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When You Are Concerned

What to do when you’re worried about your child’s communication

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As a parent, you see your child growing and developing new skills before your eyes, from language skills to social skills to motor skills. Knowing when to be concerned about a specific skill can be challenging since children naturally develop at different rates.

The information on this page can help by explaining the different kinds of communication skills that develop in young children, and the typical communication milestones to look out for. If you find you are concerned about your child’s communication, the best thing to do is consult a speech-language professional or other healthcare provider.

Types of Communication

Speech, Language and Social Communication – What’s the Difference?

Communication can be broken down into three main groups of skills, and your child is developing all of these in the early years of their life. You may discover that your child is struggling with only one of these, or that they may need support in multiple areas.

Language refers to the words we use and understand in order to communicate with each other. You child is developing two kinds of language skills:

  1. Expressive language – The ability to use words and combine them together to express ideas.
  2. Receptive language – The ability to understand the meanings of the words and sentences others use.

Some children may need extra support with only their expressive language, while other children need help with both.

Communication Milestones

The list of milestones below reflect the ages at which most children develop language and social communication skills. If your child does not develop one of the skills during these ranges, it doesn’t necessarily mean there is a problem. But if your child hasn’t reached most of the milestones for their age, we recommend that you consult with a speech-language pathologist.

  • Startles to loud noises
  • Calms to a familiar friendly voice (e.g., parent’s)
  • Has different cries for different needs (e.g., hungry cry vs. tired cry)
  • Makes cooing and gurgling sounds

  • Turns towards a sound
  • Enjoys playful interactions with others (e.g., Peek-a-boo)
  • Babbles (e.g., “bababa”) and makes different sounds
  • Makes sounds in response to someone talking to them
  • Watches faces when someone is talking

  • Enjoys playing with musical toys and toys made of varied textures
  • Stops and looks when their name is called
  • Enjoys action rhymes and songs (e.g., Pat-a-cake)
  • Follows some familiar directions/routines when paired with gestures (e.g., “Touch your toes”)
  • Shows recognition of commonly used words
  • Lets you know what they want using sounds, and/or actions (e.g., reaching)
  • Uses a variety of sounds and syllable combinations when babbling

  • Pays attention to where you are looking and pointing
  • Responds to simple directions (e.g., “Come here”)
  • Understands common words such as “all done,” “no,” and “bye-bye”
  • Uses gestures (e.g., giving objects, shaking their head, waving, or raising their arms) to communicate
  • Says one or two words
  • Imitates speech sounds

  • Enjoys listening to short storybooks
  • Understands more words than they can say, including names of everyday objects (e.g., items of clothing, body parts)
  • Understands simple questions (e.g., “Where’s Mommy?”) and simple directions (e.g., “Go get your shoes”)
  • Reaches or points to things they want while making sounds
  • Says 10-20 words, although they may not be clear

  • Enjoys simple pretend play with toys (e.g., feeding a doll or driving a car to the store)
  • Follows adult body language including pointing, gestures and facial expressions
  • Understands more simple words and directions (e.g., “Go get your book”)
  • Uses 50 or more single words and combines two words (e.g., “Mommy go”)
  • Copies sounds and words frequently
  • Takes turns in conversations

  • Shows interest in others' play
  • Participates in short conversations
  • Understands different concepts such as in/out, up/down, big/little
  • Follows two-step directions (e.g., “Go to your room and get your socks”)
  • Answers simple “who,” “what,” and “where” questions (e.g., “Where is your hat?”)
  • Uses sentences of three or more words most of the time

  • Enjoys playing with peers
  • Understands turn-taking and sharing with adults and peers
  • Answers a variety of questions, including “why” questions (e.g., “Why are your hands so dirty?”)
  • Talks in sentences with adult-like grammar
  • Talks about past and future events

  • Chooses friends and play mates
  • Takes turns in longer conversations
  • Understands most of what is said at home and school
  • Recognizes familiar signs (e.g., stop sign)
  • Follows simple stories and can retell stories
  • Uses well formed sentences
  • Asks the meaning of unfamiliar words

The Role of Parents

The first thing to do if you are concerned about your child’s communication is to consult a speech-language pathologist (SLP) or healthcare provider. Following an assessment, an SLP may recommend support for your child's speech, language and/or social communication skill development. However, to have the greatest impact on your child's outcomes, you, the parent, must play a key role in supporting your child's learning.

Why you have the greatest power to help your child
  • Research shows that young children learn to communicate best during enjoyable, everyday interactions with the important people in their lives – their parents and caregivers.
  • Your close relationship with your child means that they are most comfortable communicating with you, and that you know them best – you know their interests and preferences, and what will make interactions motivating and fun for them.
  • Since you spend the most time interacting with your child, you have many opportunities to support your child's learning within your daily activities.
  • Many studies have shown that, with the right support, parents can learn research-based strategies to use during everyday activities and interactions with their child and that, when they do this, their child’s communication improves.

