Consider having your child evaluated by a speech and language pathologist if any of these characteristics are noted:

At any age if…

• you are concerned about any aspect of speech or language development.
• you are concerned about your child’s fluency.
• your child is frustrated or embarrassed by his or her speech.
• you have learned your child is hearing impaired.

As an infant if your child…

• does not swallow well, has difficulty chewing, or has delayed oral-motor development.
• has a cleft palate.
• demonstrates neuro-motor impairment.
• has neurological or structural deficits that put him/her at a high risk for later communication or feeding problems.

At 18 months if your child…

• is not talking, has little speech sound play, or few consonants.
• has fewer than ten words, but has an advanced gesture system.
• does not respond accurately to short, simple directions accompanied by gesture.
• shows any of the previously listed problems.

At 2 years if your child…

• has few words and is not obviously increasing his or her vocabulary.
• has many words, but is unintelligible, with very few consonants or a lot of vowel distortions.
• does not understand short directions or simple questions, or does not pay attention to talking.
• shows any of the previously listed problems.

At 3 years if your child…

• is very difficult to understand.
• consistently omits initial consonants.
• has excessive nasal tone.
• is not combining three and four words into connected utterances.
• still has a lot of jargon.
• echoes a lot and does not initiate many of his own utterances.
• cannot follow two-step commands or does not respond appropriately to who, what or where questions.
• has an excessive amount of dysfluencies and is showing obvious tension or actually blocks (freezes) on some of his sounds.
• has any of the previous problems listed.

At 4 years if your child…

• is hard to understand
• consistently drops word endings.
• has noticeably faulty sentence structure.
• has consistent difficulty pronouncing multisyllabic words and either mixes up the sound order or drops out whole syllables.
• is not able to relate events with good sequence and information content.
• has any of the previous problems listed.

At 5 years if your child…

• has difficulty following directions and attending to verbal information in a classroom setting.
• does not speak in complete sentences.
• has a harsh, hoarse, or unusual voice.
• has a suspected learning disability that may be language based.
• has any of the previous problems listed.