First Words program

By six months of age, most babies will watch your face and make noises back when you talk, cry in different ways when hungry, make noises to get attention and smile at you and others. 

By 12 months, most will take turns making sounds, say 3 to 5 words but not clearly, understand "no" and shake his or her head, reach or point to something while making a sound, and understand simple questions or directions. 

By 18 months, most will say at least 20 words point to several body parts when asked, follow directions such as "drink your juice" or "sit down please", play with toys and pretend to feed a doll or drive a car. 

By two years, most use 100 or more words and consistently use short 2 to 4-word sentences (e.g., “daddy hat”, “truck go down”), follow two-part directions (e.g., “Go find your teddy bear and show it to Grandma”), have a conversation with family members or other familiar people, listen to stories and answer simple questions, and begin to add endings to words, such as running, toys. They talk in a way that people can understand their words 50 to 60 percent of the time. They also enjoy being with other children, offering toys to peers and imitating other children’s actions and words. They hold books the right way up and turn pages, “read” to stuffed animals or toys and scribble with crayons. 

By three years, most will use sentences of 5 or more words, ask and understand questions (who, what, where, why), talk about things that happened in the past (e.g., a trip to grandparents’ house, a day at childcare), tell simple stories, talk to themselves and their toys while doing pretend play. Their speech can be understood by most people outside of the family, most of the time. They start to show an awareness of rhyming and of what print can be used for (e.g., in menus, lists, signs).  

By 4 years, most children will use long sentences of 5 to 8 words with adult-type grammar, follow directions involving 3 or more steps (e.g., “First get some paper, then draw a picture, and last, give it to mom”), tell stories with a clear beginning, middle and end, talk to try to solve problems with adults and other children, demonstrate increasingly complex imaginative play. They will talk in a way that is understood by strangers almost all of the time. Most start to show their emergent literacy skills by generating simple rhymes (e.g., “cat-bat”) and matching some letters with their sounds (e.g., the “letter T says ‘tuh’). 

By six months of age, get help if your baby does not react to your voice or other sounds or does not smile or make sounds when awake. 

By 12 months, get help if your baby does not wave back at you when you say "bye-bye" and wave, or does not try to show you things by reaching or pointing. 

By 18 months, get help if your child does not respond to simple questions, does not use at least 20 words or has started to use words but stopped. 

By 21 months, get help if your child does not use 20 or more words, has stopped using words or is not using pretend play with their toys. 

By two years old, get help if your child has a limited number of words (less than 50), does not put more than two words together, acts frustrated when trying to talk or if you have a hard time understanding what he or she says, has difficulty following simple commands and does not listen well. 

By three years, get help if your child is difficult to understand when they talk to you or other people. Get help if your child uses short sentences or has difficulty listening or following commands. Get help if your child repeats words but does not seem to understand, if your child uses words in unusual ways or if your child stutters, 

By four years, get help if your child uses short sentences, has difficulty retelling an event or a story, stutters, or is difficult to understand due to speech errors by family members and other people. Get help if your child repeats words but does not seem to understand, if your child uses words in unusual ways or if your child stutters.