When to Consider Speech Therapy (Birth to 3 Years) - Free Early Milestones Checklist For Caregivers

Vivian Eller
Jun 21
3 min read

As parents, we eagerly anticipate our children's first words, their first laughs, and those adorable attempts to tell us about their day. But because every child develops at their own pace, it’s completely natural to wonder: Is my child’s speech and language developing the way it should?

If you've found yourself questioning whether your little one is hitting their communication marks, you aren't alone. Let’s break down the essential speech and language milestones from birth to age three, and discuss when it might be time to seek a professional evaluation.

Communication Milestones: Birth to 3 Years

Here is a quick look at what communication typically looks like in the earliest years of life:

Birth to 12 Months: The Foundation

Baby Sounds: Look for a clear progression. At 2–3 months, you'll hear early vowel and back-of-the-throat sounds ("cooing"). By 7–9 months, they will repeat the same syllables ("mama" or "dada"), and by 10–12 months, they’ll mix different syllables together into their own "made-up" language.
Vocabulary: Using 2 to 6 real words (besides mama/dada) by 12 months.
Understanding & Social: Recognizing words for common items, responding to simple requests (between 6–12 months), making eye contact, and playing games like peek-a-boo.

1 to 2 Years: The Vocabulary Explosion

Vocabulary Spurt: A child's vocabulary typically grows from about 10 words at 15 months, to 50 words at 18 months, and leaps to 200–300 words by age 2.
Speech Clarity: By 18 months to 2 years, an unfamiliar adult should be able to understand about 25% to 50% of what your child says.
Following Directions & Play: Following one-step directions, pointing to pictures in books, engaging in simple pretend play (like talking on a toy phone), and combining gestures with words to express needs.

2 to 3 Years: Building Sentences

Produced Sounds: Mastery of sounds like p, b, d, k, g, w, h, ng, n.
Speech Clarity: An unfamiliar adult should now understand 50% to 75% of their speech.
Vocabulary & Sentences: Vocabulary jumps to 450 words at 30 months and 1,000 words by 36 months. They should use 2-word phrases by age 2 and 3-word phrases by age 3, incorporating "-ing" words and basic pronouns.
Questions & Peer Interaction: Asking and answering simple "where/what" and basic logic questions, as well as briefly joining in play with peers and sharing activities.

When Should You Refer Your Child to Speech Therapy?

The Golden Rule: If a child is missing several of the milestones listed above, they might benefit from a speech therapy evaluation.

Missing a single milestone briefly might not be a cause for alarm, but if your child misses a lot of these developmental markers, early intervention is key. Addressing speech and language delays early gives your child the best foundation for future learning, academic success, and social confidence.

Download Our Free Screening Tool!

Want a physical copy to check off as your child grows? You can click here to download my complete speech-language screening tool for birth to 3-year-olds right here to track your child's progress at home!

How Walee Speech Therapy Can Help

If you have noticed some unchecked boxes on your child's milestone list, Walee Speech Therapy is here to support you. We believe that accessing speech therapy should be convenient, comfortable, and affordable for families.

In-Home Therapy: We provide personalized, in-home speech therapy sessions for families living in San Jose and Milpitas. Your child can learn and grow in the environment where they feel safest.
Online Therapy (Teletherapy): We offer speech evaluations and therapy online for families living anywhere in California. Online speech evaluations are highly effective, interactive, and fit seamlessly into your busy schedule.
Affordable Care: We strongly believe that financial hurdles shouldn't stand in the way of a child's development. A sliding-scale payment option is available to ensure our services are accessible to families who need them.