Early Identification of Speech, Language, and Hearing Disorders

Are you worried about your child’s speech, language, or hearing? Know the signs, and get help early.

Identify the Signs

Children develop at their own rate. Some children walk and talk early. Others take longer. Most children learn skills within an age range, such as between 12 and 18 months. A child who takes longer to learn a skill may have a problem.

It is important that you know what to expect. Below are some signs of speech, language, and hearing problems. You’ll see the expected age range next to each skill.

Learn more about what to expect from your child from birth to five years old. You can also learn more about how to Identify the Signs.

Language Disorders

Language is made up of the words we use to share ideas and get what we want. Language includes speaking, understanding, reading, and writing. A child with a language disorder may have trouble with one or more of these skills.

Signs of language problems include:

Birth–3 months

Not smiling or playing with others

4–7 months

Not babbling

7–12 months

Making only a few sounds. Not using gestures, like waving or pointing.

7 months–2 years

Not understanding what others say

12–18 months

Saying only a few words

1½–2 years

Not putting two words together

2 years

Saying fewer than 50 words

2–3 years

Having trouble playing and talking with other children

2½–3 years

Having problems with early reading and writing. For example, your child may not like to draw or look at books.

You can help your child learn language by

  • Talking, reading, and playing with your child.
  • Listening and responding to what your child says.
  • Talking with your child in the language that you are most comfortable using.
  • Teaching your child to speak another language, if you speak one.
  • Talking about what you do and what your child does during the day.
  • Using a lot of different words with your child.
  • Using longer sentences, as your child gets older.
  • Having your child play with other children.

Speech Sound Disorders

Speech is how we say sounds and words. It is normal for young children to say some sounds the wrong way. Some sounds do not develop until a child is 4, 5, or 6 years old. Signs of a speech sound disorder in young children include:

1–2 years

Not saying p, b, m, h, and w the right way in words most of the time 

2–3 years

Not saying k, g, f, t, d, and n the right way in words most of the time. Being hard to understand, 

even to people who know the child well. 

You can help your child learn to say sounds by

  • Saying sounds the right way when you talk. Your child needs good speech models.
  • Not correcting speech sounds. It is okay if your child says some sounds the wrong way.


Most of us pause or repeat a sound or word when we speak. When this happens a lot, the person may stutter. Young children may stutter for a little while. This is normal and will go away over time. Signs that stuttering might not stop include:

2½–3 years

  • Having a lot of trouble saying sounds or words
  • Repeating the first sounds of words, like “b-b-b-ball” for “ball”
  • Pausing a lot while talking
  • Stretching sounds out, like “fffffarm” for “farm”

You can help your child by

  • Giving your child time to talk.
  • Not interrupting or stopping your child while he speaks.
  • Noticing if your child gets upset when stuttering. Pay attention to how she speaks.
  • Children who stutter may close their eyes or move their face or body when talking.

Voice Disorders

We use our voice to make sounds. Our voice can change when we use it the wrong way. We can lose our voice when we are sick or after talking or yelling a lot. Signs that your child may have a voice disorder include:

  • Having a hoarse, scratchy, or breathy voice.
  • Sounding nasal, or like he talks through his nose.

You can help your child by:

  • Seeing a doctor if your child’s voice sounds different and it does not go away after a short time.
  • Keeping your child away from cigarette smoke.

Hearing Loss

Some children have a hearing loss at birth. Others lose their hearing as they get older. Some signs that your child may have a hearing loss include:
Birth–1 year Not paying attention to sounds
7 months–1 year Not responding when you call her name
1–2 years Not following simple directions
Birth–3 years Having speech and language delays

You can help your child by

  • Making sure your child has a newborn hearing screening.
  • Taking your child to the doctor if he has an ear infection.
  • Seeing an audiologist if you worry about your child’s hearing.

Your Child’s Communication: First Grade

By the end of first grade, your child should be able to do the following tasks in each area.


  • Remember what they hear.
  • Follow two- to three-step directions in a row.


  • Speak clearly so that anyone can understand him.
  • Answer harder yes/no questions.
  • Tell and retell stories that make sense.
  • Share her ideas using complete sentences.
  • Use most parts of speech, or grammar, correctly.
  • Ask and answer who, what, when, where, and why questions.
  • Stay on topic and take turns in conversation.
  • Give directions.
  • Start conversations.


  • Say words that rhyme.
  • Name all sounds in short words.
  • Put sounds together to make words.
  • Match spoken words with written words.
  • Point to letters, words, and sentences.
  • Sound out words when reading.
  • Read 100 common words by sight.
  • Read grade-level books.
  • Understand what he reads.


  • Write about her ideas.
  • Print clearly.
  • Spell words that he uses a lot.
  • Begin each sentence with capital letters. End sentences with periods or question marks.
  • Write stories, journal entries, or notes.

Your Child’s Communication: Second Grade

By the end of second grade, your child should be able to do the following tasks in each area.


