Milestones

Many children are reluctant to talk in the clinic, and so gaining the right information from parents is crucial. Make the most of the limited time you have by using the following guide. Ask questions about:

  • Speech development: when were the child’s first words, and when did the child start talking in phrases? For older children: can they use sentences or relate events that happened in the recent past?
  • Hearing: when was hearing last tested?
  • Social skills: how does the child interact with peers and adults other than family
  • Following instructions: how does the child respond when asked to find familiar objects and can the child go and get requested items from the next room/upstairs?
  • Vocabulary: For toddlers: how many words does the child know? For older children: is the child constantly learning new words.  Does the child enjoy books?  Are they regularly read to?
  • Speech clarity: how intelligible is the child to unfamiliar adults? Which speech sounds are problematic?
  • Voice: Does the child often lose his/her voice, or do they sound overly husky?
  • Fluency: If the child stammers, when did it start and are there any other family members who also stammer? Is the child distressed by the stammering?
  • For bilingual/multilingual children: please ensure these questions all relate to the child’s first language. Children who speak English as an additional language will learn English well once they have a foundation in their mother tongue.

Red Flags

Action needs to be taken if your assessment indicates any of the following, any age from approximately 3 years onwards:

  • A child whose voice sounds husky / rough or who periodically loses their voice (relevant for younger children too)
  • A child who has started to stammer (especially if there is a family history and / or they are distressed by it)
  • A child who seems to be ‘in their own world’ e.g., using little eye contact, using people as ‘tools’ rather than enjoying interaction with them, engaging in self-stimulatory and / or repetitive behaviours, demonstrating significant rigidity and strong need for the same routine

You can also use this progress checker.


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