Communication- The most important psychological need. Can be done with eyes, gestures, voice or even computers. Requires concentration, whatever the method. Necessitates the ability to receive information, interpret, and respond.


Feeding- The oral-motor precursor to speech. Involves ability to chew, swallow and drink safely, without coughing, choking or fatigue. Requires coordination between breathing patterns and movements of the mouth and tongue.

Speech- A method of communication using the voice. Involves the ability to sustain a long, effortless exhalation as the words are spoken. Requires the fine muscles of the face, tongue, and jaw to move with absolute control. Should be easily understood by all.


        Outline of Speech and Language Development Skills-Communication:


0-3 Months: Maintains eye contact during feeding, shows different responses to parents voice, crying goes away with adult eye contact, smiles, appears relaxed with care, comfortable with handling, seeks parent interaction, laughs, shows interest in people, cries for attention, different cries for different needs, plays with rattle, looks at objects briefly, attempts to imitate facial expressions, quiets to familiar voice, moves to respond to voice, shows awareness, attends to other voices, attends to speakers mouth, vocalizes to smile and talk, vocalizes two different sounds, coos, produces hunger cry, vocalizes to express pleasure, cries for attention, makes sounds in back of throat

3-6 Months: Stops crying when spoken too, shows different responses for different caregivers, maintains eye contact, vocalizes, imitates facial expressions, smiles at self in mirror, reaches for objects, bangs objects, smiles and laughs during games, turns head towards voice, looks for voice, responds to other sounds, knows own name, responds to “no” sometimes, anticipates feedings, vocalizes to singing, takes turn vocalizing, laughs, babbles, stops babbling when spoken too, initiates talking, does sound play, whines with purpose, attempts to interact with adult, interrupts another person talking

6-9 Months: Response to “come here”, responds to name, responds to friendly and angry tones, initial separation of fear, desires to be with people, uses gestures with caregivers, gestures for protests, vocalizes to gain attention and to call others, smiles and laughs during games, participates in games with caregivers, anticipates play activities, searches for hidden objects, reaches for self in mirror, mouthing or banging of objects, knows family names, attends to music or singing, responds to “up”, responds to “no’ most of the time, maintains attention to caregiver talking, responds to sounds when not visible, stops when name is called, attends to pictures, vocalizes four syllables, vocalizes two-syllable combinations, vocalizes to objects that move, imitates syllables, vocalizes during games, sings to familiar songs, shouts for attention, says “mama” or “dada” meaningfully


9-12 Months: Shows sensitivities to other family members moods, displays fears of strangers, allows release of contact in new situations, social attention, indicates desire to change activity, vocalizes when person calls, plays peekaboo, reaches up to gesture to be picked up, waves “hi” and “bye”, extends arm when wants object, points to indicate awareness, resists removal of toys, tries to get objects out of reach, imitates stirring with a spoon, pushes toy car, attends to new words, gives objects back when requested, performs routine activities, looks at objects when named, follows simple commands occasionally, understands simple questions, gestures to verbal requests, attempts to verbalize to verbal requests, identifies body parts on self, imitates consonants and vowel combinations, imitates non-speech sounds, vocalizes with intent, uses word to call a person, says one to two words spontaneously, vocalizes for change of activity, imitates names of familiar objects

12-15 Months: Uses one or more words with meaning, is aware of social value of speech, understands simple instructions, imitates other children, responds to other children, turn taking, vocalizes for interactions, feeds others, combs/brushes hair and teeth, hugs dolls, animals or people, shakes head “no”, plays fetching game, imitates patting doll, shows shoes or clothing, explores toys, follows one step commands during play, responds to request to “use words”, maintains attention to pictures, performs finger play, responds to “give to me”, points to 2 action words, understands new words, identifies 3 body parts, says eight to ten words spontaneously, names one object frequently, varies pitch when vocalizing, imitates new words, combines vocalizations with gesture, imitates three animal sounds, wakes with a communication call, sings independently, takes turns vocalizing with children, asks to have needs met


