By Registered Health Visitor – Julia Headland
Around 10% of children will have speech, language and communication needs and this number is set to rise following Covid where it has been found that, due to lockdown and mask wearing, babies social communication skills may have been impeded, suggests research published online in the Archives of Disease in Childhood (cited by Journal of Health visiting 2022).
I get many worried parents concerned that their child may have a speech and language delay so with this in mind, I thought I would look at 0-3 years and explore what is typical of this age group.
I hope to give you a benchmark so you can identify where you think there may be an issue and therefore it can be addressed early, as with nearly all developmental delays, early intervention has been shown to have better outcomes.
It is important to remember though, that as well as delays caused by covid, children develop their speech and understanding at different rates so please don’t fret if your child doesn’t fit exactly into the schedule of development below because this could change quite quickly but please speak with your Health visitor or GP if you are concerned and things haven’t improved. Below are some guidelines from Speech and Language UK (2023) for ages 0-3 years.
0-6 months
Your baby should usually be:
Turning towards a sound when they hear it.
Startled by loud noises.
Watching your face when you talk to them.
Smiling and laughing when other people smile and laugh.
Making sounds to themselves like cooing, gurgling, and babbling.
Making noises like coos and squeals to get your attention.
Having different cries for different needs, for example a cry when they are hungry often differs from a cry when they are tired.
Contact your Health Visitor if:
Your baby is not startled by loud noises.
Your baby does not engage in eye contact when spoken to.
If your baby does not smile when smiled at.
Your baby does not look at your face with interest when being spoken to.
6-12 months
Your baby should usually be:
Listening carefully and turning to someone talking on the other side of the room.
Looking at you when you speak and when their name is called.
Babbling strings of sound like mama, dada, no-no.
Making noises, pointing, and looking at you to get your attention.
Smiling at people when they are being smiled at.
Starting to understand words like ‘bye- bye’ and ‘up’ especially when a gesture is used at the same time.
Recognising the names of familiar objects like ‘car’ and ‘daddy’.
Enjoying action songs and rhymes and get excited when sung to.
Taking turns in conversations babbling back to an adult.
Contact your Health Visitor if your child does not:
Respond to noises by nine months.
Point to things they are interested in by 1 year.
12-18 months
As mentioned above, children develop skills at different rates but by 18 months, usually children will be able to:
Enjoy listening to music and singing and sometimes move their body to dance to the music.
Enjoy looking at simple picture books together with an adult, understand many more words than they can say, including the names of everyday objects like furniture, clothing, and body parts.
Understand some simple questions and instructions like “where’s teddy” and “kiss mummy”.
Say up to twenty single words such as cup, daddy, ‘dog’ to ask for things or to comment on what they see, even though it may not be clear yet.
Use a lot of babble and single words while they are playing, often sounding like they are speaking in sentences even though they are not saying real words.
Copy lots of things that they see adults doing like saying hello or waving goodbye.
Enjoy simple pretend play such as giving dolly a drink or pretending to talk on the phone.
Contact your Health Visitor if:
Your child does not babble to talk by 12-15 months.
Your child does not say their first words by 18 months.
Your child does not appear to understand some of what you say to them by 18 months.
2-3 years
By 3 years, usually children will:
Listen and remember simple stories with pictures.
Understand longer instructions such as ‘make teddy jump’ or ‘where’s mummy’s coat?’
Understand simple ‘who,’ ‘what’ and ‘where’ questions.
Use up to 300 words.
Put 4 or 5 words together to make short sentences, such as ‘want more juice’ or ‘he took my ball’.
Ask lots of questions. They should want to find out the name of things and learn new words.
Use action words such as ‘run’ and ‘fall’ as well as words for the names of things.
Start to use simple plurals by adding ‘s’ fir example ‘shoes’ or ‘cars’.
Use a wider range of speech sounds. However, many children will shorten longer words such as saying ‘nana’ for ‘banana.’ They may also have difficulty where lots of sounds happen together in a word, e.g., they may say ‘pider’ instead of ‘spider’.
Often have problems saying more difficult sounds like sh, ch, th and r. However, people that know them are likely to understand them.
Now play with other children and share things like toys.
Sometimes sound as if they are stammering or stuttering. They are usually trying to share their ideas before their language skills are ready. This is perfectly normal at this age, just show that you are listening and give them plenty of time and try not to interrupt them.
Contact your Health Visitor if:
Your child points or shows what they want rather than says it.
They only use single words instead of joining up words together into short sentences.
They are slow to respond to your instructions.
They rely on being shown what to do rather than being told.
You cannot understand most of what they say.
Ways in which parents/carers can help with the development of speech and language:
Always encourage the babies care giver to look at the baby when making sounds and talk to them when performing tasks like bathing, feeding, or getting them dressed.
0-6 months- advise parents and carers to hold their babies close, look and talk to them, sing to them, and repeat sounds.
From 6-12 months-parents and caregivers should be encouraged to name and point to things, look through
books, limit dummy use to sleep times only and encourage peek-a boo interaction games which will help with turn taking, attention and listening skills.
From 12-18 months- provide your child with choices through language, toys, books, songs, and nursery rhymes.
From 18-24 months, encourage your child to repeat words, use simple instructions and ask the child to point at things, limit time spent watching tv and encourage a small amount of time of interaction and play every day.
From 2-3 years-encourage your child to build sentences, say their name before the start of the sentence and start using words with meaning.
(NHS 2020)
If in doubt, remember the NSPCC campaign: ‘Look, Say, Sing, Play’. (NSPCC 2023)
———End———
For those people I have not yet met, my name is Julia Headland and I am a registered health visitor and registered general nurse with a degree in public health and over 20 years of experience. I am very pleased to work alongside the Norfolk House Nursery team.
You can arrange to meet me for confidential advice or guidance about your child’s health or development; during the pandemic these consultations are being conducted by Zoom or telephone.
My consultations are free of charge and they are confidential.
You can book an appointment with me via the Norfolk House Nursery staff.
You can also follow me on social media:
Facebook: @JuliaHeadlandPrivateHealthVisitor
Instagram: jh_privatehealthvisitor