When to have your child evaluated by a speech and language pathologist.
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.
...your child is discovered to be hearing impaired.
As an infant if your child...
...has an unusual or ineffective suck reflex, does not swallow well, has difficulty chewing, or has delayed oral-motor development.
...has a cleft palate.
...demonstrates neuro-motor impairment.
...has a permanent indwelling trach tube.
...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 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 to an unfamiliar listener.
...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.