15-18 Months: Plays away from familiar people, requests help, retreats to parents when unfamiliar person approaches, points to objects, controls behavior of self and others, uses words to protest, plays with toy in different ways, plays ball, puts objects inside other, hands toy to caregivers for help, imitates housework, identifies 6 body parts, finds objects not in sight, completes 2 requests with one object, chooses 2 objects upon request, understands 50 words, identifies objects by category, says 15 meaningful words, uses “t”, “d”, “n” and “h”, talks rather than using gestures, asks “what’s that?”, asks for “more”, names five to seven familiar objects

18-21 Months: Engages adult-like dialogue, uses words during pretend play, uses words to interact with others, takes turns during conversations, leads caregiver to object they want, indicates when wet, pretends play musical instrument, puts on or takes off clothing, pretends dance to music, gestures to request actions and toileting needs, groups objects, uses two toys in pretend play, identifies body parts and clothing, understands “sit down” and “come here”, identifies 4 body parts and clothing items on self, chooses five familiar objects, understands action words, identifies pictures when named, uses single words frequently, imitates two-three word phrases, imitates environmental noises (telephone, sirens), verbalizes two different needs, uses two-word phrases occasionally

21-24 Months: Pretends to pour from container, flies toy airplane, pretends to write, puts away toys upon request, attempts to repair broken toys, stacks and assembles toys, chooses one objects when requested in a group of five, follows two-step commands, understands new words rapidly, points to four action words in a picture, uses two-word phrases frequently, uses 50 different words, uses new words regularly, uses three-word phrases occasionally, refers to self by name, uses pronouns occasionally, 150-300 words=24 months

24-27 Months: Pretend talk on telephone, wipes hands and face, gives “five”, performs many activities during play, chooses toys selectively, uses toys appropriately, points to four action words in a picture, recognizes family member names, understands concept of one, understands size concepts, imitates two numbers or unrelated words upon request, uses three-word phrases frequently, asks for assistance with personal needs, uses action words

27-30 Months: Plays with other children, talks more in play with other children, shares toys, responds to simple questions, identifies four objects by function, understands location phrases, names one color, refers to self as “I” and “me”, uses two sentence types, responds to greetings, responds does not want something “no”, “not” or “don’t”

30-33 Months: Plays longer, acts out with familiar routines, pretends to perform caregivers routines, uses dolls as playmate, understands five common action words, follows two-steps unrelated commands, understands concepts of one and all, answers “yes” and “no” questions, imitates series of three numbers, uses plurals (socks, shoes, two eyes), uses prepositions (in, on, under or inside object), states gender, states first and last name

33-36 Months: Uses objects to represent other things, shows interest in why and how things work, follows three-step unrelated commands, identifies parts of an object, responds to “wh” questions, expresses recent activities through verbalizations (tells about their day), uses verb forms (walked, or walking), expresses physical state (hungry, tired, cold), converses in sentences, counts to three, 900-1000 words= 36 months

48 Months: Knows names of familiar animals, names common objects in picture books, knows more colors, uses prepositions (over and under), make-believe play, understands concepts of larger when a contrast is presented, readily follows simple commands even if stimulus of object is not in sight, much repetition of words, phrases, syllables, and even sounds, has most vowels and consonants p, b, m, w, n,

60 Months: Uses adverbs and adjectives, knows opposites (big-little, hard-soft, heavy-light), can count to ten, intelligible speech in spite of articulation problems, should have all vowels and consonants m, p, b, h, w, k, g, t, d, n, ng, y (yellow), should be able to repeat sentences as long as nine words, should be able to define common objects in terms of use (hat, shoe, chair) should be able to follow three commands given without interruptions, should know age, should know simple concepts- morning, afternoon, night, day, later, tomorrow, yesterday, today, should use long sentences and compound sentences, speech on the whole should be grammatically correct

6 Years: Should add these consonants f, v, sh, zh, th, Speech should be completely intelligible an socially useful, should be able to tell one a connected story about a picture