Speech-Language & Swallowing Milestones

The following speech-language skills are typically found at the ages indicated.

Age	Speech-Language Skills	Feeding Skills
Birth to 2 months	Startles to loud sounds Quiets or smiles to voice Makes pleasure sounds (cooing) Vocalizes or cries for different needs	Takes 2-4 ounces of liquid per feeding Takes 6 or more feedings per day Sucks or suckles on a bottle (may lose some liquid from the mouth and tongue may be sticking out slightly)
3-4 months	Babbles Pays attention to and looks toward music and sounds Vocalizes excitement and displeasure	Takes 4-7 ounces of liquid Takes 4-6 feedings per day Improved coordination when sucking on a bottle, with up to 20 sucks in a row between pauses
5-6 months	Smiles Babbles Pays attention to and looks toward music and sounds Vocalizes excitement and displeasure	Takes liquids, infant cereal and pureed foods Takes 9-10 ounces of food or liquid per feeding Takes 4-6 feedings per day
7-9 months	Produces a variety of vowel and consonant sounds in their babble Vocalizes during games and songs Imitates duplicated syllables (e.g., “bababa”) Attends to music, speech and pictures Stops or responds to name or “no”	Takes thicker purees (i.e., Stage 2 baby foods) and mashed table foods Readily opens mouth to take food from a spoon May suck liquid from an open cup, losing liquid from the mouth and/or occasionally coughing/choking with larger mouthfuls Starting to eat simple solids and may move their tongue toward the sides if solids are placed on the molar regions
10-12 months	Says 1 or 2 words (e.g., bye-bye, mama, dada) Vocalizes with intent frequently Imitates more sounds Gives objects upon request Follows simple commands or routines with gestures or cues Enjoys speech games, such as Peek-A-Boo Starting to identify basic body parts	Can take multiple swallows in a row from an open cup Starting to bite into solid food (e.g., soft cookie), breaking off a piece to chew Begins independent hand-to-mouth feeding May occasionally lose food or saliva from the mouth while chewing
12-15 months	Attends to pictures Shakes head “no” Says or imitates 8 to 10 words Follows 1-step directions Responds to name	Takes liquids and ground, mashed or coarsely chopped table foods Can move solids from the center to the molar regions independently, using their tongue
18 months	Says 15 to 20 words Talks more than gesturing Asks “What's That?” and “More?” Understands 50 words	Does a better job of chewing and swallowing without losing food from the mouth Starting to move foods from side-to-side while chewing
21 months	Identifies a few body parts or clothing items on self Uses at 25-50 words Understands basic commands and questions (e.g., “Where's your shoe?”) Listens to stories, songs and rhymes Points to pictures in a book when named Frequently uses single words Occasionally uses 2-word phrases	Uses controlled, sustained chewing
24 months (2 years)	Uses 50-100 different words Uses 2-word phrases frequently Refers to self by their name Follows a 2-step direction (e.g., “Pick up your shoes and bring them to mommy”) Can choose 1 object from a group of several items	Able to drink from a cup without losing liquid from the mouth Chews and swallows solids without losing food from the mouth Regularly moves foods from side-to-side while chewing
30 months	Uses 3-word phrases frequently Tells you their name Asks for help Uses negation, such as “no” or “not” Uses action words Understands “big” and “little”
36 months (3 years)	Matches colors Names a few colors Answers simple “yes/no”, “what” and “where” questions Counts to 3 Uses sentences to communicate Follows a 3-step direction Correctly says the following sounds: m, n, ng, p, f, h, w, k, g, b, d and t Speech is 70-80% intelligible	Generally eats the same foods as the rest of the family
4 years	Speech is 90% intelligible Sentences may range 4 to 8 words in length Asks and answers a variety of “wh” questions Accurately relays a long story Starting to use complex sentences Starting to use grammatically correct sentences Counts to 10

Concerns

Your child may benefit from a speech-language or feeding-swallowing evaluation if you have concerns in any of the following areas:

Language

Child has not met typically expected milestones for speech and language development
Child stopped producing words that they were previously saying
Any regression in speech, language or social skills at any age
Reduced or no eye contact during play or communication
Does not respond to voice or sounds
Hoarse voice quality or frequent loss of voice
Child sounds as though they are speaking through the nose
Child's speech sounds like they always have a cold

Feeding & Swallowing

Poor weight gain, weight loss or failure to thrive
Choking, gagging or coughing during or after meals
Ongoing problems with vomiting during or after meals
Increased respiratory sounds or congestion during or after feedings
Food or liquids come through the nose when the child is eating or drinking
History of traumatic choking incident
History of poor eating and breathing coordination
Ongoing or recurrent respiratory issues
Delayed transition through food textures or from bottle to cup drinking
Aversion or avoidance of all foods in a specific texture or food group
Irritability, crying or arching during or after meals
Mealtimes are very difficult or take a long time to complete
Inappropriate or excessive drooling