Speech Therapy



What is a Language Disorder?

Some children have problems with understanding, also called receptive language. They may have trouble:



  • Understanding what gestures mean

  • Following directions

  • Answering questions 

  • Identifying objects and pictures 

  • Taking turns when talking with others 

Some children have problems talking, also called expressive language. They may have trouble:

  • Asking questions 

  • Naming objects

  • Using gestures

  • Putting words together into sentences 

  • Learning songs and rhymes 

  • Using correct pronouns, like "he" or "they" 

  • Knowing how to start a conversation and keep it going 

Many children have problems with both understanding and talking.

Some children also have trouble with early reading and writing, such as:


  • Holding a book right side up

  • Looking at pictures in a book and turning pages

  • Telling a story with a beginning, a middle, and an end

  • Naming letters and numbers

  • Learning the alphabet


What is a Speech Disorder?

Most children make some mistakes as they learn to say new words. A speech sound disorder occurs when mistakes continue past a certain age. Every sound has a different range of ages when the child should make the sound correctly. Speech sound disorders include problems with articulation (making sounds) and phonological processes(sound patterns).


To see the age range during which most children develop each sound, visit Talking Child's speech chart.

Childhood apraxia of speech (CAS) is a motor speech disorder. Children with CAS have problems saying sounds, syllables, and words. This is not because of muscle weakness or paralysis. The brain has problems planning to move the body parts (e.g., lips, jaw, tongue) needed for speech. The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words.



What is a Voice Disorder?

Voice disorders are classified as problems with voice quality, loudness, pitch, and resonance. The major cause of voice disorders in children is vocal abuse (using the vocal cords incorrectly and in a damaging way). The speech-language pathologist can assist the child by identifying situations that promote poor vocal habits along with teaching proper vocal hygiene.



What is a Fluency Disorder?

Stuttering is a disorder of speech that affects the fluent production of sounds, words, phrases, and sentences. Types of dysfluencies include part-word repetitions (“d-d-d-dog”), prolongations (“b___oy”), broken words (“lis-ten”), whole word repetitions (“She She She”), phrase repetitions (“I want to, I want to go”), and interjections (“um”). In addition, secondary behaviors may occur. These behaviors are particular to the individual and develop as the individual tries to cope with his stuttering. Occasionally children experience a period of dysfluency between the ages of three and six. These are normal dysfluencies and can be characterized by interjections, whole word repetitions, and phrase repetitions.



What is Augmentative and Alternative Communication?

Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.

People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth


Speech and Language Milestones

By 9 to 12 months of age

Receptive Language


  • Responds when you call their name

  • Respond when you say "no"

  • Turn their head and look for a sound when they can't see what is making it (e.g. a noise coming from inside the cupboard or something behind them)

  • Anticipate what will happen next (e.g. giggle before you take your hands away in a game of peek-a-boo)

  • Look at objects or people when attention is given to them (e.g. pointing to a picture/person or an object such as a plane up in the sky

  • Take your hand when you hold it out and say "let's go!"

  • Understand common phrases/sayings used in the family

Expressive Language

  • Respond to someone by smiling or shying away

  • Use gestures, such as pointing, pulling or poking things to communicate what they want or need

  • Copy actions and sounds (e.g. clapping hands)

  • Vocalises some vowel like sounds (e.g. ee, oo)

  • Vocalise one or two consonant sounds (e.g. m, d, p)

  • Combine sounds to form a syllable (e.g. da, pa)

  • Seek attention from others around them

  • Play simple turn-taking games like peek-a-boo


By 12mths to 24mths

Receptive Language

  • Identifies common objects and pictures (e.g. points to common pictures in books or picks them up from a group of objects on the floor)

  • Identifies common body parts

  • Responds to "NO", "wait", "stop" (even if only briefly!)

  • Understands common simple directions which involve words such as:

    • Give it to me

    • Show it to me

    • Point to it

    • Where is it?

    • Put it down

    • Pick it up

  • Understand simple "what's that?" questions

  • Play with toys and use objects appropriately in play

Expressive language

  • Copies and imitates a lot of actions (like jumping, hand actions in nursery rhymes)

  • Copies and imitates lots of common words

  • Holds out toys or other objects to show people

  • Uses vocalizations to ask for things

  • Babble short strings which sounds almost like real words and sentences

  • Uses 50-200 words by 2 years

  • Combining 2 or more words together (e.g. "more ball", "no mum", "give me", "put down truck")

  • Label photos of objects

  • By 2yrs of age using words more often than gestures

  • Non-family members can understand 50-75% of the child's speech by 2yrs of age 


By 2yrs to 3yrs

Receptive language

  • Understand describing words

    • Open/close (car doors, doors, cupboards and toys)

    • Wet/dry

    • Big/little

    • Same/different

  • Understand place words

    • In/out

    • On/off

    • Up/down

    • Under/over

    • Top/bottom

  • Understand quantity words

    • More/gone

    • One/lots

    • Empty/full

  • Understand "wh" questions

    • What's this?

