Speech Delay Red Flags Checklist

Clear age-based markers for when to seek a speech-language evaluation

How to Use This

How to Use This: Find your child's age group and review only that section. If you check even ONE item, contact a speech-language pathologist for an evaluation. The 'Where to Get Help' section at the bottom has specific steps for getting services.

Definitions

Key terms: 'Echolalia' means repeating words or phrases exactly as heard, without understanding their meaning. 'Intelligibility' means how well strangers can understand your child's speech. 'Selective mutism' is when a child can speak but consistently does not speak in certain situations (like school).

Important

This checklist is a screening guide, not a diagnosis. If you have concerns about your child's speech or language, request a professional evaluation. You do not need to wait for your pediatrician to raise the issue first — parents who act early get the best outcomes.

Early identification of speech and language delays leads to significantly better outcomes. The brain's plasticity for language is highest in the first 3 years, and intervention during this window is dramatically more effective than after age 5. This checklist is not a diagnostic tool — it's a screening guide. If you check ANY red flag items at your child's age, request an evaluation from a speech-language pathologist. You do not need a doctor's referral to get an evaluation in most states, and early intervention services (birth to 3) are often free or low-cost.

By 6 Months — Seek Evaluation If:

Does not react to loud sounds

Does not turn toward sound sources

By 9 Months — Seek Evaluation If:

No babbling at all (no 'baba', 'dada', 'mama' sounds)

Does not respond to own name

By 12 Months — Seek Evaluation If:

No babbling with consonants (only vowel sounds)

Does not use gestures: pointing, waving, reaching

By 18 Months — Seek Evaluation If:

Uses fewer than 10 words

Does not point to show you things (not just to request)

By 24 Months — Seek Evaluation If:

Uses fewer than 50 words

Does not combine 2 words together ('more milk', 'daddy go')

By 3 Years — Seek Evaluation If:

Does not use 3-word sentences

Speech is less than 50% intelligible to unfamiliar listeners

By 4 Years — Seek Evaluation If:

Speech is less than 75% intelligible to unfamiliar listeners

Does not use 4+ word sentences

By 5 Years — Seek Evaluation If:

Speech is not fully intelligible to strangers (aside from r, l, s, th sounds)

Cannot tell a story with a beginning, middle, and end

Red Flags at ANY Age

Important

Seek immediate evaluation if your child shows ANY of the following at any age: Loss of previously acquired words or social skills (regression); No response to their name by 12 months; No pointing or gesturing by 12 months; No single words by 16 months; No spontaneous 2-word phrases by 24 months; Consistent echolalia (repeating exactly what's said without understanding).

Where to Get Help

1Early Intervention (birth-3 years): Contact your state's Part C program. Services are typically free. Search 'early intervention [your state]' or call the Pediatrician for a referral.
2Preschool Special Education (3-5 years): Contact your local school district. Under IDEA, schools must evaluate and provide services for eligible children at no cost.

Trust your instincts. If something feels off, get an evaluation. You will never regret evaluating too early. The data is clear: children who receive speech-language intervention before age 3 have significantly better outcomes than those who start after age 5. 'Wait and see' is the most expensive advice in speech pathology.

Budget Tip

Budget tip: Early Intervention services (birth to 3) are free or low-cost in most states through the Part C program. School district evaluations (ages 3-5) are free under federal law. You do not need a doctor's referral in most states — call directly.

Next Steps

Next Steps: If your child flags on this checklist, contact your state's Early Intervention program (birth-3) or your local school district (ages 3-5) this week. Use the Language Milestone Tracker to monitor progress during and after any intervention.