receptive language delay

A Guide to Receptive Language Delay

Receptive language is the ability to understand verbal (spoken) and nonverbal (written, gestural) language. Receptive language includes skills such as following directions, understanding gestures, identifying vocabulary and basic concepts, and answering questions. Are you wondering if your child’s receptive language skills are developmentally appropriate? Read on for a guide to receptive language delays.

Refer to this guide of common receptive language developmental milestones:


Age Milestones
0-3 months Turns to a familiar voice, smiles in response to voice
4-6 months Searches for sound sources, responds to ‘no’, shows interest in music and toys
7-12 months Responds to name, begins to respond to requests, understands 3-50 words
1-2 years Follows simple commands, points to pictures in books when named, points to a few body parts
2-3 years Follows 2-step commands, understands in/on/under/stop/go
3-4 years Understands simple ‘what’, ‘who’, ‘where’ questions
4-5 years Answers simple questions about stories


 There are multiple causes for difficulties with receptive language. Some of them include:

  •              Additional developmental disorders or delays
  •              Hearing loss
  •              Lack of exposure to language
  •              Intellectual disabilities
  •              Unknown origin

Here are some ideas to foster receptive language development at home:receptive language delay

  1. Label Objects: Name and point to objects when reading books and during daily routines such as meals, baths, and bedtime. Modeling the words helps to increase a child’s vocabulary.
  2. Simplify your Language: Use simple words and short word combinations. Instead of saying, “Oh, look at the car go!” say “Car go!” Rather than asking “Do you want more apple juice?” say “more juice?” This limits the amount of information the child needs to process in order to understand the message.
  3. Provide Cues: Give the child visual and/or gestural cues when communicating with the child. A visual cue could be a real or pictured object. A gestural cue could be pointing, turning, or gazing towards an object. They aid in improving receptive language because they provide additional information that is processed differently than verbal language. They also help the child pair meaning with verbal words.
  4. Give Directions: Practice following directions by making them fun. Give directions such as “Go find daddy”, “jump up and down”, and “clap your hands”. Provide a model for the child if needed.
  5. Check for Understanding: Be sure the child understands the direction, question, or information by having them repeat what they heard. Provide the child a repetition and/or re-word parts of the message using fewer words and simple, familiar language.

Wondering about red flags for a receptive language delay? Click here to learn more.

Reference: Paul, Rhea. (2007). Language Disorders from Infancy through Adolescence. St Louis, MO: Mosby Elsevier.

Receptive Language Delay: 5 Red Flags

Toddler Developmental MilestoneReceptive language delay is the inability to understand verbal (spoken) and nonverbal (written, gestural) language. Receptive language includes skills such as following directions, answering questions, responding to gestures, participating in conversation, and identifying age-appropriate vocabulary and concepts. A receptive language delay occurs when a child is achieving developmental milestones in the expected sequence, but is meeting them at a later age than his or her peers. How do you know when a child may have a receptive language delay? Here are some examples of
five red flags:

1. Difficulty Following Directions

Adult’s Input Expected Age of Mastery Red Flag Response/Action
“Bring me your cup” 12 months Bringing an undesired item, or no item at all
“Get your coat and put on your shoes” 24-36 months Bringing an undesired item, or no item at all

2. Difficulty answering questions

Adult’s Input Expected Age of Mastery Red Flag Response/Action
“More drink?” 12 months No gesture, vocalization, or word produced to indicate ‘yes’ or ‘no’
“All done?” 12-24 months No vocalization, gesture, or word response produced

3. Difficulty understanding gestures and nonverbal cues

Adult’s Input Expected Age of Mastery Red Flag Response/Action
Reaching out arms for a hug 12 months No response to the prompt and gesture, continuing their desired activity
Holding up a hand for a high-five 24 months No response to the prompt and gesture, continuing their desired activity

4. Difficulty engaging in conversation

Adult’s Input Expected Age of Mastery Red Flag Response/Action
“Hi!” 12 months No vocalization, gesture, or word response produced
“What are you doing?” 24-36 months A verbal response, no response, or a gesture unrelated to the child’s activity

5. Difficulty identifying age-appropriate vocabulary and concepts

Adult’s Input Expected Age of Mastery Red Flag Response/Action
“I see an apple” 12-24 months Not following eye gaze or pointing finger to the object/picture
“Find the cow” 12-24 months Not following eye gaze or pointing finger to the object/picture

Keep in mind that all children are unique and the above ages of mastery are approximate!

