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Important Development Milestones

 Per the National Institute on Deafness and Other Communication Disorders (NIDCD) & Talk Tools

Language Milestones
Important Milestones

Birth to 6 Months

  • Reacts to loud sounds

  • Calms down or smiles when spoken to

  • Recognizes and is calmed by familiar voice

  • When feeding, starts or stops sucking in response to sound

  • Coos and makes pleasure sounds

  • Has a special way of crying for different needs

  • Smiles in response to familiar people

  • Follows sounds with eyes

  • Responds to changes in the vocal tones 

  • Notices toys that make sounds 

  • Pays attention to music

  • Babbles in a using many different sounds, beginning with p, b, and m 

  • Laughs 

  • Babbles when excited or unhappy

  • Makes gurgling sounds when alone or playing with company

6 - 12 Months

  • Enjoys playing peek-a-boo and pat-a-cake

  • Localizes to sounds 

  • Listens when spoken to 

  • Understands words for common items such as “cup,” “shoe,” or “juice”

  • Responds to requests (“Come here”)

  • Babbles using long and short groups of sounds (“tata, upup, bibibi”)

  • Babbles to get and keep attention

  • Communicates using gestures such as waving or holding up arms

  • Imitates different speech sounds

  • Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday

​12 -18 Months​

  • Imitates word approximations

  • Follows 1-step directions without cues (e.g., get your ball)

  • Points to at least three body parts

  • Labels objects upon request

  • Uses 20-50 meaningful words

18 - 24 Months

  • Follows 2-step directions without cues (e.g., get the ball and the car)

  • Understands “what” and “where” questions

  • Asks simple questions using correct intonation

  • Says 100+ words

  • Is at least 50% intelligible

  • Uses 2 word phrases consistently

24 - 36 Months​

  • Approximately 75% intelligible

  • Correctly produces the following phonemes (sounds) consistently: /p, b, m, t, d, n, h, w/, along with all vowels and diphthongs (“ay” “ow” “oi” “oh” etc)

  • Answers questions with yes/no 

  • Responds to “what”, “where” and “who” questions

  • Asks simple questions

  • Uses 3-4 words consistently

  • Is beginning to take conversational turns

  • Play and talks to other children

Feeding Milestone
Important Milestones

Birth to 3 Months

  • Rooting & phasic bite reflex

  • Suckle on nipple

  • Suck-Swallow reflex

  • Nose breathing

  • Incomplete lip closure

  • Suckling pattern

  • Mouth opens in anticipation of feeding

  • Improved lip closure

  • Orientation to midline

  • Liquids only

  • Gag reflex on front third of tongue

  • Tongue is cupped to provide channel for backward movement of liquid

  • Fatty sucking pads, lips, tongue, palate function as a unit

  • Hand on bottle/breast

  • Lateral tongue reflex

4-6 Months

  • Voluntary control of mouth

  • Rooting reflex decreases

  • Phasic bite decreases by 5 months 

  • Munch-chew pattern is active between 5-6 months 

  • Decreased coordination of suckle, swallow, breath as suckling becomes more active

  • Gag reflex is moving back/slightly less sensitive

  • Pursing of lips 

  • Liquids and purees

  • Sucking pattern used with spoon

  • Gagging with new textures

  • Lip closure increased

7 - 9 Months 

  • Lower lip used to stabilize cup drinking (jaw is still unstable) 

  • Lateral tongue reflex resolves (6-8 months)

  • Some tongue protrusion to facilitate a swallow

  • Gag reflex is on back third of tongue

  • Teething begins around 5-9 months (drooling occurs)

  • Mouth closure around top of cup

  • Beginning of active transfer of food side to center, center to side

10 - 12 Months 

  • Independent finger feeding

  • Increased cup drinking as weaned from nipple

  • Removes from spoon using lips

  • Cleans lower lip with teeth 

  • Gag moves back to pharyngeal wall 

13 - 18 Months 

  • Can drink using straw

  • Consumes all textures


19 - 24 Months 

  • Primarily self-feeding

  • Swallows with lip closure

  • Rotary chewing predominates

25 - 36 Months Old

  • Completely self-feeding

  • Uses fork independently

  • Holds cup with one hand

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