When To Refer

If you have any concerns, questions then please phone me for a chat.

Communication is vital and affects every aspect of our lives. Over 1 million children and young people in the UK have some kind of communication difficulty and that’s 2-3 in every UK classroom. 50-90% of children with persistent speech, language and communication difficulties go on to have reading difficulties.

“Effective communication skills don’t just happen. They need to be actively developed and nurtured from infancy, throughout a child’s life and educational journey” (The Communication Trust: Our Strategy 2013-2017).

If these difficulties are resolved by the age of 5 and a half, students are more likely to go on to develop good reading and spelling skills. As this good performance continues throughout their school careers they then go on to pass as many exams on leaving school as children who have no history of speech, language and communication difficulties.

A poll undertaken by I CAN showed that only 43% of parents of 0 - 5 years olds were able to correctly identify the stages of communication.

Stages of communication

Developmental milestones provide useful guidance by offering approximate ages and stages; however they can cause unnecessary anxiety. Below are some ages and stages for typical speech, language and communication development for English-only speaking children. These milestones will also not be entirely suitable to monitor some groups of children for who may have a different set of ages/ stages to follow (e.g. Down syndrome, English as an Additional Language, Hearing Impaired/ Deaf children etc.). I advise that you talk to me when you believe that your child’s development may be described by one of the ‘causes for concern’ for that given age or if your child is older.

Remember every child is individual and they don’t grow up at the same pace. If you have any concerns then please contact me to discuss this further.

By 6 months children:

  • Turn towards a sound when they hear it.
  • Startle at noises/ sounds.
  • Change facial and body reaction when they hear different tones of voice (e.g. anger, affection).
  • Recognise your voice and appears to recognise own name.
  • Watch your face when you talk to them.
  • Explore toys by looking, mouthing, banging or feeling.
  • Smile and laugh when other people smile and laugh.
  • Squeal, yell, growl and blow raspberries.
  • Make sounds to themselves, like cooing, gurgling and babbling (using some vowels and consonants such as: a, b, p, t, and d).
  • Make noises, like coos or squeals, to get your attention.
  • Have different cries for different needs. For example one cry for hunger, another when they are tired.
  • May respond to an adult talking to them or start a conversation by vocalising/ babbling.

Causes for concern if your child by 6 months:

Doesn’t smile.Is rarely comforted by parent’s voice or touch.Does not visually track moving objects.Doesn’t turn to noises.Does not look towards speaker.Doesn’t make any noise (e.g. laugh, squeal or babbling noises).

By 1 year children:

  • Listen carefully, and turn to someone talking on the other side of the room.
  • Look at you when you speak and when their name is called.
  • Smile at people who are smiling at them.
  • Will show affection to familiar people, e.g. hugs, pats, and kisses.
  • Will sit with an adult and look at simple pictures in books, for at least a few seconds.
  • Demonstrates appropriate, but fleeting use of toys and objects (e.g. hair brush to hair, hat on head, and cup to mouth etc.).
  • Enjoy action songs and rhymes and get excited when sung to.
  • Will initiate simple action games using gestures or sounds (e.g. ‘Row row row your boat’, ‘round and round the garden’).
  • Start to understand words like 'bye-bye' and 'up' especially when a gesture is used at the same time.
  • Recognises the names of familiar objects, things like ‘car’ and ‘daddy’.
  • Responds appropriately to simple words or phrases (e.g. up, bye bye, come here, no, clap hands).
  • Make noises, point and look at you to get your attention.
  • Talks to people and toys in long tuneful stretches.
  • Babble strings of sounds, like ‘no-no’ and ‘go-go’.
  • Take turns in conversations, babbling back to an adult.

Causes for concern if your child by 1 year:

Doesn’t respond to noises (expected by 9 months).Doesn’t quickly and accurately turn to the source of loud sounds/ noises.Does not look in the direction of a pointing finger.Does not identify familiar everyday objects when they are named.Doesn’t point to things they are interested in.Doesn’t try to gain your attention by making noises. This could be through eye contact, facial expressions or reaching.Does not use gestures such as waving or shaking head.Limited or no babbling (expected by 9 months).Does not indicate when happy or upset (expected by 9 months).

