Since all children develop at their own pace, it may be difficult to know whether or not your child has a speech delay. However, the sooner delays are discovered and addressed, the better chance your child has if catching up to his or her peers. A speech delay could also signal a more serious issue, such as autism, learning disability or deafness. If your child isn’t hitting these milestones, contact your pediatrician.

Babies will start coo as early as two months old. Babbling starts at around four to six months. Babies should respond to sound right from birth. Most hospitals routinely test hearing on all newborns, but thy may sometimes miss problems. Newborns should startle at loud or unexpected noises, throwing their arms out and bringing them together and sometimes crying. Babies who are around four months should respond to your speech with babbling. If your baby does not respond to speech when not looking at you, it may signal a hearing problem.

By six months, your baby should babble syllables, look toward sounds, and listen when music is playing. Around nine months, your baby should be able to use different sound patterns and recognize different tones of voice. Your baby will also start to recognize that there is a name for every object.

At about 12 months, your child should say his or her first word, other than mama or dada. Toddlers at this age babble a wide variety of sounds that includes vowels and consonants. Your toddler should try to imitate words spoken by family members, and should follow simple, one-step directions.

Toddlers who are 18 months old should use anywhere from 5 to 20 words. They understand many more, and should identify common objects by pointing when asked. Children this age should know the names of at least two body parts, and point to them when asked. Some children this age will can follow simple two part directions.

By two years old your child should use about 50 words and understand around 200. Children this age should be able to point to all body parts when asked. They should also be forming simple, two-word sentences and following more complex instructions. Two-year-olds should also recognize images of themselves. 

If your child does not meet all of these milestones according to guidelines, it may be no cause for concern. Your child might start slowly and catch up over time. However, it may indicate a problem. Since treatment will be more effective the sooner it is started, any concerns about your child’s development should be brought to the attention of his or her health care provider.

Evaluation starts with your child’s regular healthcare provider. This will be a simple evaluation of the speech and listening skills the provider sees and hears combined with a description of your concerns. A referral may be made for a hearing test, in case that is the problem. Sometimes a neurological assessment is also given. If your child passes these evaluations, a referral will be made for a formal speech evaluation by a licensed speech pathologist. After the formal evaluation the pathologist will either set up regular speech therapy sessions or determine that none are needed. Children who start speech therapy early often catch up to their peers before starting school.