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HomeClinics, Services & ProgramsDirectoryFirst Words program

First Words program

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There comes a time when the gurgles and coos of your baby evolve and you start to understand even more clearly through the use of words the thoughts that go on behind his or her eyes. You may wonder about the normal phases of language development, how you can help it along and when you should become concerned if your child does not seem to talk.

Normal stages of speech development

Every baby develops in his or her own way. They learn a great deal in the first five years of life. By the time your child is ready to go to school, however he or she should be able to speak and listen well. The following are a few milestones that babies and children generally follow. Some children will take a little longer without there being any problem.

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 two or three 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 point to several body parts when asked, play with toys and pretend to do things like feeding a doll or going in a car, say at least 20 words, and follow directions such as "drink your juice" or "sit down please."

By two to three years, most will use short 2 to 4 word sentences, follow two-part directions, 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.

By three to four years, most will use sentences of five to eight words, give directions like "fix this for me", ask many questions, tell about things they have done, talk to themselves and their toys, tell a story or sing a song, and tell you when they are tired.

Stimulating your baby to talk

Babies learn to talk by listening to voices and sounds. There are definitely some things that you can do to help your child in developing their speech and language skills.

Playing and enjoying music together provide wonderful opportunities to enjoy each other and to try a few simple but helpful techniques. Get your child's attention; by getting down to your child's level so you can be face to face. Play games and talk about things that interest your child. Talk about and show interest in what he or she sees, feels, and does. Copy the sounds and actions your child makes. You play a key role in helping them put feeling into words. Children learn best by doing, so involve him or her in your activities. Tell and show your child what you are doing. You can use facial expressions and silly voices to make it more fun. When you talk to your child, remember that everything has a name. Use short and simple sentences. It is good to repeat yourself a lot, however it is critical to give your child a chance to answer.

When to call for help

The flip side of normal speech and language development stages is knowing when your child might need a little extra help. You know your child best. Some children do grow out of speech and language problems, but waiting to see if they will is not recommended. Children do develop at different rates, however, in general the following can indicate that it's time to call for help:

By six months of age, get help if your baby does not react to your voice or other sounds, or if your baby 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, use at least 20 words or has started to use words but stopped.

By two to three years, get help if your child acts frustrated when trying to talk, or if you have a hard time understanding what he or she says. Get help if your child does not put more than two words together, or does not listen well.

By three to four years, get help if your child repeats words but does not seem to understand, your child stutters, other people have a hard time understanding what your child says, or your child uses words in an unusual way.

Where to find help

CHEO is a community partner in the First Words Preschool Speech and Language Program. First Words is Ottawa's Preschool Speech and Language Program for children from birth to eligibility for senior kindergarten. This program, led by the Pinecrest-Queensway Community Health Centre (PQCHC), helps typically developing preschool children reach their full communication potential. First Words focuses on the prevention, early identification and treatment of speech and language problems. If you are concerned about your child's communication, please complete the First Words Communication Checkup.

Referrals to First Words may also be made directly to the CHEO Access Team by phone at 613-737-2757 or by fax at 613-738-4841.

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