First Time User? Enroll now.
COVID-19: Vaccine information, visitor restrictions, and additional resources | Medicaid: The program is changing and you must take steps to keep your UNC Health providers
Home > Health Library > Speech and Language Development
Speech and language are the skills we use to communicate with others. We form these skills during the first years of life. By age 6, most children learn the basics. Try to talk and read to your child often to boost these skills.
Speech is making the sounds that become words—the physical act of talking.
Language is our system of using words to communicate. It includes using words and gestures to say what we mean, and understanding what others say.
Infants start learning in the womb, where they hear and respond to familiar voices. The fastest learning occurs from ages 2 to 5 years.
Speech and language milestones help tell whether a child is developing as expected. Milestones are certain skills, such as babbling, saying "mama" or "dada," or putting two words together. Usually, a child needs to master one milestone before reaching the next.
Babies usually start cooing at around 2 months and are babbling by about 6 months. A child usually speaks in gibberish, called jargon, by the first birthday. At 15 to 18 months, a typical toddler understands much more than he or she is able to put into words. Starting around 18 months, many children have a burst in talking. By 24 months, children tend to use at least 50 words and are also starting to use two-word phrases.
Keep in mind that the age at which children reach milestones varies from child to child. Some children, especially girls, are advanced. Others develop more slowly.
A child who is surrounded by speech and language all the time usually learns language skills faster. Talking to and reading to your child will have a big effect on how well your child is able to communicate later. Children who are seldom spoken to or read to usually learn to talk later than other children their age.
Sometimes there is a reason that a child has a speech and language problem. For instance, a child may have a language delay because of trouble hearing or because of a developmental disorder such as autism. Often, there is not a clear cause.
It's important to track your child's speech and language development. A child can overcome many speech and language problems with treatment, especially when you catch problems early.
Your doctor will check your child's speech and language skills during regular well-child visits. But call your doctor anytime you have concerns about how your child is developing.
Mild and temporary speech delays can occur. Some children learn new words faster than others do. But if your child is not saying words by 18 months, or says fewer than 50 words by 24 months, talk with your doctor.
Although speech and language continue to develop through adolescence, children usually reach major milestones in predictable stages by 6 years of age. The exact pace at which speech and language develop varies among children, especially the age at which they begin to talk.
Communication skills are often categorized as receptive language and expressive language. Receptive language is the understanding of words and sounds. Expressive language is the use of speech (sounds and words) and gestures to communicate meaning.
Developmental milestones can be described according to age.
Mild and temporary speech delays can occur in some children.
Some children learn new words faster than others do. If your child is not saying words by 18 months, or can say fewer than 50 words by 24 months, talk with your doctor. All children with a speech delay should have their hearing tested.
Keep in mind that many different things determine a child's speech development. Be aware of the common misconceptions about what causes speech and language delays, such as laziness or developmental differences between boys and girls. Even if some of these things contribute to a child's speaking slightly later than others of the same age, they are not the cause of significant speech delays. True delays are related to developmental or health issues, such as some types of hearing loss or a family history of speech and language delay.
Red flags for speech and language developmental delays are generally based on established speech and language milestones. Talk to your child's doctor any time you have concerns. It is critical to identify speech and language delays early and rule out other conditions, such as difficulty hearing. Early diagnosis allows the doctor to recommend treatments that can help prevent long-term problems.
While they learn and master new language skills, children sometimes talk in ways that are demanding or impolite. For example, a child may say "Give me!" when he or she wants a toy. Often this behavior is the result of children's inability to find the words that fit their feelings, or they are simply repeating what is being said around them. Gently remind your child to use an appropriate voice and manners. And consistently model polite speech and behavior.
Some parents think that their child is constantly talking or chattering. This is a child's way of practicing. It is not necessary for parents to listen and respond to everything a talkative child says, but don't completely tune out your chatterer either. Singing and dancing with your child and playing music or reading stories geared toward children will help your child learn to listen and to express himself or herself.
