Speech and Language Milestones

Hearing, speech, and language are all interconnected. Oftentimes, hearing difficulties are first noticed when a child does not respond to sounds appropriately or develops language skills slower than his or her peers. All children grow and progress at their own pace and reach milestones at different ages, but the list of guidelines below is an excellent place to begin if you suspect your child may have a hearing loss.

Infant hearing loss

Birth to Five Months

  • Vocalizes pleasure and displeasure sounds (laughs, giggles, cries, or fusses)
  • Vocally responds when a caregiver speaks


Six to 11 Months

  • Understands “no-no”
  • Babbles (says “ba-ba-ba”)
  • Says ma-ma or da-da without meaning
  • Tries to communicate by actions or gestures
  • Tries to repeat caregiver sounds
  • Says first word


12 to 17 Months

  • Answers simple questions non-verbally
  • Says two to three words to label a person or object
  • Tries to imitate simple words
  • Vocabulary of four to six words


18 to 23 Months

  • Correctly pronounces most vowels and n, m, p, h and begins to use other speech sounds
  • Vocabulary of around 50 words (pronunciation is often unclear)
  • Asks for common foods by name
  • Makes animal sounds such as “moo” or “woof”
  • Starting to combine words such as “more milk”
  • Begins to use pronouns such as “mine”
  • Uses phrases of two or more words

Toddler hearing loss

Two to Three Years

  • Knows some spatial concepts such as “in” or “on”
  • Knows pronouns such as “you,” “me,” “her”
  • Knows descriptive words such as “big” or “happy”
  • Vocabulary of 250 to 900 words
  • Uses three-word sentences
  • Speech becomes more accurate but may still leave off ending sounds
  • Answers simple questions
  • Begins to use more pronouns such as “you” or “I”
  • Uses question inflection to ask for something such as “my ball?”
  • Begins to use plurals such as “shoes” or “socks” and regular past tense verbs such as “jumped”


Three to Four Years

  • Groups objects such as foods, clothes, etc.
  • Identifies colors
  • Uses most speech sounds but may distort some of the more difficult sounds such as r, s, sh, ch, y, v, z, th – these sounds may not be fully mastered until age seven or eight
  • Uses consonants in the beginning, middle, and ends of words – some of the more difficult consonants may be distorted, but attempts to say them are sufficient
  • Strangers can understand much of what is said
  • Ability to describe the use of objects such as “fork,” “car,” etc.
  • Has fun with language – enjoys poems and recognizes language absurdities such as “Is that an elephant on your head?”
  • Expresses ideas and feelings rather than just talking about the world around him/her
  • Uses verbs that end in “ing,” such as “walking” and “talking”
  • Answers simple questions such as “What do you do when you are hungry?”
  • Repeats sentences


Four to Five Years

  • Understands spatial concepts such as “behind” and “next to”
  • Understands complex questions
  • Speech is generally understandable with some mistakes pronouncing difficult or complex words such as “hippopotamus”
  • Vocabulary of about 1,500 words
  • Uses some irregular past tense verbs such as “ran” and “fell”
  • Describes how to do things such as painting or drawing
  • Defines words
  • Lists items that belong in a category such as animals, vehicles, foods, etc.
  • Answers “why” questions

Young adult hearing loss

Five Years +

  • Understands more than 2,000 words
  • Understands time sequences (what happened first, second, third, etc.)
  • Carries out a series of three directions
  • Understands rhyming
  • Engages in conversation
  • Sentences can be eight or more words in length
  • Uses compound and complex sentences
  • Describes objects
  • Uses imagination to create stories

If your child has missed some of these milestones or appears to struggle with speech and language, consult your pediatrician. Your child may need to see an audiologist for a hearing screening.

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