By 18 months children:

  • Enjoy games like ‘peek-a-boo’, ‘pat-a-cake’ and toys that make a noise.
  • Start to understand a few simple words, like ‘drink’, ‘shoe’ and ‘car’. Also simple instructions like ‘get your book’, 'kick ball' and 'give me'.
  • Focus on self-directed activities and attention is single-channeled.
  • Enjoy exploring toys (e.g. putting them in boxes and tipping them out).
  • Start to enjoy simple pretend play, for example pretending to talk on the phone or getting an adult to do pretend drinking from a cup.
  • Point to things when asked, like familiar people and objects such as ‘book’ and ‘car’.
  • Will call an adult’s attention to an object/ picture/ toy and wait for a comment (e.g. points to a ball and looks at the adult).
  • Gesture or point, often with words or sounds to show what they want.
  • Intersperse real words in their babble (e.g. ‘maubaba-doggy-dada’).
  • Regularly use up to 20 simple words, such as 'cup', 'daddy' and 'dog'. These words may not always be easily recognised by unfamiliar adults.
  • Copy lots of things (i.e. key words) that adults say, actions and gestures that they make.

Causes for concern if your child by 18 months:

Does not look around to see where a loud/ sudden sound is coming from or respond to their name being called.Shows little interest in playing with main carers and not demanding attention of others.Behaviour is inappropriate with others (e.g. very poor eye contact, lots of screaming, extreme dislike of body contact etc.).Doesn’t respond to “no” or “bye bye”.Hasn’t started babbling to communicate (expected by 12-15 months).Hasn’t started saying their first words (expected by 15-18 months).Doesn’t use at least 6-10 words consistently (remember they do not need to be easily recognisable to unfamiliar adults).

By 2 years children:

  • Concentrate on activities for longer, like playing with a particular toy.
  • Sit and listen to simple stories with pictures.
  • Enjoy pretend play with their toys, such as feeding dolly.
  • Engage in simple sequences of pretend play (e.g. wrapping teddy up and putting teddy to bed).
  • Understand between 200 and 500 words.
  • Understand more simple questions and instructions. For example 'where is your shoe?' and 'show me your nose'.
  • Respond to a range of instructions containing 2 key words without visual or contextual cues(e.g. Put teddy on the bed).
  • Communicate using a combination of gestures, looking, sounds and words.
  • Copy sounds and words a lot.
  • Answers questions appropriately with yes or
  • Use 50 or more single words. These will also become more recognisable to others.
  • Are putting 2 words together more often, such as ‘more juice’ or ‘bye nanny’.
  • Use the same word or phrase for different reasons (e.g. ‘mummy cat’ might mean ‘look I see a cat’, ‘mummy I want a cat’, or ‘mummy that cat is eating’).
  • Start to take turns in a conversation
  • Use a limited number of sounds in their words – often these are p, b, t, d, m and w. Children will also often miss the ends off words at this stage. They can usually be understood about half of the time.

Causes for concern if your child by 2 years:

Is unable to concentrate for short intense periods on self-chosen toy/ activity.Is unable or is slow to follow simple instructions/ directions.Is reliant on gesture to understand simple instructions in daily life.Isn’t attempting to imitate language or actions in play.Isn’t saying 25 recognisable words.Has a vocabulary of less than 50 words.Has decreased interest in social interaction or what is going on around them.Has any loss of language or social skill (relevant at any age).

