What is a speech or language difficulty?

A difficulty may exist if a child exhibits a delay or disorder in the area of speech or language. Speech is defined as the production of sounds and syllables. It is the verbal expression of language. Language has to do with meanings, rather than sounds. Language is defined as a system of verbal, written, or gestured symbols that are used to communicate. It is the progress of understanding and expressing information in a meaningful way.

Why is early intervention important?

The most valuable and critical period for acquiring speech and language skills is the initial 3 years of life, when the brain is developing and maturing. During this time, the brain is best able to absorb speech and language. That is why it is so important to seek help. The earlier your child’s speech and language difficulties are identified and treated, the greater chance your child has for improvements and success in achieving his or her fullest potential. You should not “wait and see” if a problem goes away or continues. You may miss many months of valuable therapy.

What are some red flags?

“Red Flags” are essentially warning signs that an aspect of your child’s development may warrant a referral to a specialist. You may want to consult an ASHA-certified speech-language pathologist if you identify one or more of the following red flags in your child.

Keep in mind, this chart is meant merely as a general guide. It is not a comprehensive list of red flags. This content is for informational purposes only and should not be used to diagnose speech and/or language delays/disorders.

Age Red Flags
Birth to
6 months
  • No sounds (cooing)/quiet baby
  • Doesn’t react to you
  • No eye contact
  • No attention to voice or music
7 months to 12 months
  • Quiet baby—few vocalizations
  • No sound play or babbling
  • No pointing or gesturing by 12 months
  • Does not respond to voice or sounds
12 months to 24 months
  • No communicative gestures such as pointing or pulling
  • Vocalizations with only vowels
  • No imitative skills
  • No response to parent’s vocalizations
  • Limited variety of consonants
  • Limited spoken vocabulary
  • No response to name, directions, or questions
24 months to 36 months
  • Unintelligible speech
  • Limited vocabulary
  • No 2-word combinations
3 years
  • Unintelligible speech
  • Limited vocabulary
  • Lack of longer utterances
  • Limited consonants
  • Minimal response to questions or directions
4 years
  • Difficulty following 2 or 3‐step directions
  • Limited vocabulary use (average of 1,500 words at this age)
  • Difficulty with concepts such as big/little, open/close
  • Does not use at least 4‐word sentences
  • Speech is still difficult to understand
  • Difficulty listening to a short story and answering simple questions about it
5 years
  • Demonstrates difficulty with expression and/or understanding of language
  • Uses pronouns incorrectly
  • Speech is not understood by others
  • Does not engage in reciprocal conversation and/or make comments relevant to the situation
  • Cannot answer “how” and “why” questions, or questions about past or future events
6+ years
  • Vague expressive language skills that often leaves the communicative partner confused (i.e. difficulty with retelling stories or events)
  • A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately.
  • When there is a general concern shared by parents, caregivers or teachers regarding the child’s communication skills, including voice and fluency.

Whatever your child's age, recognizing and treating problems early on is the best approach to help with speech and language delays. With proper therapy and time, your child will likely be better able to communicate with you and the rest of the world.