Early intervention is crucial. This checklist can be used from birth to age four to help you decide if your child needs help with their speech and language development.

Has your baby had their hearing screened?

If you live in Toronto and your baby did not have their hearing screened at birth, please contact Surrey Place.

Does the child:

  • Startle in response to loud noises?
  • Turn to where a sound is coming from?
  • Make different cries for different needs (hungry, tired)?
  • Watch your face as you talk?
  • Smile/laugh in response to your smiles and laughs?
  • Imitate coughs or other sounds such as ah, eh, buh?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Respond to their name?
  • Respond to the telephone ringing or a knock at the door?
  • Understand being told no?
  • Get what they want through using gestures (reaching to be picked up)?
  • Play social games with you (Peek-a-Boo)?
  • Enjoy being around people?
  • Babble and repeat sounds such as babababa or duhduhduh?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Follow simple one-step directions (sit down)?
  • Look across the room to a toy when adult points at it?
  • Consistently use three to five words?
  • Use gestures to communicate (waves hi/bye, shakes head for no)?
  • Get your attention using sounds, gestures and pointing while looking at your eyes?
  • Bring you toys to show you?
  • Perform for social attention and praise?
  • Combine lots of sounds together as though talking (abada baduh abee)?
  • Show an interest in simple picture books?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Understand the meaning of in and out, off and on?
  • Point to more than 2 body parts when asked?
  • Use at least 20 words consistently?
  • Respond with words or gestures to simple questions (Where’s teddy? What’s that?)?
  • Demonstrate some pretend play with toys (gives teddy bear a drink, pretends a bowl is a hat)?
  • Make at least four different consonant sounds (p ,b, m, n, d, g, w, h)?
  • Enjoy being read to and sharing simple books with you?
  • Point to pictures using one finger?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Follow two-step directions (Go find your teddy bear and show it to Grandma.)?
  • Use 100 to 150 words?
  • Use at least two pronouns (you, me, mine)?
  • Consistently combine two to four words in short phrases (Daddy hat. Truck go down.)?
  • Enjoy being around other children?
  • Begin to offer toys to other children and imitate other children’s actions and words?
  • Use words that are understood by others 50 to 60 per cent of the time?
  • Form words or sounds easily and without effort?
  • Hold books the right way up and turn the pages?
  • Read to stuffed animals or toys?
  • Scribble with crayons?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Understand the concepts of size (big/little) and quantity (a little/a lot, more)?
  • Use some adult grammar (two cookies, bird flying, I jumped)?
  • Use over 350 words?
  • Use action words such as run, spill, fall?
  • Participate in some turn-taking activities with peers, using both words and toys?
  • Demonstrate concern when another child is hurt or sad?
  • Combine several actions in play (puts blocks in the train and drives the train, drops the blocks off.)?
  • Put sounds at the beginning of most words?
  • Use words with two or more syllables or beats (ba-na-na, com-pu-ter, a-pple)?
  • Recognize familiar logos and signs involving print (Stop sign)?
  • Remember and understand familiar stories?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Understand who, what, where and why questions?
  • Create long sentences using five to eight words?
  • Talk about past events (trip to grandparents house, day at child care)?
  • Tell simple stories?
  • Show affection for favourite playmates?
  • Engage in multi-step pretend play (pretending to cook a meal, repair a car)?
  • Talk in a way that most people outside of the family understand what she/he is saying most of the time?
  • Have an understanding of the function of print (menus, lists, signs)?
  • Show interest in, and awareness of, rhyming words?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Does the child:

  • Follow directions involving three or more steps (First get some paper, then draw a picture and give it to Mommy)?
  • Use adult type grammar?
  • Tell stories with a beginning, middle and end?
  • Talk to try and solve problems with adults and with other children?
  • Show increasingly complex imaginary play?
  • Talk in a way that is understood by strangers almost all the time?
  • Generate simple rhymes (cat-bat)?
  • Match some letters with their sounds (letter b says buh, letter t says tuh)?

If you answered NO to any of these questions, contact a speech language pathologist to book a communication assessment. Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.

Risk Factors and Warning Signs

Some children are at greater risk for having a communication delay or disorder. These can include:

  • Family history of speech and language delay or disorder
  • Babies born prematurely (pregnancy lasted less than 37 weeks)
  • Babies with poor physical health
  • Exposure to alcohol and/or certain medications during pregnancy or breastfeeding
  • Complications during pregnancy or birth

Within the first nine to to12 months of age, there are some additional signs that may indicate the need for a communication assessment:

  • Child does not use any gestures (example: reaching, waving)
  • Child rarely smiles at family/peers
  • Child makes few sounds (example: limited or no babbling)
  • Child plays only by themselves and does not let others join in
  • Child rarely looks at other peoples’ faces
  • Child does not respond to their own name

If your child has any known risk factors or red flags, contact a speech language pathologist to book a communication assessment. Research shows that early identification and intervention is important to set your child up for success.

Speech and language services for preschool-aged children and their families are available at no cost through Surrey Place.