How do I know if my child's speech-language and feeding skills are developing appropriately?

Check our milestone chart to see if your child is on target.

Age

Speech-Language Skills

Feeding Skills

Birth-2 months

· Startles to loud sounds

· Quiets/smiles to voice

· Makes pleasure sounds (cooing)

· Vocalizes/cries for different needs

· Takes 2 to 4 ounces of liquid per feeding; 6+ feedings per day

· Sucks or suckles on a bottle (may lose some liquid from the mouth; tongue may be sticking out slightly)

3-4 months

· Babbles

· Pays attention to and looks toward music and sounds

· Vocalizes excitement and displeasure

· Takes 4-7 ounces of liquid; 4 to 6 feedings per day

· Improved coordination when sucking on a bottle, with up to 20 sucks in a row between pauses

5-6months

· Babbles

· Pays attention to and looks toward music and sounds

· Vocalizes excitement and displeasure

· Smiles

· Takes liquids and infant cereal and pureed foods

· Takes 9 to 10 ounces of food or liquid per feeding; 4 to 6 feedings per day

7-9 months

· Produces a variety of vowel and consonant sounds in their babble

· Vocalizes during games and songs

· Imitates duplicated syllables (e.g., “bababa”)

· Attends to music, speech and pictures

· Stops or responds to name or “no”

· Takes thicker purees (i.e., Stage 2 baby foods) and mashed table foods

· Readily opens mouth to take food from a spoon

· May suck liquid from an open cup, losing liquid from the mouth and/or occasionally coughing/choking with larger mouthfuls

· Starting to munch on simple solids, and may move their tongue toward the sides if solids are placed on the molar regions

10-12 months

· Says 1 or 2 words (e.g., bye-bye, mama, dada)

· Vocalizes with intent frequently

· Imitates more sounds

· Gives objects upon request

· Follows simple commands or routines with gestures/cues

· Enjoys speech games, such as Peek-A-Boo

· Starting to identify basic body parts

· Can take multiple swallows in a row from an open cup

· Starting to bite into solid (e.g., soft cookie), breaking off a piece to chew

· Begins independent hand-to-mouth feeding

· May occasionally lose food or saliva from the mouth while chewing

12-15 months

· Attends to pictures

· Shakes head “no”

· Says or imitates 8 to 10 words

· Follows 1-step directions

· Responds to name

· Takes liquids and ground, mashed, or coarsely chopped table foods (including easily chewed meats)

· Can move solids from the center to the molar regions independently, using their tongue.

18 months

· Says 15 to 20 words

· Talks more than gesturing

· Asks “What's That?” and “More?”

· Understands 50 words

· Does a better job of chewing/swallowing without losing food from the mouth

· Starting to move foods from side-to-side while chewing

21 months

· Identifies a few body parts/clothing items on self

· Uses at 25-50 words

· Understands basic commands and questions (e.g., “Where's your shoe?”)

· Listens to stories, songs and rhymes

· Points to pictures in a book when named

· Frequently uses single words

· Occasionally uses 2-word phrases

· Uses controlled, sustained chewing

24 months

(2 years)

· Uses 50-100 different words

· Uses 2-word phrases frequently

· Refers to self by their name

· Follows a 2-step direction (e.g., “Pick up your shoes and bring them to mommy”)

· Can choose 1 object from a group of several items

· Able to drink from a cup without losing liquid from the mouth

· Chews and swallows solids without losing food from the mouth

· Regularly moves foods from side-to-side while chewing

30 months

· Uses 3-word phrases frequently

· Tells you their name

· Asks for help

· Uses negation, such as “no” or “not”

· Uses action words

· Understands “big” and “little”

36 months

(3 years)

· Matches colors

· Names a few colors

· Answers simple “yes/no”, “what” and “where” questions

· Counts to 3

· Uses sentences to communicate

· Follows a 3-step direction

· Correctly says the following sounds: m, n, ng, p, f, h, w, k, g, b, d, t.

· Speech is 70-80% intelligible.

· Generally eats the same foods as the rest of the family

4 years

· Speech is 90% intelligible

· Sentences may range 4 to 8 words in length

· Asks and answers a variety of “wh” questions

· Accurately relays a long story

· Starting to use complex sentences

· Starting to use grammatically correct sentences

· Counts to 10

RED FLAGS

Your child may benefit from a speech-language or feeding-swallowing evaluation if you have concerns in any of the following areas:

Speech - language:

  • Child has not met typically expected milestones for speech and language development
  • Child stopped producing words that he/she was previously saying
  • Any regression in speech, language or social skills at any age
  • Reduced or no eye contact during play or communication
  • Does not respond to voice or sounds
  • Hoarse voice quality or frequent loss of voice
  • Child sounds as though he/she is speaking through the nose
  • Child's speech sounds like he/she always has a cold

Feeding and swallowing:

  • Poor weight gain, weight loss or failure to thrive
  • Choking, gagging or coughing during or after meals
  • Ongoing problems with vomiting during or after meals
  • Increased respiratory sounds or congestion during or after feedings
  • Food or liquids come through the nose when the child is eating or drinking
  • History of traumatic choking incident
  • History of poor eating and breathing coordination
  • Ongoing or recurrent respiratory issues
  • Delayed transition through food textures or from bottle to cup drinking
  • Aversion or avoidance of all foods in a specific texture or food group
  • Irritability, crying or arching during or after meals
  • Mealtimes are very difficult or take a long time to complete
  • Inappropriate or excessive drooling

If you have concerns regarding your child's voice, speech-language or feeding/swallowing skills, please schedule an evaluation.

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