  • Follow 3–4 directions in a row.
  • Understand direction words, like here, there, over, next to, before, or later.
  • Answers questions about a second grade-level story.


  • Speak clearly.
  • Answer harder yes/no questions.
  • Ask and answer who, what, when, where, and why questions.
  • Use more complex sentences.
  • Explain words and ideas.
  • Give directions with 3–4 steps.
  • Use words to inform, persuade, and entertain.
  • Stay on topic, take turns, and keep eye contact during conversations.
  • Start and end conversations.


  • Know how letters make sounds in words, called phonics.
  • Recognize many words by sight.
  • Use clues when reading to figure out words. For example, looking at pictures or titles to help read a word.
  • Reread parts of a story and fix mistakes.
  • Find information to answer questions.
  • Explain important points of a story, like the main idea, characters, and plot.
  • Use personal experiences to guess what might happen next in a story.
  • Read and retell a story in the correct order.
  • Read grade-level stories and poetry silently and out loud smoothly.
  • Read on his own.


  • Write clearly.
  • Use different sentences to write essays, poetry, or short stories.
  • Use basic punctuation and capitalization.
  • Organize writing with a beginning, middle, and an end.
  • Spell words correctly that he uses a lot.
  • Stop spelling by sound and start spelling correctly. For example, she may move from “grl” to girl.”

Your Child’s Communication: Third Grade

By the end of third grade, your child should be able to do the following tasks in each area.


  • Pay attention in groups.
  • Understand grade-level information.


  • Speak clearly. Know when to talk with a soft or loud voice.
  • Ask and answer questions.
  • Be a part of conversations and group discussions.
  • Use words related to school subjects. For example, math, science, or history words.
  • Stay on topic, use eye contact, and take turns in conversation.
  • Summarize a story.
  • Explain what she learned in school.


  • Understand phonics, or how sounds and words go together.
  • Use word analysis skills. This means knowing root words, prefixes, and suffixes. For example, he can add the prefix “bi” to the root word “cycle” for “bicycle.” Or, he can add the suffix “ist” to the root word “cycle” for “cyclist.”
  • Use clues from a story to help understand what she reads.
  • Predict and explain what will happen next in stories. Compare stories and tell how stories are different.
  • Ask and answer questions about what he reads.
  • Use what she knows to learn about new topics.
  • Read grade-level books with few mistakes.
  • Reread and correct errors.


  • Plan, organize, revise, and edit.
  • Write stories, letters, and short reports.
  • Use details in writing. Spell simple words correctly. Correct most spelling without help. Use a dictionary to correct spelling.

Your Child’s Communication: Fourth Grade

By the end of fourth grade, your child should be able to do the following tasks in each area.


  • Listen to and understand information.
  • Form opinions based on what she hears.
  • Listen for specific reasons, such as to learn, enjoy, or convince.


  • Use words correctly in conversation.
  • Use language for many reasons, like asking questions, arguing, and joking.
  • Understand some figurative language. This is language that uses words in new or different ways. For example, “This classroom is a zoo!”
  • Take part in group discussions.
  • Give correct directions to others.
  • Summarize ideas in his own words.
  • Organize information so it is clear.
  • Give clear speeches.


  • Read for specific reasons.
  • Read grade-level books smoothly and with few mistakes.
  • Use what he knows to understand new material.
  • Follow written directions.
  • Take brief notes.
  • Link what she learns in one subject to other subjects.
  • Learn meanings of new words by looking at word origins, synonyms, and other meanings.
  • Use reference materials, like a dictionary.
  • Talk about the author’s reason for writing a story and about the writing style.
  • Read and understand different types of writing, like fiction, nonfiction, and poetry.
  • Make inferences from texts. This means that she guesses what a writer means when it is not stated clearly. She uses clues in the story and what she knows from her life to guess.
  • Talk about what she reads in her own words, called paraphrasing.


  • Write stories and explanations. Write many paragraphs about the same topic.
  • Develop a plan for writing that includes a beginning, a middle, and an end.
  • Organize writing around a main idea.
  • Edit final copies for grammar, punctuation, and spelling.

Your Child’s Communication: Fifth Grade

By the end of fifth grade, your child should be able to do the following tasks in each area.


  • Listen and draw conclusions in different classes.


  • Make planned speeches. She should know her audience and include information for that group.
  • Deliver a speech. He should keep eye contact and use gestures and a loud voice.
  • Take part in class discussions.
  • Summarize main points.
  • Report about information from group activities.


  • Read grade-level books smoothly and with few mistakes.
  • Learn meanings of new words by looking at word origins, synonyms, and other meanings.
  • Decide what information is important when reading.
  • Read different types of text, like fiction, nonfiction, and poetry.
  • Describe how a character and a plot develop.
  • Talk about poetry and what poems might mean.
  • Study an author’s language and style.
  • Use reference materials to support opinions.


  • Write for a variety of reasons.
  • Use many different words when writing.
  • Vary sentence structure.
  • Revise writing to make it clearer.
  • Edit final copies.
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