Child-based Indicators

How do I know if my child needs a speech or language evaluation?

 

Indications of Evaluation Needs in children 6 to 36 months of age:

If by 6 months, your child does not yet:

  • Enjoy playful actions
  • Reach for objects
  • Turn head when he/she hears a voice
  • Recognize own name
  • Babble or vocalize, especially when being talked or sung to

If by 9 months, your child does not yet:

  • Engage in games by smiling or laughing
  • Search for objects when moved out of sight
  • Mouth objects or toys (oral exploration is very important!)
  • Attend to music or song
  • Respond to name being called
  • Wave when cued or prompted

If by 12 months, your child does not yet: 

  • Use gestures (reaching to be picked up/down, wave hi/bye, point to objects/toys when interested)
  • Imitate gross motor movements
  • Understand simple commands or questions
  • Identify any body parts
  • Say mama/dada (or variation) meaningfully
  • Imitate animal sounds, words or environmental noises
  • Use some words to gain attention, label toys/objects

If by 18 months, your child does not yet: 

  • Request help when needed (especially when motivated)
  • Use at least 15 words
  • Use consonant sounds /t,d,n,h/ or imitate /p,b/
  • Request “more”
  • Name/label favorite toys or name some familiar family members

If by 24 months, your child does not yet: 

  • Demonstrate pretend and symbolic play (e.g., pretend play with toys/use imagination and use objects to represent something else such as using a block to represent an ice cube in a cup)
  • Put toys away when toldFollow novel commands or follow two step instructions
  • Understand new words, especially when presented in various activities/situations 
  • Use two word phrases (including adding new words) and use or imitate 3 word phrases
  • Tell about something that happened
  • Use at least 50 words

Between 24-36 months, your child should demonstrate ability to: 

  • Identify body parts and clothing
  • Recognize actions
  • Understand use of objects (e.g., fork is for eating, cup is for drinking, crayon is for coloring)
  • Demonstrate understanding of basic concepts (e.g., big/little, cold/hot, open/closed, wet/dry, etc.)
  • Demonstrate understanding of quantity concepts (e.g., take one, give me some, etc.)
  • Use words to ask questions, tell about something that happened, make requests, and answer yes/no consistently
  • Use a variety of word combinations (i.e., phrases containing nouns, pronouns, adjectives, verbs)

 

Other indicators:

You should also consider having your toddler evaluated if you notice he/she:

  • Exhibits limited or inconsistent eye contact
  • Does not turn when name is called
  • Does not recognize familiar people’s names 
  • Does not localize to sound (e.g., look toward street when ambulance passes with sirens, look toward location of loud sounds)
  • Covers ears frequently when exposed to music, loud sounds, or seem bothered by commotion
  • Asks “what?” frequently
  • Does not appear to comprehend what was said
  • Answers questions inappropriately quite often
  • Does not yet initiate communication with peers or familiar adults (e.g., doesn’t seem to know how to interact with other kids at the park, doesn’t desire attention from familiar adults)
  • Is not talking or saying very little.
  • Talking mostly in vowels (e.g., "ih" or “ah” for “this” or “that”).
  • Using one frequently produced sound or syllable to represent a variety of words.
  • Not yet combining words into phrases or sentences.
  • Not yet babbling or talking, was a “good baby” with little or no fussing, whining, crying

Consider having your school-aged child be evaluated for speech or language if he/she:

  • Cannot be understood by peers and teachers
  • Has consistent speech sound errors
  • Receives speech or language services at school. Due to high caseloads, schools usually cannot offer individual sessions or the amount of minutes that would help the child progress more rapidly)
  • Has difficulty expressing ideas clearly, or if language is vague
  • Stutters 
  • Demonstrates word finding errors
  • Has a hard time learning new vocabulary words, using vocabulary words in the correct context, or has limited vocabulary
  • Has a hard time with retelling of a story, movie, or event
  • Exhibits difficulty with pronouns (e.g., “him went there”)
  • Has difficulty with topic maintenance during a conversation
  • Has difficulty understanding questions and following directions that are presented either verbally or are written

Download and print this list for reviewing and sharing.