This document outlines typical speech and language development milestones from birth to 2 years of age. It notes that newborns can localize sounds and begin to smile by 1 month. Between 3-6 months, infants can imitate sounds, and between 4-8 months they begin babbling with isolated sounds. Comprehension of words emerges around 6-10 months, and the first words other than "mama" or "dada" are usually spoken between 9-14 months. By 18-22 months, children use two-word phrases or sentences. The document also covers normal hearing development milestones within the first two years.

1. Speech and language
development BY KANHA
AAROH TTC New Delhi
1st year 2022-24

2. Newborns
 Can localize a sound to their right or left side
shortly after being born and will turn their head
or look in the direction of a sound.
 This works best with loud noises when the baby
is awake and alert, but they should also be able
to hear soft sounds.
 They can also begin to smile spontaneously
and in response to someone by 1 month. Infants
learn to recognize their parents by 1-2 1/2
months.

3.  By 3-6 months
 Infants can imitate speech sounds
 By 4-8 months
 Monosyllabic babbling, or making isolated sounds
with vowels and consonants (ba, da, ga, goo, etc)
usually begins
 By 5-9 months
 Polysyllabic babbling, or repeating vowels and
consonants (babababa, lalalalala, etc) usually begins

4.  By 6-10 months.
 Comprehending individual words (mommy, daddy, no)
usually occurs
 most infants can say mama/dada nonspecifically, using
the words as more than just a label for his parents.
 Many infants can follow a one step command with a
gesture (for example, asking for an object and holding your
hand out)
 By 7-11 months.
 He should be able to follow a one step command without a
gesture
 By 7-12 months.
 The correct use of mama/dada as a label for a parent
usually occurs

5.  By 9-14 months
 The first word (other than mama/dada) is usually spoken
 By 10-15 months
 He should be able to point to an object that he wants.
 By 11-20 months
 Child will be able to say 4-6 words (other than mama/dada
and names of family members or pets)
 By 14-21 months
 He should be able to follow a two step command without a
gesture

6.  By 18-22 months
 Two word combinations or sentences are used and
can include phrases like 'Want milk', 'More juice‘
 By 16-24 months
 A vocabulary spurt leading to a 50+ word
vocabulary occurs

7. • In addition to the screening tests described above,
Physical therapist may be able to calculate child's motor
quotient (MQ), which is his motor age (his age as
calculated by what milestones he has met) divided by his
chronological age and multiplied by 100.
• A motor quotient above 70 is considered normal, and
between 50-70 is suspicious and requires further
evaluation, although it is probably normal, and below 50
is considered abnormal.
• For example, if child is 12 months old and has just begun
to pull to a stand (motor age of 9 months, the age when
most children are pulling to a stand), his MQ would be
(9/12)*100 or 75, which is probably normal.
• On the other hand, if he has just begun to roll over
(motor age of 5 months), then his MQ is (5/12)*100 or 42
and this is probably abnormal

8.  Parents are usually the first ones to think that there is a problem
with their child's motor, social, and/or speech and language
development, and this parental concern should be enough to
initiate further evaluation.
 In addition to a formal hearing test (for children with speech
delays), neurological exam (which will look at child's muscle
tone, strength, reflexes, coordination, etc), and developmental
assessment by their Pediatrician.
 Children with developmental delays should be referred to an
early childhood intervention program (for children under 3).
 So that an evaluation can be initiated and a treatment plan
developed, including physical therapy, occupational therapy and
possible speech therapy.
 He may also need a referral to a Pediatric Neurologist and/or a
Developmental Pediatrician for further evaluation and treatment.

9. Normal Hearing Development in
Children

10.  The first two important years
The first two year is the time during which hearing
develops in children. It is important for parents to be able
to recognize signs of a hearing problem as early as
possible and seek medical attention if there are any
concerns.
Here is a guide of signs of normal hearing development
by age through the first 2 years of life:

11. • By 4 months of age a baby should
• Move or react when someone speaks or in response to
any noise.
• Startle when there is a very loud noise.
• By seven months a baby should:
• Turn his/her head towards a voice or a noise (when a
parent calls even without being seen).
• Stir or move in response to a noise or voice.
• Startle when there is a large sound.
• By 9 months a baby should:
• Turn his/her head to find out where a sound is coming
from.
• Turn around if a parent is calling from behind.
• Stir or move in response to voice or any sound.
• Startle when there is a very loud noise.

12. • At 12 months a baby should:
• Turn his/her head in all directions and show an interest
in a person's voice or a particular sound.
• Repeat sounds that parents make.
• Startle in response to a loud noise.
• At 2 years of age a child should:
• Be able to point out a part of his body when asked
without seeing that person's lips move.
• Be able to point to the right picture when asked
(for example: Where is the cat? Where is the bird?).
• Be able to do simple tasks like give you one of his/her
toys when asked, without seeing that person's lips move.