Learn more about the power of parents

How a Hanen Certified SLP Can Help

Hanen Certified SLPs have additional specialized training in the most effective ways to support parents to play a leading role in their child’s communication development. Either by offering a Hanen Program for parents or by supporting you in one-to-one sessions, the SLP can help you learn how to use research-based communication-building techniques during your everyday interactions with your child. In this way, you maximize your child’s opportunities to learn.

Find a Hanen Certified SLP
Why choose a Hanen SLP?

Programs for Parents

The Hanen Centre™ specializes in developing programs for supporting parents to play a leading role in their child’s communication development. We have programs in the areas of language and social communication.

Hanen Certified SLPs offer the following Hanen Programs to parents around the world, either in person or online:


It Takes Two to Talk®

The Hanen Program® for Parents of Children with Language Delays

This program helps parents to learn how to support their child’s language-learning during everyday activities and interactions.

Learn more


More Than Words®

The Hanen Program® for Parents of Autistic Children or Children Who May Benefit from Social Communication Support

This program helps parents build their child’s social and communication skills during everyday routines and enjoyable interactions.

Learn more


Target Word™

The Hanen Program® for Parents of Children Who Are Late Talkers

This program helps parents of young children (18 -30 months) to build their child's expressive vocabulary during everyday activities.

Learn more


TalkAbility™

The Hanen Program® for Parents of Autistic Children Who Are Speaking in Sentences and Having Conversations

This program helps parents of autistic children (ages 4-8) support their child to have more extended conversations and form deeper connections with adults and peers.

Learn more


Why Hanen Programs Are Effective

You receive the highest quality learning experience

Your learning during a Hanen Program is just as important as your child’s learning. Hanen Programs are based on research showing what helps adults learn best. This includes opportunities to practice, discuss, and watch real-life examples of parents using the strategies with children.

You learn and connect with other parents

You attend weekly sessions with the SLP and other parents to learn strategies in an environment designed for adult learning. This gives you the opportunity to hear other parents’ experiences, and to talk and connect with them.

You receive personalized support from the SLP

At specific intervals between group sessions, you and your child meet with the SLP. During this meeting, you receive personalized coaching and practice opportunities, and have the chance to discuss progress and goals, and to plan for at-home practice.

What you learn becomes a natural part of your everyday life

The strategies you learn don’t just help you support your child’s communication – they help you understand your child better, have more fun interacting with them and connect with them better. This can reduce stress and lead to more enjoyable interactions for the whole family. You’ll find that the strategies you learn become such a natural part of your interactions that, in time, you won’t even need to think about them.

Parent Experiences

Parents learn many strategies in a Hanen program, but they often tell us it’s the ones that seemed the simplest at first that have the most life-changing impact. Here is a video of a few parents talking about powerful strategies they learned in the It Takes Two to Talk® program.


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Resources

Each Hanen Program has a practical guidebook that supports parents’ learning throughout the program. You can use these guidebooks to start supporting your child right away or to supplement the support your family is already receiving. You’ll learn more about how your child is communicating right now, and what you can do during enjoyable everyday interactions to help them learn.

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References

  1. Curtis, P. R., Kaiser, A. P., Estabrook, R., & Roberts, M. Y. (2019). The longitudinal effects of early language intervention on children's problem behaviors. Child development, 90(2), 576-592. 
  2. Heidlage, J. K., Cunningham, J. E., Kaiser, A. P., Trivette, C. M., Barton, E. E., Frey, J. R., & Roberts, M. Y. (2020). The effects of parent-implemented language interventions on child linguistic outcomes: A meta-analysis. Early Childhood Research Quarterly, 50, 6-23. 
  3. Pathways.org. (2023).  Milestones & Abilities. https://pathways.org/all-ages/milestones/
  4. Roberts, M., & Kaiser, A. (2011). The Effectiveness of Parent-Implemented Language Intervention: A Meta-Analysis. American Journal of Speech-Language Pathology, 20, 180–199. 
  5. Sangster, K. (2018). Critical Review: Does Parent-Implemented Early Intervention Improve Language Outcomes in Preschoolers with Language Impairments? University of Western Ontario. https://www.uwo.ca/fhs/lwm/teaching/EBP/2017_18/Kennie%20Sangster.pdf   
  6. Sone, B. J., Lee, J., & Roberts, M. Y. (2021). Comparing instructional approaches in caregiver-implemented intervention: An interdisciplinary systematic review and meta-analysis. Journal of Early Intervention, 43(4), 339-360. 
  7. Speech-Language & Audiology Canada. (2014).  Speech, Language and Hearing Milestones [Brochure]. www.sac-oac.ca  
  8. Speech and Language UK. (2023).  Ages and stages. https://speechandlanguage.org.uk/talking-point/parents/ages-and-stages/  
  9. Zhao, B., Liu, Y., Liu, J., & Liu, Y. (2022). Early Family Intervention in Children with Language Delay: The Effect of Language Level and Communication Ability. Evidence-Based Complementary and Alternative Medicine, 2022.