Amy Kallenbach Speech Therapists
Amy Kallenbach Speech Therapists
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Does my child need speech therapy?

Children are beautifully unique and develop communication skills at their own rate. However, between certain age ranges (for example, between 18-24 months or 2-3 years old), important skills should be developing. Below are some red flags or warning signals (in age stages) that indicate a possible speech-language difficulty. 


Please be aware that should you notice a single red flag at a specific age stage, this does not necessarily mean that there is a problem. However, should you note 2,3 ,4 or more at or below your child’s age, a consultation with a speech-language therapist is warranted. In addition, should you, your child’s doctor, or teacher have any concerns, please do not wait and see and rather get into contact with me.


*information gathered from ASHA-American Speech-Language-Hearing Association, SAC-Speech-Language & Audiology Canada and The Hanen Centre


Some Warning Signals or Red Flags of a Possible Communication Difficulty

By 3 months

  • Doesn’t startle to loud sounds 
  • Doesn’t sooth/calm to a familiar voice
  • Doesn’t smile at you
  • Doesn’t make cooing sounds

By 6-7 months

  • Doesn’t move eyes to the direction of the sound
  • Doesn’t notice toys that make sound or respond to music
  • Not babbling (e.g.: pa, ba,) or making different sounds
  • Doesn’t make sounds back when you talk (such as cooing, babbling, laughing)

By 12 months

  • Doesn’t turn and look in the correct direction of a sound.
  • Doesn’t respond to her/his name
  • Doesn’t babble with changes in tone or sounds (e.g.: dadadadadadadadada or badabadamimi)
  • Doesn’t use gestures like waving “hi/bye”, shaking head for “no” or reaching for ‘up’
  • Doesn’t let you know in some way (i.e., using sounds and/or actions) what s/he wants or if s/he needs help with something.

By 15 months

  • Doesn't understand and respond to words such as "no" and "up"
  • Not saying any words
  • When asked “Where’s the...?” doesn’t point to the relevant objects or pictures 
  • Doesn’t point to things that grab his/her attention as if to say, “Look at that!”  and then look straight at you

By 18 months

  • Doesn’t understand and respond to simple commands such as "Don't touch"
  • Uses less than 20 single words 
  • Doesn’t respond with a word or gesture to a question such as “What’s that?” or “Where’s your shirt?”
  • When asked to show two or three major body parts (such as head, nose, eyes, and feet), s/he is unable to do so
  • Doesn’t look at your face when talking to you

By 24 months

  • Uses fewer than 100 words
  • Doesn’t consistently join two words together like "Teddy gone" or “sock off” 
  • Doesn’t take turns in a conversation
  • Doesn’t pretend with toys, such as feeding a doll or making a toy man drive a car
  • Doesn’t follow 1-part instructions such as “kick the ball”
  • Not saying the sounds /p/, /b/, /m/, /h/, and /w/ correctly in words most of the time 

By 30 months 

  • Uses fewer than 300 words
  • Doesn’t use action words like “run”, “eat”, “fall”
  • Not using more mature grammatical markers, such as “two cups” and “baby eating”

By 3 years 

  • Doesn’t understand opposites such as big-little, up-down
  • Struggles to follow 2-part instructions such as “Get the apple and put it in the bag”
  • Doesn’t ask questions
  • Not using sentences of 3 or more words most of the time (e.g.: “I don’t like apples”, “My car is here”)
  • Not using words such as ‘in’, ‘on’ and ‘under’
  • Not saying the sounds /k/, /g/, /f/, /t/, /d/, and /n/ correctly in words most of the time. 

By 4 years 

  • Doesn’t understand words for family such as ‘brother’, ‘grandmother’
  • Struggles to answer a variety of simple questions such as ‘who’, ‘what’, and ‘where’
  • Doesn’t put 4 words together consistently in a sentence (e.g.: “I put Teddy over there”)
  • Struggles to talk about what happened during the day (i.e., daily activities)
  • Doesn’t ask ‘when’ and ‘how’questions

By 5 years:

  • Not saying most speech sounds in words correctly
  • Doesn’t understand words for order (e.g.: ‘first’, ‘next,’ ‘last’) and time (e.g.: ‘yesterday’, ‘today’, ‘tomorrow’)
  • Struggles to follow classroom directions (e.g.: Cross out the animals on your page that live on the farm)
  • Not using more complex sentences that have more than one action word (e.g.: “I jumped over two hoops but Mark jumped over three”)
  • Experiences difficulty with telling a short story
  • Struggles to recognise familiar signs (e.g.: the Woolworths sign) 
  • Difficulty with rhyming, clapping words into syllables, identifying the beginning sound in words and learning letters and their sounds

School-going children (i.e., 5 years +) may show the following, although not limited to, difficulties:

  • Immature articulation errors and difficulty articulating several longer words (e.g.: ‘electrician’, ‘hippopotamus’)
  • Immature grammatical errors (e.g.: “The girl have a horse” ‘Then she ridedthe horse to the castle’’)
  • Difficulty in telling stories as the length and detail of the stories increases 
  • Struggles to provide adequate descriptions and/or explanations
  • Difficulties in sounding out words and the manipulation of sounds in words. Challenges with letter-sound recognition and identification of sounds in words may persist
  • Difficulties in reading grade appropriate texts accurately and fluently
  • Struggles with applying a strong set of spelling strategies.
  • Challenges in understanding the main idea or in making inferences from the text
  • Struggles expressing ideas through writing

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