If you're concerned about your child's speech and language development, there are some things to watch for. An infant who isn't responding to sound or who isn't vocalizing is of particular concern.
Between 12 and 24 months, reasons for concern include a child who:
- isn't using gestures, such as pointing or waving bye-bye, by 12 months
- prefers gestures over vocalizations to communicate at 18 months
- has trouble imitating sounds by 18 months
- has difficulty understanding simple verbal requests
Seek an evaluation if a child over 2 years old:
- can only imitate speech or actions and doesn't produce words or phrases spontaneously
- says only certain sounds or words repeatedly and can't use oral language to communicate more than his or her immediate needs
- can't follow simple directions
- has an unusual tone of voice (such as raspy or nasal sounding)
- is more difficult to understand than expected for his or her age.
Parents and regular caregivers should understand about half of a child's speech at 2 years and about three quarters at 3 years. By 4 years old, a child should be mostly understood, even by people who don't know the child.