Most children make developmentally appropriate "mistakes" when they first learn to talk. For example, children commonly mispronounce words, such as saying "pasghetti" for "spaghetti." As children listen to other people, they often correct their mistakes. They learn to say words clearly and use grammar correctly through practice.
During routine well-child visits, the doctor uses various methods to test your child's development. You'll often answer questions about whether your child has reached milestones for his or her age. And the doctor will use your comments to assess your child's speech and language development. If your child is suspected of having a speech or language delay, the doctor will refer your child to a speech-language pathologist to have specific tests that measure nonverbal intelligence, language skills, and vocabulary.
Hearing problems can be an important cause of speech and language delays in children. For this reason, hearing tests are very important when there is any suspected speech and language development delay. Hearing problems that are caught and treated within 6 months after birth may help prevent some developmental problems, including those related to speech and language development.
The United States Preventive Services Task Force recommends that all newborns be screened for hearing loss.footnote 1 Most newborns in the U.S. are screened for hearing loss before leaving the hospital. Call your doctor if at any time you think your child may have a hearing problem. Even if the newborn test did not show hearing loss, hearing problems could arise.
Call your doctor anytime you or another caregiver has concerns about your child's speech and language development. Be aware of signs that point to a possible developmental delay, such as when your child does not make sounds that are expected for your child's age.
Your doctor will do a physical exam and ask questions about your child's medical history. This information can help your doctor identify developmental patterns and assess whether any other conditions, such as hearing loss, are interfering with development.
Your doctor may also recommend other tests to:
Talking and reading to your baby and, later, encouraging conversation are vital contributions to your child's speech and language development. The size of a 2-year-old's vocabulary is directly related to how much parents and other caregivers have spoken to that child from infancy.
Newborn babies are programmed to learn, and most parents are naturally excellent language teachers. The kinds of interactions and conversations parents normally engage in with their children, from "baby talk" to repeating words, happen to be perfect language lessons. Talking, reading, listening, and responding to babies and young children usually are all that is needed to help them learn to talk.
Teaching sign language to babies 6 months or older could also help them in several ways. Signing gives babies a way to express their wants and needs when they can't talk. And it gives you another way to bond with your child.
Start reading to your child before he or she is 6 months old. And continue to read to your child each day. Reading to your young child is an especially important learning activity for several reasons. While reading, you and your child share a comforting closeness. You also both focus on the same picture and the same concept. Your child can ask you questions, and you can reinforce his or her observations. Reading provides opportunities for children to learn new words that they would not normally come across in everyday conversation. Reading frequently to your child may help with his or her speech development, later reading abilities, and school performance.
If you have concerns about your own reading skills, seek out an adult reading program at your local library or public school system. You can also see America's Literacy Directory online to find reading programs in your area. The website address is www.literacydirectory.org.
To encourage and support your child's speech and language development:
U.S. Preventive Services Task Force (2008). Universal screening for hearing loss in newborns: Recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf08/newbornhear/newbhearrs.htm.
Current as of:
February 10, 2021
Author: Healthwise StaffMedical Review: Susan C. Kim MD - PediatricsJohn Pope MD - PediatricsKathleen Romito MD - Family MedicineLouis Pellegrino MD - Developmental Pediatrics
Current as of: February 10, 2021
Author: Healthwise Staff
Medical Review:Susan C. Kim MD - Pediatrics & John Pope MD - Pediatrics & Kathleen Romito MD - Family Medicine & Louis Pellegrino MD - Developmental Pediatrics
To learn more about Healthwise, visit Healthwise.org.
© 1995-2021 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
1505 SW Cary Parkway
REX Healthcare of Cary, Suite 210
Cary, NC 27511
2076 NC Highway 42 W.
Johnston Professional Plaza, Suite 100
Clayton, NC 27520
781 Avent Ferry Road
REX Healthcare of Holly Springs, Suite 212
Holly Springs, NC 27540
4414 Lake Boone Trail
REX Medical Plaza, Suite 505
Raleigh, NC 27607
910 Berkshire Road
Smithfield, NC 27577