By 3 years children:

  • Understand longer instructions (without visual clues), such as 'make teddy jump' or 'where's mummy's coat?'
  • Understand simple 'who', 'what' and 'where' questions.
  • Listen to and remember simple stories with pictures.
  • Now play more with other children and share things.
  • Use up to 300-450 words.
  • Put 4 or 5 words together to make short sentences, such as 'want more juice' or ‘he took my ball’.
  • Beginning to talk about events in the past and future.
  • Ask lots of questions. They will want to find out the name of things and learn new words.
  • Use action words as well as nouns, such as ‘run’ and ‘fall’. They use a few adjectives (e.g. hot, cold, big, and dirty) and understand more adjectives.
  • Start to use simple plurals by adding ‘s’, for example ‘shoes’ or ‘cars’.
  • Knows a range of nursery rhymes and will fill in missing words.
  • Use a wider range of speech sounds. However, many children will shorten longer words, such as saying ‘nana’ instead of ‘banana’. They may also have difficulty where lots of consonant sounds occur together in a word, e.g. they may say ‘pider’ instead of 'spider.'
  • Speech is mostly understood by others with the usual immaturities. They often have problems saying more difficult sounds like sh, ch, th and r.
  • Sometimes sound as if they are stammering or stuttering.  They are usually trying to share their ideas quickly before their language skills are ready. This is perfectly normal, just show you are listening (i.e. maintain eye contact and relaxed facial expression) and give them plenty of time.
  • Can take turns in conversation and initiate a conversation.

Causes for concern if your child by 3 years:

Never concentrates on anything for more than a few seconds.Is not interested in playing with others.Has little pretend or imaginative play.Is slow to respond to instructions.Relies on being shown what to do rather than being told.Points or shows what they want rather than say it.Only says single words instead of joining words together into short sentences.Speech is very difficult to understand, sometimes even to familiar adults.

By 4 years children:

  • Can fetch up to 3 things at a time when asked and when fully attentive.
  • Enjoy make-believe play.
  • Start to plan games with others and involve others more in their play.
  • Listen to longer stories and answer questions about a storybook they have just read. They talk about events in their lives related to the story.
  • Understand and often use colour, number and time related words, for example, 'red' car, 'three' fingers and 'yesterday / tomorrow'.
  • Be able to answer questions about ‘why’ something has happened.
  • Actively learn language and have vocabulary of over a 1000 words
  • Use longer sentences and link sentences together.
  • Describe events that have already happened e.g. 'we went to the park.' They still make mistakes with tense such as say 'runned' for ‘ran’ and 'swimmed' for ‘swam’.
  • Start to like simple jokes.
  • Ask many questions using words like ‘what’ ‘where’ ‘when’ and ‘why’.
  • Have difficulties with a small number of sounds – for example r, w, l, f, th, sh, ch and dz.

Causes for concern if your child by 4 years:

Is unable to concentrate on anything for more than a few minutes at a time.Is unresponsive or slow to follow instructions.Has difficulty or is uninterested in mixing with peers.Does not respond to or ask questions.Is struggling to turn ideas into sentences.Uses language that is jumbled and difficult to understand.Does not use a range of grammatical structures (e.g. verb endings or plurals).Stumbles on words (risk factors: family history of stammering and problem has been persistent for over 6 months).

By 5 years children:

  • Choose their own friends and play mates.
  • Understand spoken instructions without stopping what they are doing to look at the speaker.
  • Understand more complicated language such as ‘first’, ‘last’, ‘might’, ‘may be’, ‘above’ and ‘in between’.
  • Understand words that describe sequences such as “first we are going to the shop, next we will play in the park”.
  • Given a verbal description of people, animals, things can name them accurately
  • Take turns in much longer conversations.
  • Will direct or contribute play through conversation, and will try to negotiate and co-operate with peers
  • In pairs or on own, can take a spoken message and bring back an answer, if needed.
  • Have an approximate vocabulary size of 2000 words
  • Use sentences that are well formed. However, they may still have some difficulties with grammar. For example, saying 'sheeps' instead of 'sheep' or 'goed' instead of 'went'.
  • Can describe objects, animals, plants etc. (providing a minimum of 3 attributes)
  • Think more about the meanings of words, such as describing the meaning of simple words or asking what a new word means.
  • Can say what will happen next in routines and stories.
  • Use most sounds effectively. However, they may have some difficulties with more difficult words which are longer or contain consonant clusters such as 'scribble' or 'elephant'. Also possible difficulty pronouncing ‘th’, ‘ch’, ‘j’, ‘l’, ‘r’ and ‘v’