Receptive language skills are essential for communication because they precede and provide a foundation for expressive language skills. For example, you can expect a child to understand what a cup is before producing the word ‘cup’. A child may demonstrate comprehension by following your gaze to a target item, pointing or reaching for a desired object, and following directions appropriately.

Click here to learn more about expressive v. receptive language!

how early is too early for a speech language evaluation

How Young is Too Young for a Speech Language Evaluation?

If you have concerns about your baby’s ability to listen or communicate, it is never too early for her to be evaluated by a speech-language pathologist.

The first three years of your baby’s life is a critical period for learning language. Rapid growth and change in your baby’s brain makes learning easiest and most efficient during these years. Your baby is listening to you speak, watching you gesture and emote, and learning pre-verbal communication skills that lay the foundation for future speech and language development. Therefore, ensuring that your baby’s development is on-track from the start is very important.

How do I know if my baby needs to be evaluated for a speech or language concern?

  1. Your baby is not meeting speech and language developmental milestones on time:how early is too early for a speech language evaluation

Long before your baby says her first words, she is listening and communicating in a variety of ways:

  • By 3 months, she quiets or smiles when you talk to her and cries differently to express different needs
  • By 6 months, she responds to changes in the tone of your voice, babbles with many different sounds, and vocalizes excitement and displeasure
  • By 1 year, she makes gestures (e.g., waves) to communicate, imitates speech sounds, and says one or two words

These skills, along with other speech and language milestones, generally follow a similar sequence of development in typically developing children. And, though there is variation across all children, these milestones are usually expected at particular ages. The predictability of your baby’s language development allows speech-language pathologists to evaluate your baby’s skills long before she starts saying her first words. Looking at milestone charts and comparing them to your baby’s skills will give you hints about whether your baby might be on track or delayed.

  1. Your baby displays one or more of the following “red flags” for communication disorders*:
  • Does not babble by 9 months
  • Does not say first words by 15 months
  • Does not respond to communication appropriately
  • Does not make eye contact
  • Sudden loss of skills or slowing of development
  • Does not show interest in communication

*Adapted from Please see web site for more information.

  1. Your baby has hearing problems or a previously diagnosed neurodevelopmental disorder:
  • Hearing Problems: 92% of children with hearing loss are born to hearing parents. The ability to hear is essential to your child’s language development, as decreased linguistic input may negatively impact language. Furthermore, otitis media (middle ear infection) is common in children ages birth to 3. It may be harder for children to hear and understand language if sound is dampened by fluid in the middle ear. Therefore, children with frequent ear infections should have their hearing tested to ensure full access to their linguistic environment.
  • Neurodevelopmental Disorder: Neurodevelopmental disorders are disabilities associated with the functioning of the nervous system and brain. Children with these disorders are at higher risk of having speech and language problems.


What Can I do if I see One of These Red Flags?

If your baby is not meeting developmental milestones, displays any “red flags,” or has hearing difficulties or a neurodevelopmental disorder, you can take action by finding a speech-language pathologist in your area and scheduling an evaluation. Click here more information about how to select a speech-language pathologist, as well as what happens during a speech-language evaluation.

Developing Speech and Language AND Cooking a Pumpkin Pie

Developing speech and language AND cooking a pumpkin pie. Can you believe it?  Thanksgiving is right around the corner! Let’s talk for a minute about the staple of any Thanksgiving dessert table…the pumpkin pie. Many of us are looking for the perfect recipe, I know I am constantly searching! Before you jump straight into cooking, consider the following ways you can make this a fun activity that will help support your child’s speech and language needs.

