Hearing Problems and Speech and Language Milestones

Children may reach speech and language milestones at different ages. But in some cases a child that isn’t developing speech and language on track may have a hearing problem.

Signs of a hearing problem

Being able to hear is important for good speech and language growth. A child who doesn’t respond to sounds or who isn’t developing language skills may have trouble hearing. The age guidelines below may help you know if your child has a hearing problem. Talk with your child's healthcare provider if you think your child isn’t developing speech and language skills on time.

Milestones of speech and language

Birth to 5 months

  • Coos

  • Makes sounds of pleasure and displeasure (laughs, giggles, cries, or fusses)

  • Makes noise when talked to

6 to 11 months

  • Understands "no-no"

  • Babbles (says "ba-ba-ba")

  • Says "ma-ma" or "da-da" without meaning

  • Tries to communicate by actions or gestures

  • Tries to repeat your sounds

  • Says first word

12 to 17 months

  • Answers simple questions without speech

  • Says 2 to 3 words to label a person or object (pronunciation may not be clear)

  • Tries to imitate simple words

  • Vocabulary of 4 to 6 words

18 to 23 months

  • Correctly says most vowels and n, m, p, h, especially in the beginning of syllables and short words; also begins to use other speech sounds

  • Vocabulary of 50 words, pronunciation is often unclear

  • Asks for common foods by name

  • Makes animal sounds, such as "moo"

  • Starting to combine words, such as "more milk"

  • Begins to use pronouns, such as "mine"

  • Uses 2-word phrases

2 to 3 years

  • Knows some spatial concepts, such as "in," "on"

  • Knows pronouns, such as "you," "me," "her"

  • Knows words to describe things, such as "big," "happy"

  • Uses 3-word sentences

  • Speech is becoming more accurate, but may still leave off ending sounds; strangers may not be able to understand much of what is said

  • Answers simple questions

  • Begins to use more pronouns, such as "you," "I"

  • Raises pitch when asking for something, such as "my ball?"

  • Begins to use plurals, such as "shoes" or "socks" and regular past tense verbs, such as "jumped"

3 to 4 years

  • Groups objects, such as foods and clothes

  • Identifies colors

  • Uses most speech sounds, but may distort some of the more difficult sounds, such as l, r, s, sh, ch, y, v, z, th and these sounds may not be fully mastered until age 7 or 8

  • Uses consonants in the beginning, middle, and ends of words; some of the more difficult consonants may be distorted, but attempts to say them

  • Strangers are able to understand much of what is said

  • Able to describe the use of objects, such as "fork," "car"

  • Has fun with language; enjoys poems and recognizes language absurdities, such as, "is that an elephant on your head?"

  • Expresses ideas and feelings rather than just talking about the world around him or her

  • Uses verbs that end in "ing," such as "walking" and "talking"

  • Answers simple questions, such as "What do you do when you are hungry?"

  • Repeats sentences

4 to 5 years

  • Understands spatial concepts, such as "behind," "next to"

  • Understands complex questions

  • Speech is understandable, but makes mistakes pronouncing long, difficult, or complex words, such as "hippopotamus"

  • Uses some irregular past tense verbs, such as "ran," "fell"

  • Describes how to do things, such as painting a picture

  • Defines words

  • Lists items that belong in a category, such as animals and vehicles

  • Answers "why" questions

5 years

  • Understands time sequences (what happened first, second, and third)

  • Carries out a series of 3 directions

  • Understands rhyming

  • Can carry on a conversation

  • Sentences can be 8 or more words in length

  • Uses compound and complex sentences

  • Describes objects

  • Uses imagination to create stories