Causes for concern if your child by 5 years:

Is easily distracted in the classroom.Has difficulty understanding complex sentences and require extra individual support to follow spoken language.Has a poor understanding of concepts (e.g. relating to size, shape, position, quantity, time and sequence).Has difficulty using abstract ideas such as size or time.Has difficulty organising ideas in order.Doesn’t have the right words to be able to say what they want.Talks about lots of different topics in the same group of sentences (i.e. doesn’t stay on topic).Misses out some words. For example, saying ‘playing ball’ instead of ‘doggy is playing with the ball’.Isn’t using the right sounds so that their speech is at times difficult to understand.

By 6 years children:

  • Regularly look at books on their own and turn pages in order, talking about the story as they go along.
  • Can reproduce initial and final sounds in words (e.g. initially: m for man and finally: m for ham). Can provide words that start with a given sound (e.g. m: man, moon, mummy)
  • Can produce simple rhyming words (e.g. mat, cat, hat)
  • Can read some high frequency words in different print mediums (e.g. books, signs etc.)
  • Have a vocabulary of up to 7,000 words
  • Use a range of adjectives, adverbs and can use comparative language (e.g. larger than etc.)
  • Talk about similarities and differences in the meaning of words
  • Can arrange pictures in a sequence and describe the sequence as well as summarise the sequence/ story
  • Can discuss their feelings and make suggestions for the feelings of others
  • Can solve simple problems and identify causes
  • Can make simple inferences (i.e. explain something using clues rather than being told all the information beforehand) and make simple deductions
  • Give further information for clarification when needed

Causes for concern if your child by 6 years:

Find it hard to understand language about things in the past or future.Respond to just part of an instructions, usually the beginning or end.Find it hard to learn and understand the meaning of words.Struggle to understand phrases that can mean more than one thing, such as “pull your socks up”.Use short sentences, often with words missing or in the wrong order.Find it hard to make up stories. This shows in written work as well as talking.Is not learning at school, but nobody can explain why.Is struggling to make and keep friends.


Summary of language development from beyond 6 years

Between 6 and 10 years children:

  • Develop an understanding of humour and non-literal language.
  • Acquire 3,000-5,000 new words each year and they understand more abstract language (e.g. freedom) with extensive vocabulary in a specific area (i.e. relating to a particular self- interest).
  • Understand and use passive sentences e.g. “the thief is chased by the policeman”.
  • Use language to predict and draw conclusions.
  • Can take on board the perspective of others and adapt their communication accordingly. They also show agreement or disagreement.
  • Start conversations with adults and children they don’t know.


Between 10-12 years children:

  • Use longer sentences; usually 7-12 words or more.
  • Begin to use meta-linguistic and meta-cognitive verbs (i.e. verbs used to talk about language such as; ‘infer’, ‘deduce’, ‘imply’).
  • Understand and use sarcasm as well as witty humour.
  • Develop the ability to have extended conversations.
  • Understand and use slang terms with friends. They keep up with rapidly changing ‘street talk’
  • Are able to change topic well in conversations.

12 years plus children:

  • Understand and use idioms (e.g. ‘he was caught red-handed’).
  • May have a vocabulary size of 50,000 words or more.
  • Know that they talk differently to friends than to teachers.
  • Develop sophisticated language for persuasion and negotiations.
  • Are able to write in a range of styles: formal and informal.


I CAN (www.ican.org.uk)

Anne Locke and Maggie Beech, 2005 NferNelson Publishing Company Ltd

Linguisystems (www.linguisystems.com)

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