Here is a list of ways you can make cooking a pumpkin pie
into a speech and language activity:


  • Direction following: Read through the recipe with your child and have him follow directions as you say them out loud. If your child needs extra support draw pictures in the same order that correspond with each step. For example, draw pictures of the ingredients, cooking utensils, etc.
  • Word recall: Read a list of ingredients out loud and have your child repeat a few, or all, items needed. This is a great way for your child to practice their listening and memory skills. If your child is able, you can ask them to recall items from a list a few minutes later or in steps. For example, if you’ve already used the pumpkin ask them if they remember what ingredient was next on their list.
  • Auditory Comprehension: Read the recipe out loud to your child and have them repeat the steps back to you (different from recalling the ingredients). This is great if your child is working on language processing skills. Your child may need to have the information broken down into smaller chunks, and this is okay.
  • Articulation: Find a few words within the recipe that have your child’s target sound or sounds in them. Ask them to use these words often throughout cooking and repeat them whenever they come up. For example, if their target sound is /k/ you can say, “Pumpkin, that has your /k/ sound in it, you try saying it!”
  • Fluency: The texture of pumpkin lends itself to a conversation about smooth versus bumpy. When encouraging your child to use fluent speech, you can ask them to use smooth speech versus bumpy speech with disfluencies.

Remember, cooking with your child should be fun! Pick one or two of the above activities and gently incorporate it into your holiday fun. Don’t stress yourself or your child too much by making cooking into a structured learning task. These are some great ways for you to support your child’s speech and language needs while still enjoying some family fun!

Here is the recipe for a great pumpkin pie:


1 (15 ounce) can pumpkin
1 (14 ounce) can Sweetened Condensed Milk
2 large eggs1 teaspoon ground cinnamon
  • 1/2 teaspoon ground ginger
  • 1/2 teaspoon ground nutmeg
  • 1/2 teaspoon salt
  • (9 inch) unbaked pie crust


1. Preheat oven to 425 degrees F. Whisk pumpkin, sweetened condensed milk, eggs, spices and salt in medium bowl until smooth. Pour into crust. Bake 15 minutes.
2. Reduce oven temperature to 350 degrees F and continue baking 35 to 40 minutes or until knife inserted 1 inch from crust comes out clean. Cool. Garnish as desired. Store leftovers covered in refrigerator

how to make carving a pumpkin a speech and language activity

Carving a Pumpkin – Make it a Speech and Language Activity!

One of my favorite Halloween memories from childhood is carving pumpkins with my dad. I loved the excitement of picking them out, pulling out all the yucky guts, deciding on faces, lighting them up and then, of course, making pumpkin seeds. With Halloween right around corner, it’s a great time to carve some pumpkins and make memories with your kids. Below are 3 ways you can work speech and language goals into this fun holiday activity!

3 Ways to Make Carving a Pumpkin a Speech and Language Activity:

1. Going to the pumpkin patch: There is so much to see at the pumpkin patch! This is a great opportunity to talkhow to make carving a pumpkin a speech and language activity about size concepts as well as to compare and contrast.

  • Have your child find the biggest or smallest pumpkin.
  • After picking out your pumpkins, have your child put them in order from biggest to smallest (or vice versa).
  • Compare the sizes and shapes of the pumpkins.
  • Use similes to describe the pumpkins. “It’s a big as a____.”

2. Carving the pumpkin. But first, talk about how you’re going to do it.

  • Make “How to Carve a Pumpkin” directions and problem solve with your child about what’s going to happen first, next, and last. They can draw or write out the steps.
  • If your child is younger, use one of these sequencing activities to help with the sequencing!

Sequence 1
Sequence 2
Sequence 3

3. Making pumpkin seeds. Cooking and recipes are great ways to work on language comprehension, vocabulary, and sequencing skills.

  • Click here for a great recipe – it gives you different seasoning options.
  • After reading through the recipe ask comprehension questions such as “What are two ingredients we need?” or “How hot should the oven be?”
  • Have your child recall all the steps of the recipe. It might be helpful to draw, or write them out.
  • Talk about the different seasoning options and how they might taste; use descriptive vocabulary words to describe the flavors! Spicy, fiery, zesty, sweet, fragrant, etc.

Happy Halloween!

Click here for 5 more speech and language themed Halloween activities!




5 fun halloweend speech and language activities

5 Halloween Themed Language Activities

Most kids LOVE Halloween. Costumes, trick-or-treating, candy….I mean really, what’s not to love? Here are 5 fun Halloween themed speech and language activities for you and your family to enjoy! P.S., All of these games are FREE!

