Smart Talk Speech

​Warning Signs that should trigger a referral to an SLP at any age:

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• Shows decline in ability to be understood by family, friends, and/or caregivers in the expression of basic needs, preferences, and feelings

• Speech is usually slurred; difficulty controlling respiration for speech; abnormal loudness, rhythm, or vocal quality

• Produces no meaningful words or sounds that are understood only by family

• Speaks loudly in high pitched voice with frequent distortion, omission, and substitution of sounds

• Exhibits difficulty learning sounds to form words; may sound nasal, strangled and/or breathy

• Sound errors are prevalent but variable (i.e., "dog" could be produced "dog," "tog," "gog," "god" by same child)

• Varies from rarely being able to produce sounds to ongoing speech that is rarely understood, or speech that is usually understood with frequent sound errors

• Unaware of sound variations or exhibits varying degrees of frustration and/or anxiety regarding inability to "control speech"

• Cannot produce movements for sound production or sounds are produced without voice (whispered speech)

• Exhibits frustration and/or avoidance of speech due to difficulties

 

Age-specific Warning Signs

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By 6 months:

• Does not laugh or squeal

• Does not look toward new sounds

 

By 9 months:

• Has limited or no babbling

• Does not indicate when upset

 

By 12 months:

• Does not point to objects

• Does not use gestures such as waving or shaking head

 

By 15 months:

• Has not used first word

• Does not respond to “no” and “bye-bye” appropriately

 

By 18 months:

• Does not use at least six to ten words consistently

• Does not hear well or discriminate between sounds

 

By 20 months:

• Does not use at least six consonant sounds (especially /p, b, m, n, w, h/)

• Does not follow simple directions

 

By 24 months (2 years):

• Has a vocabulary of less than 50 words

• Has decreased interest in social interactions compared with previously

 

By 3 years:

• Cannot be understood by family and/or caregivers more than 50% of the time

• Cannot correctly produce vowels and the consonants /p, b, m, w/ in words

• Cannot repeat when not understood without getting frustrated

 

By 4 years:

• Cannot be understood by family/strangers more than 75% of the time

• Cannot correctly produce /t, d, k, g, f /

• Cannot be asked to repeat without becoming sensitive

 

By 5 years:

• Cannot be understood in all situations by most listeners

• Cannot correctly produce most speech sounds

• Cannot be asked to repeat without exhibiting frustration

 

 

 

 

*Information courtesy of the American Speech-Language Hearing Association (ASHA) and the Linguisystems Milestones Development Guide (Flahive and Lanza, 2012)

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