Is my child’s speech age-appropriate?

Those magical first words from your baby are music to your ears! And that playlist typically grows as your child grows. But because every child is different and develops sounds, words and sentences at varying rates, you might be wondering if your child’s speech is appropriate for their age.An important factor to consider if you suspect your child might not be up-to-speed vocally is the ability to hear. Hearing is essential for proper speech and language development, and hearing problems can affect speech. Kids who have trouble hearing may have trouble saying, understanding, imitating and using language. Hearing problems may be suspected in children who aren’t responding to sounds or not developing their language skills appropriately.If you are suspicious that your child may not be developing speech and language skills correctly, talk to your child's pediatrician, who can refer you to an audiologist to test your child’s hearing whenever there's a speech concern.Here are some age-related speech and language milestones from the The National Institute on Deafness and Other Communication Disorders and other experts that may help you decide if your child’s speech is on track with their age group.Birth to 5 months

• Coos
• Vocalizes pleasure and displeasure sounds differently (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 nonverbally
• 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

• 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" or "on" and pronouns, such as "you," "me" or "her"
• Knows descriptive words, such as "big" or "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" or "I"
• Uses question inflection to ask 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 or 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. These sounds may not be fully mastered until age 7 or 8.
• Uses consonants in the beginning, middle and end 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" or "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 them
• Uses verbs that end in "ing," such as "walking" or "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" or "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" or "fell"
• Describes how to do things, such as painting a picture
• Lists items that belong in a category, such as animals or vehicles
• Answers "why" questions

5 years

• Understands time sequences (for example, what happened first, second or third)
• Carries out a series of 3 directions
• Understands rhyming
• Engages in conversation
• Sentences can be 8 or more words in length
• Uses compound and complex sentences
• Describes objects
• Uses imagination to create stories

What causes speech or language delays?According to KidsHeath.org, in addition to hearing problems, a speech delay might be due to:

• an oral impairment, like problems with the tongue or palate (the roof of the mouth)
• a short frenulum (the fold beneath the tongue), which can limit tongue movement

Many children with speech delays have oral-motor problems. These happen when there's a hitch in the areas of the brain responsible for speech, making it difficult to coordinate the lips, tongue and jaw to make speech sounds. These kids also might have other oral-motor problems, such as feeding difficulties.Ear infections, especially chronic infections, can affect hearing. But as long as there is normal hearing in one ear, speech and language should develop normally.As with any concerns or questions you have, talk to your pediatrician about whether your child’s development milestones are on track.