5 Fun Halloween Themed Language Activities:

  1. Halloween Scattergories -Try and come up with a Halloween related word for each letter of the alphabet. Take5 fun halloweend speech and language activities it one step further and have your child explain the relationship between the scattergory words and Halloween.
  2. Which Witch is Which? -Similar to Guess Who, this game is great for language comprehension, question formulation, and turn-taking! There is also a “hint” page to help out little ones!
  3. Build a Haunted House -This is a great activity for little ones who like arts and crafts! It’s a fun game that targets auditory memory, following directions and basic concepts. You’ll need scissors, glue, construction paper, and crayons or markers.
  4. Spooky Story-Find a spooky picture (kid friendly, of course!) and make up a spooky story together. Make a list of descriptive words related to Halloween and try to use them in your story. For older kids, take turns writing a sentence for the story. For example, you can start with, “It was a dark and scary night,” and your child gets to fill in the next sentence. You can also set up interesting scenarios to further challenge the story writing. For example, “The skeleton walked into the house and he couldn’t believe what he saw!” This is a great way for you to collaborate together!
  5. Carve a Pumpkin-But first, talk about how you’re going to do it. Make “How to Carve a Pumpkin” directions and problem solve with your child about what’s going to happen first, next, and last. They can draw or write out the steps. If your child is younger, use one of these sequencing activities to help with the sequencing:

Click here for 5 fun fine motor activities for Halloween!


10 Great Speech and Language Apps

10 Great Apps for Speech and Language Development

These days, kids can work an iPad or iPhone before they even say their first words, and they can definitely navigate technology better than Grandma or Grandpa can. There are a number of benefits to using apps for speech and language development. First and foremost, kids love using the iPad. It’s shiny, animated, and it makes noise. It can help them maintain attention to an activity or speech and language task that they otherwise might not be interested in. And, it’s highly portable. However, the most important thing to remember when turning to the iPad for speech and language work, is that the iPad itself will NOT teach your child. Your interaction and engagement with your child and the application will be where the magic happens.

Here is a list of 10 great applications for speech and language development:


Name Age Range Focus Cost
Peekaboo Barn 6 months to 3 years Spatial concepts, vocabulary, animal sounds, turn-taking etc. Lite version or $1.99
Duck Duck Moose

(10 different apps)

6 months + Interactive apps, spatial concepts, vocabulary, categories, turn-taking etc. $1.99
Articulation Station All ages Speech sounds in words, sentences, stories Free download, sound packages are $2.99
Easy-Bake Treats 3+ “Wh-” questions, turn-taking, concepts, categories Free
Speech with Milo (15 different apps) 3+ Varied. Apps include focus on sequencing, articulation, prepositions, etc. $2.99
Sentence Creator 4+ Syntax (sentence structure) Free
Toca Boca

(over 15 different apps)

3+ Dependent on app. Mostly play-based but these apps are great for turn-taking, concepts, “wh-“ questions, categories, vocabulary, etc. Free – $2.99
Super Duper – Name that Category 3+ Categorization $3.99
Super Duper – Making Inferences 4+ Inferencing, answering “wh-” questions, reading, reasoning $3.99
Super Duper – Practicing Pragmatics 5+ Social language skills (i.e. politeness, solving problems, feelings, requesting, etc.) $3.99

articulation norms

Articulation Norms

Children acquire language in a typical pattern – first making isolated sounds, next syllables, followed by words, and eventually children begin to combine words into sentences to express their wants and needs. During this time of language acquisition, children are rapidly learning new sounds. Parents will notice that children don’t yet speak in adult-like dialogue and much of what a child is saying may be unintelligible to unfamiliar listeners. Rapid speech-language development can leave parents wondering, is my child developing appropriately?

The chart below represents ages that most children will acquire certain sounds. Some children will begin to use sounds earlier, and some later.

