ASHA Announces New Developmental Milestones for Children Ages Birth to 5

(Rockville, MD) The American Speech-Language-Hearing Association (ASHA) announces today the free, online availability of new checklists that detail communication (speech, language, and hearing) milestones for children ages birth to 5 years as well as feeding and swallowing milestones for children ages birth to 3 years. These milestones provide parents and caregivers with a roadmap of what to expect during their child’s early years of life—and can alert them to the early signs of a potential developmental delay or disorder.

“ASHA’s new milestones will help parents and caregivers know what’s typical within each age range and how their children are progressing,” said Lemmietta McNeilly, PhD, CCC-SLP, ASHA Chief Staff Officer, Speech-Language Pathology. “If parents notice that their child isn’t demonstrating particular groups of skills, that’s a signal that the child may benefit from an evaluation by an audiologist or speech-language pathologist. We encourage families to seek help right away if they’re at all concerned about their child’s development. Ideally, intervention will occur when the brain is most flexible—which is between birth and 3 years. However, it’s never too late for children to benefit from audiology or speech-language pathology services.”

Audiologists specialize in assessing and treating hearing and related disorders. Speech-language pathologists assess and treat speech, language, and swallowing disorders. ASHA—the national, professional, scientific, and credentialing association for these professionals—is uniquely positioned to provide accurate, trusted milestones on children’s communication and swallowing to the public.

In the past, ASHA periodically updated its existing communication milestones. To inform the new communication checklists, the Association considered the latest peer-reviewed studies for children ages birth to 5 years who are learning English in the United States. Its milestones for feeding and swallowing are a new addition and are based on international studies.

Communication and Swallowing Disorders Common in Young Children

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), 11% of children ages 3–6 years have a voice, speech, language, or swallowing disorder. For every 1,000 children in the United States, two to three of them are born with a detectable level of hearing loss in one or both ears. Children can also acquire hearing loss after birth—from illnesses, noise exposure, and various other causes.

The availability of these new checklists comes at a particularly critical time. In polling conducted earlier this year, ASHA members overwhelmingly reported seeing more children with behavioral, social, and language difficulties—as well as more cases of undetected hearing loss—as compared with the numbers before the COVID-19 pandemic. Informing the public about milestones and the signs of possible disorders is a critical way to identify and treat more children with developmental disorders at earlier ages. This can maximize a child’s kindergarten readiness as well as reduce their likelihood of needing special education services in schools.

Communication Milestones

Examples of ASHA’s communication milestones for children ages birth to 5 years include the following:

• Quiets or smiles when you talk (birth to 3 months).
• Vocalizes different vowel sounds—sometimes combined with a consonant—like uuuuuummm, aaaaaaagoo, or daaaaaaaaaa (4 to 6 months).
• Babbles long strings of sounds, like mamamama, upup, or babababa (7 to 9 months).
• Points, waves, and shows or gives objects (10 to 12 months).
• Follows directions—like “Give me the ball,” “Hug the teddy bear,” “Come here,” or “Show me your nose” (13 to 18 months).
• Puts two or more words together—like “more water” or “go outside” (19 to 24 months).
• Says their name when asked (2 to 3 years).
• Tells you a story from a book or a video (3 to 4 years).
• Recognizes and names 10 or more letters and can usually write their own name (4 to 5 years).

Feeding and Swallowing Milestones

Examples of ASHA’s feeding and swallowing milestones include the following:

• Turns head towards nipple and opens mouth (birth to 3 months).
• Opens mouth for spoon (4 to 6 months).
• Brings foods to mouth with hands and starts to feed self (6 to 9 months).
• Begins chewing food on both sides of mouth—called “rotary chewing” (9 to 12 months).
• Drinks from a sippy cup without help; can drink from an open cup with some spilling (12 to 18 months).
• Chews all foods, including those with tougher textures, without gagging or choking (2 to 3 years).

Using ASHA’s Checklists

ASHA’s checklists provide the age ranges when a majority (75%) of children demonstrate particular skills. Families should keep in mind that each child develops differently, even within the same family. Skills develop over time—not on a child’s exact birthday. This is why ASHA’s milestones have ranges (e.g., “7 to 9 months” rather than “at 7 months”).

If a child isn’t meeting one milestone in an age range, this doesn’t necessarily mean that the child needs an evaluation. However, if a child lacks several skills, is not learning new skills, or is losing skills that they once had, then ASHA encourages families to consult their pediatrician and visit an ASHA-certified audiologist or speech-language pathologist. The Association provides a searchable database of these professionals at www.asha.org/profind. Families can also connect with their local early identification program (a listing of contacts by state is available from the Centers for Disease Control and Prevention).

ASHA’s checklists can also be used by pediatricians, daycare providers, and other professionals to communicate with parents about their child’s development or as a basis for referrals. However, these checklists are not used to diagnose a communication or swallowing disorder—audiologists and speech-language pathologists have specific tests and criteria for doing so.

View the full checklists, as well as tips for families to build a child’s communication and feeding skills at home, at on.asha.org/dev-milestones.

About the American Speech-Language-Hearing Association (ASHA)

ASHA is the national professional, scientific, and credentialing association for 228,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders.