Speech milestones 18-24 months

CDC writes milestones as things most children (75 percent or more) can do by a listed age. The lists are communication tools. They are not a validated screen. AAP asks clinicians for a general developmental screen at 18 months and autism screens at 18 and 24 months. CDC on monitoring and screening explains the difference. Read This week before you treat a checklist as a test.

From CDC milestones by 18 months, most children try three or more words besides mama or dada, follow a one-step direction without a gesture, and point to show you something interesting.

From CDC milestones by 2 years, most children say at least two words together, such as more milk; point to pictures in a book when asked; point to at least two body parts when asked; and use more gestures than waving and pointing, such as a kiss or a nod.

Those sentences are for conversation with a clinician, not for a chart on the fridge with stickers. A child who points, looks back at you, and brings you a shoe is already doing a lot of language work without a noun you recognize.

Talk is the intervention you already have. Add a word to theirs. If they say ball, you can say red ball. Wait. Give them a beat to try a word before you fetch the cup. Read the same short books. Point and pause. Narration beats a quiz.

Try this

1. Add a word to theirs instead of correcting the sound.
2. Wait before you fetch the thing they want.
3. Read the same short books. Point and pause.
4. Write one new word or gesture for the visit. That is more useful than a count you invented at midnight.
5. If you are worried, say so at the visit. Ask what screen they use and what happens next.

Lost words matter. So does a child who does not point to share interest. Those are reasons to call, not reasons to wait for a birthday. CDC tells parents they know their child best. That sentence is doing real work. Use it.

In the house this month

Bilingual homes sometimes get told to pick one language. That is not CDC milestone advice. Speak the language you speak well. The child needs a fluent face. If you are worried, say so at the visit and ask how they interpret word counts in more than one language.

Hearing matters. A child with frequent ear infections may have fewer clear words. That is a clinician question, not a wait-and-see slogan. Ask about hearing if words are few or if you are repeating yourself more than the room thinks is funny.

Older siblings will talk for the toddler. Ask them, kindly, to wait. The pause is the lesson. A house where every request is filled before a sound comes out will have fewer sounds.

Write the funny words. Bring them. A clinician can do more with baba, more, and uh-oh used on purpose than with I think we have twenty words, maybe.

What you can skip

Skip flashcards the night before a visit. Skip word-count contests at the park. Skip wait and see if you are worried.

Skip correcting every sound. Add a word. Wait. Talk to the clinician about the rest.

Keep the range in view

Most children have a few extra words at 18 months and two-word phrases at 2. Those are most-children lines. A missed item is a conversation. A lost skill or a quiet worry is a call. Screening at the visit is the tool, not a kitchen quiz.

Check in if

Call your pediatrician if a skill was lost. Ask about screening if there are few or no words besides mama or dada by 18 months, no two-word phrases by 2 years, or no pointing to share interest. Missing one item is a reason to talk, not a verdict. You can contact early intervention without a referral.

Related ages: 12-18 months, 18-24 months, 24-36 months. Pillars: Behavior.

Sources

1. CDC. Milestones by 18 months. cdc.gov/act-early/milestones/18-months.html
2. CDC. Milestones by 2 years. cdc.gov/act-early/milestones/2-years.html
3. CDC. Developmental monitoring and screening. cdc.gov/act-early
4. Lipkin PH, Macias MM. Promoting optimal development through surveillance and screening. Pediatrics. 2020;145(1):e20193449. publications.aap.org