Speech and language
Speech and Language Milestones: Birth to Seven
What most children do by each age, stated as a range rather than a deadline — and when to ask.
- Editorially Reviewed
- Evidence Based
- Patient Focused
Speech and language develop in a broadly predictable sequence, but the range of normal is wide and children vary considerably. Most children say a first word around their first birthday, combine two words by around two, and are understood by unfamiliar adults by around four. What matters more than any single milestone is the overall pattern: several things behind at once, a widening gap over time, or the loss of a skill previously held. Understanding also matters more than speaking, and it is easier to miss. If something concerns you, evaluation is free for children under three in the United States, requires no doctor's referral, and a parent can arrange it directly.
When to seek help
Any one of these is reason enough to ask. You do not need several.
- Your child has lost words or skills they previously had
- They do not respond to sound, or do not turn toward voices
- No babbling and no response to their own name by the end of the first year
- No pointing, waving, or showing by around 18 months
- Not putting two words together by around two
- Unfamiliar adults cannot understand them at four
- They seem to understand much less than you would expect
How to use this page
These are ranges, not deadlines. Most children reach these milestones somewhere within a window, and a child slightly behind on one thing is usually not a concern.
What matters is the pattern. Several areas behind at once, a gap that widens rather than closes, or a skill that has gone backward.
Premature babies are usually assessed against corrected age, adjusting for how early they arrived. Ask your pediatrician how long that adjustment applies.
Bilingualism does not cause delay. A bilingual child may have fewer words in each language while having a comparable total across both, and being told to drop a home language is outdated advice.
Milestones at a glance
The left column is what ASHA publishes for each age band, quoted where the wording is precise. The right column is the inverse of that milestone — what is worth raising if it has not happened by the end of the band. It is a prompt to ask, not a diagnostic threshold.
| Age | What most children do | Worth asking about if not |
|---|---|---|
| Birth to 3 months | Alerts to sound, turns or looks toward voices, quiets or smiles when you talk. Coos and makes sounds back and forth with you. | No reaction to sound, and no cooing or sound-making back and forth |
| 4 to 6 months | Reacts to toys that make sounds, responds to facial expressions, giggles and laughs. Makes vowel sounds, sometimes combined with a consonant. | No response to sounds or to your face, and no vocal play |
| 7 to 12 months | Looks at you when you call their name, stops for a moment at no, and responds to simple phrases. Babbles long strings of sounds, says one or two words, and points, waves, and shows or gives objects. | No babbling, no response to their name, and no gestures |
| 13 to 18 months | Points to make requests, to comment, or to get information, and uses gestures such as clapping or a high-five. | Not pointing and not using gestures |
| 19 to 24 months | “Uses and understands at least 50 different words for food, toys, animals, and body parts” and “puts two or more words together”. Follows two-step directions. | Not putting two words together |
| 2 to 3 years | Uses word combinations often, asks why and how. “Speech is becoming clearer but may not be understandable to unfamiliar listeners.” | Not combining words, or very hard for you to understand |
| 3 to 4 years | “By age 4 years, your child speaks so that people can understand most of what they say.” Mistakes on later sounds — l, j, r, sh, ch, s, v, z, th — are still expected. | Unfamiliar adults still cannot understand them |
| 4 to 5 years | “Produces grammatically correct sentences” that are longer and more complex, produces most consonants correctly, and tells stories with characters and settings. | Speech unclear in conversation, or cannot follow a two-step instruction |
| 5 to 7 years | Holds extended conversation, follows longer instructions, begins to understand figurative language, and develops reading and writing alongside spoken language. ASHA’s published milestones stop at five, so this band is described in general terms rather than quoted. | Persistent difficulty being understood, or difficulty following classroom instructions |
Understanding matters more than talking
Receptive language — understanding — develops ahead of expressive language, and difficulty with it is both more concerning and far easier to miss.
A child who understands well and says little has a different picture from a child who does neither, and the second is the more important to assess.
Why it gets missed: a child who does not understand can watch what everyone else is doing, follow the room, and appear to be keeping up. In a classroom that works for a surprisingly long time.