    • Yes/no questions (e.g. "Is this your drink?")

    • What is the boy/girl doing?

  • Understand the function of an object (e.g. "What do we do with a spoon?")

  • Have a large noun and verb vocabulary where they can point to a range of pictures

  • Understand gender (e.g. "Is this a boy or a girl?")

Expressive Language

  • Asks lots of questions (e.g. "What is that?", "Where is it?")

  • Label a large range of pictures and actions

  • Combines 2-4 word sentences often when talking

  • Answer simple "What's this?", "What is the boy doing?" and "Where is it?" questions

  • Answer "yes" and "no" questions

  • Uses "-ing" at the end of action words where appropriate (e.g. running)

  • Uses little words like "the", "a"

  • People other than family members can understand 75-100% of the child's speech by 3yrs of age


By 3yrs to 3.5yrs

Receptive Language

  • Understand describing words (hard/soft)

  • Understand quantity words such as (one/some/all)

  • Understand questions such as, "who is that?", "who is jumping/running/eating?"

  • Understand "where" questions (e.g. "Where is the ball?")

  • Identifies 2-3 colors. Can point to 2-3 different colors when a selection of different colored balls are placed in front of them

  • Understand negatives (e.g. "Point to the box with no toys")

Expressive Language

  • Uses 3-5 word sentences (e.g. "the boy is jumping")

  • Uses 800 words

  • Can answer simple questions (e.g. "who is that?")


By 3.5yrs to 4yrs

Receptive Language

  • Understand describing words (e.g. "tall/short", "long/short")

  • Understand place words such as "front/back", "next to", "inside/outside"

  • Beginning to understand "why?" questions

Expressive Language

  • Uses 1000-1500 words

  • Uses little words "is/are" and "he/she", "I", "me", "mine" correctly

  • Beginning to respond correctly to "why?" questions (e.g. "Why do you brush your teeth?")

  • Uses joining words such as "because", "then", "and" (e.g. "The boy is big and mean!")

  • Can tell a story of 2 events in sequence (e.g. "I went to the shops then to McDonalds")

  • Begins to use language for jokes and teasing

  • Might correct others

  • Asks a lot of "how", "why" and "when" questions and expects detailed answers

  • Becoming very intelligible to others in conversation


 By 4yrs to 5yrs

 Receptive Language

  • Comprehend between 2000-2800 words

  • Understand place words (e.g. "between", "above/below", "middle", "first/next/last")

  • Beginning to understand comparatives (e.g. "this one is big, and this one is bigger")

  • Understand difference between day and night

  • Beginning to understand "when" questions

Expressive Language

  • Uses 1500-2000 words

  • Uses joining words such as "if", "so", "but"

  • Uses possessive pronouns such as "his", "her"

  • Use words such as "could" and "would"

  • Combines five to eight words in a sentence

  • Repeats days of the week in sequence

  • Identify the odd one out from a group of three items

  • Tells a long story in sequence, but may not stick to the same idea throughout the story


By 5yrs to 6yrs

Receptive Language

  • Understand time concepts such as "morning/afternoon", "yesterday/tomorrow", "before/after", "now/later"

  • Understands and responds to "when" questions

  • By 6yrs of age knows "right" from "left"

Expressive Language

  • Using all pronouns correctly ("he/she", "his/her", "himself/herself", "me", "mine", "I" etc)

  • Names days of the week in order

  • Tells a long story maintaining theme and sequence

  • Grammar is mostly correct

  • By 6yrs of age able to identify and label a number of alphabet letters

  • Can Identify similarities and differences in objects


Bowen, C. (1998). Speech-language-therapy dot com. Retrieved from www.speech-language-therapy.com on (10/01/2011)
Gard, A. Gilman, L. Gorman, J. (1993). Speech and Language Development Chart (2nd ed.). Austin, Texas: Pro-edOwens, R.E. (2001)Language Development: An Introduction (5th Ed.). Boston: Allyn & Bacon.

Paul, R. (2001). Language Disorders from Infancy through Adolescence: Assessment and Intervention(2nd Ed.). St Louis, Missouri: Mosby, Inc.

Reynell, J. & Gruber, C. (1990). Reynell Development Language Scales. Los Angeles: Western Psychological Services.

Zimmeramn, I.L. Steiner, V.G. & Pond, R.E. (2002). Preschool Language Scale - Fourth Edition - Australian Language Adaptation (PLS-4). San Antonio: The Psychological Corporation.

If you have concerns regarding your child's communication skills, contact Chatterbox Pediatric Therapy to schedule an evaluation. 

Call us:


Find us: 

110 Pipemakers Circle, Ste 115   &  2451 B Hwy 17 South

Pooler, Ga 31322                                Richmond Hill, Ga 31324