Articulation Norms by Age:


Age Speech Sound Intelligibility Warning Signs
3-3 ½ m, n, h, w, p, t, k, b, d, g, f, y (yes), tw- (twin), kw- (quick), and most vowel sounds Approx. 75% intelligible to adults Child should be understood by parents, caregivers. Should correctly produce vowels and /p, b, m, w/ sounds. Child should repeat/clarify without frustration.
4- 4 ½ v, j (jump or giant), gl- (glow) Approx. 100% intelligible to adults, may still have errors Child should be understood by familiar and unfamiliar listeners. Should correctly produce /t, d, k, f, g/ sounds. Child should repeat/clarify without frustration.
5- 5 ½ s, “sh,” “th” (they) sp-, st-, sk-, sm-, sn-, sw-, bl-, pl-, kl- (as in clap), fl-, tr-, kr- (cracker) Approx. 100% intelligible to adults, may still have errors Child should be understood by familiar and unfamiliar listeners the majority of the time. Child should correctly produce the majority of speech sounds. Child should repeat/clarify without frustration.
6 years r, l, z, “ng” (wing), “th” (think), “ch” (check) 100% intelligible, most sounds should be mastered Child should be understood by familiar and unfamiliar listeners the majority of the time.

1Bleile, K.M. (2004). Manual of articulation and phonological disorders: Infancy through adulthood, Second edition. Clifton Park,

NY: Delmar Learning.

child does not qualify for speech language services

Your Child Doesn’t Qualify for Speech-Language Services-Now What?




The start of the school year brings new school supplies, new teachers, and can bring new evaluations. Children are often flagged by doctors, teachers, or other school staff and subsequently may participate in a speech screening or possible evaluation. Following this evaluation, children may or may not qualify for ongoing speech-language services. If they don’t qualify, what do you do next?

Steps to take if your child does not qualify for needed speech-language services:

  1. If you still feel the child requires services, ask for a second opinion! If the child is told at school that he doesn’t qualify, this could be based on a child’s age or ability level. Often times the severity of a child’s difficulties may impact his qualifying for services, taking in to account age-matched peers.
  2. Watch and wait. If a child doesn’t qualify for services now, he might later! Depending on the child’s specific areas of need, articulation norms are tied to ages, so oftentimes therapists will wait until the child is in the expected age range before targeting a given sound. For example, /r/ is a later developing sound, so typically therapists won’t work on /r/ production until a child is 5 or 6 years old!
  3. Promote speech and language skills at home! Parents and siblings can be a great support for children with speech and language difficulties. Parents can model their own appropriate speech and language skills and recast if a child is struggling. When recasting, for example, parents can expand upon their child’s utterance to increase the length or make it more adult-like. If a child says, “ball,” parents can follow that with, “oh, you want the ball?” Siblings can also be a great help to work on peer interactions, turn taking, direction following and appropriate interaction and play!

Should your child not qualify for services right now – don’t give up! A licensed speech-language pathologist can help. SLPs may provide home programs to help target weak areas, and will often re-screen or even re-evaluate in 6 months or a year.

Click here for more information on our Speech-Language Pathology program.

speech language evaluation

What to Expect at a Speech-Language Screening




When parents first become concerned with their child’s speech or language development, a screening can be a good step to determine if a child will warrant a full speech-language evaluation.  Speech screenings can be informal or formal.  Here is what to expect at  each type of speech-language evaluation.

Speech-Language screenings can take on two forms-formal or informal:

Informal Screening:

• Lasts approximately 15 minutes
• Can take the form of a conversation with a licensed speech-language
Pathologist (SLP)
• May involve some play-based activities
• Often involves observation during peer interactions
• SLP may ask child age-appropriate questions to determine abilities for
answering questions, forming sentences, and articulation
• There is no formal protocol to follow
• There is always a parent meeting with the therapist after the screening to make recommendations

Formal Screening:

• Lasts approximately 15 minutes
• Often has a criterion check list of skills
• Will look at speech and language production
• May have images for child to name or fill-in-the-blank sentences
• Usually has questions for child to answer
• There is always a parent meeting with the therapist after the screening to make recommendations

Screenings can be a great tool to determine if a child warrants a full speech-language evaluation. A screening alone is not diagnostically reliable and should only be used as a tool to decide if an evaluation is necessary. A licensed speech-language pathologist will not make goals about ongoing therapy until an evaluation is completed, however, after both formal and informal screenings, an SLP will meet with parents to create a plan for the next step: either conduct an evaluation or decide that the child is on track with speech and language and wait 3-6 months before screening again!

Click here to view our Speech and Language Milestones Infographic!