What to look for: following instructions without you gesturing; responding appropriately to a question rather than repeating it back; understanding words for things that are not in front of them.
Any assessment should test both. If only expressive language was assessed, that is worth asking about.
What helps at every age
Follow their lead. Name what your child is already looking at rather than redirecting them to what you want to talk about.
Wait longer than feels natural. Leave a pause after you speak, long enough to feel awkward. Children who are still developing language need more processing time than most adults naturally allow.
Expand rather than correct. They say "car," you say "big car" or "car goes fast." Modeling works better than correcting.
Comment more than you question. Comments teach language; questions test it. Most adults ask far more than they comment, and reversing that ratio is one of the more effective changes available.
Narrate your routines. What you are doing, while you are doing it. Repetition inside a predictable routine is how language is learned.
Read together, and let them lead it. Pointing at pictures, naming things, and going off-script all count.
Reduce competing noise. Television off during conversation, one person talking at a time.
How to get an evaluation
Do I need a referral?
No, if your child is under three. In the United States, the early intervention evaluation is free, has no income requirement, needs no diagnosis, and a parent can refer their own child directly. Search for early intervention in your state.
From three, request an evaluation from your school district in writing — that starts a legal timeline that a phone call does not.
Your pediatrician can also refer at any age.
What does it cost?
The early intervention evaluation is free. School district services are free where a child qualifies. Private therapy is available at any age and insurance coverage varies.
Bring video. A child says very little in an unfamiliar room, and recordings of them at home are genuinely useful to an assessor.
Where to go next
This page is the reference for speech and language milestones specifically. For anything wider:
- Speech and language — what speech is versus language, and the conditions involved
- Speech delay — what to do when milestones are not being met
- Stuttering · Apraxia of speech
- Speech therapy for infants and toddlers — what therapy actually involves
- Child development — milestones across all areas, not only speech
Frequently Asked Questions
Does being bilingual delay speech?
No. Bilingual children may have fewer words in each language while having a comparable total. Dropping a home language is outdated advice and is not recommended.
When do babies say their first words?
Most babies say a first word around their first birthday. ASHA places saying one or two words in the 7 to 12 month band, alongside babbling long strings of sounds and pointing, waving, and showing objects. Gestures come before words and matter just as much.
How many words should a 2-year-old know?
ASHA states that between 19 and 24 months a child "uses and understands at least 50 different words for food, toys, animals, and body parts" and "puts two or more words together." The combining matters as much as the count.
How can I help my child's speech develop?
Follow their lead, wait longer than feels natural after speaking, expand on what they say rather than correcting it, and comment more than you question. Reading together and reducing background noise both help.
My child was premature. Should I use their actual age?
Generally no — premature babies are usually assessed against corrected age. Your pediatrician can tell you how long that adjustment applies.
What should I do if my child is not meeting milestones?
Have hearing tested, then arrange an evaluation. Under three in the US it is free and you can arrange it yourself without a referral. From three, request one from your school district in writing.
At what age should my child's speech be clear to strangers?
ASHA states that by age four, a child "speaks so that people can understand most of what they say." Before that, familiar adults understand more than strangers do, which is expected rather than a concern.
My child understands everything but barely speaks. Is that better or worse?
Better than difficulty with both, but still worth assessing. Strong understanding with limited speech is a different picture from difficulty with both, and the plan differs.
Sources
- American Speech-Language-Hearing Association. Communication milestones — the consumer series covering birth to 1 year, 13–18 months, 19–24 months, 2–3 years, 3–4 years and 4–5 years. Checked August 19, 2026.
- Centers for Disease Control and Prevention. Learn the Signs. Act Early. — developmental milestone checklists. Checked August 19, 2026.
- Crowe K, McLeod S. Children’s English Consonant Acquisition in the United States: A Review. American Journal of Speech-Language Pathology; 2020;29(4):2155–2169. doi:10.1044/2020_ajslp-19-00168. DOI verified at Crossref; abstract read at Europe PMC.
Disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. If your child has lost words or skills they previously had, contact your child's doctor promptly.