Speech-Language & Occupational Therapy

  • Enjoys games like peek-a-boo and pat-a-cake.
  • Turns and looks in direction of sounds.
  • Listens when spoken to.
  • Recognizes words for common items like "cup," "shoe," "juice," "book."
  • Begins to respond to requests ("Come here," "Want more?").


    
    

  • Points to a few body parts when asked.
  • Follows single directions and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.

    
    



  • Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down").
  • Follows two requests ("Get the book and put it on the table").
  • Listens to and enjoys hearing stories for longer periods of time.

    
    



    

  • Hears you when you call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Answers simple "who?," "what?," "where?," "why?" questions.

      


 
    

  • Pays attention to short stories and answers simple questions about them.
  • Understands words that involve sequencing (first, next, last) and time (yesterday, today, tomorrow).
  • Hears and understands most of what is said at home and in school

Birth-3 Months

4-6 Months

  • Moves eyes in direction of sounds.
  • Responds to changes in tone of your voice.
  • Notices toys that make sounds.
  • Pays attention to music.
  • Startles to loud sounds.
  • Quiets or smiles when spoken to.
  • Seems to recognize your voice and quiets if crying.
  • Increases or decreases sucking behavior in response to sound.

Milestones

When to see an occupational therapist?

  • Poor coordination
  • Decreased balance (“clumsiness”)
  • Delayed motor skill development
  • Low muscle tone or strength
  • Difficulty with handwriting
  • Been diagnosed with a learning disability
  • Difficulty completing tasks that seem easily attained by peers
  • Behavioral challenges or social skill issues
  • Decreased attention or ability to participate in age appropriate activities
  • Decreased self-esteem and self-concept
  • Decreased visual skills including visual perceptual skills and ocular motor skills
  • Difficulties with feeding, is a picky eater or a messy eater 

 

Talking

1-2 Years

3-4 Years

4-5 Years

7-12 Months

Design Therapy of Miami

Normal Development Milestones


Every child is unique and has an individual rate of development. This chart represents, on average, the age by which most children will accomplish skills in hearing,  understanding, and talking. If you feel that your child is not meeting these milestones a  speech/language evaluation may be needed to determine his/her current  levels. 

Hearing and Understanding

2-3 Years

  • Makes pleasure sounds (cooing, gooing).
  • Cries differently for different needs.
  • Smiles when sees you.   

    


  • Babbling sounds more speech-like with many different sounds, including p, b, and m.
  • Chuckles and laughs.
  • Vocalizes excitement and displeasure.
  • Makes gurgling sounds when left alone and when playing with you. 

 


  • Babbling has both long and short groups of sounds such as "tata upup bibibibi."
  • Uses speech or non-crying sounds to get and keep attention.
  • Uses gestures to communicate (waving, holding arms to be picked up).
  • Imitates different speech sounds.
  • Has 1 or 2 words (hi, dog, dada, mama) around first birthday, although all sounds may not be clear.

       
    

  • Says more words every month.
  • Uses some 1-2-word questions ("where kitty?" "go bye-bye?" "what's that?").
  • Puts 2 words together ("more cookie," "no juice," "mommy book").
  • Uses many different consonant sounds at the beginning of words.   

    
    

  • Has a word for almost everything.
  • Uses 2-3-words to talk about and ask for things    Uses k, g, f, t, d, and n sounds.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or directs attention to objects by naming them.

    
    
    

  • Talks about activities at school or at friends' homes.
  • People outside family usually understand child's speech.
  • Uses a lot of sentences that have 4 or more words.
  •  Usually talks easily without repeating syllables or words.

    
    
    

  • Uses sentences that give lots of details ("The biggest peach is mine").
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Says most sounds correctly except a few like l, s, r, v, z, j, ch, sh, th.
  • Says rhyming words.
  • Names some letters and numbers.
  • Uses the same grammar as the rest of the family.