10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-09

What are ASHA speech milestones and why do they matter?

The American Speech-Language-Hearing Association (ASHA) is the national professional body for speech-language pathologists (SLPs) in the United States. When your pediatrician, an early intervention program, or a school district talks about "speech milestones," they are almost always pointing to the benchmarks ASHA compiled from decades of peer-reviewed research.^[1]

Milestones are not pass/fail tests. They describe what most children (roughly 75 to 90 percent, depending on the skill) can do by a given age. A child who misses one milestone in isolation may be perfectly fine. A child who misses several in a row probably needs a closer look.

That distinction matters because parents keep hearing two opposite pieces of bad advice. One is "don't worry, Einstein didn't talk until he was four," which ignores real warning signs. The other is "your child failed the milestone checklist," which treats a developmental range as a single cutoff. ASHA groups skills into age bands rather than single birthdays, which is a smarter way to read them.^[1]

The milestones cover four overlapping areas: speech sounds (articulation), receptive language (understanding), expressive language (talking), and social communication (using language with other people). A delay in any one area is worth flagging. Delays across all four at once are a stronger signal, and they are the pattern linked to conditions like autism spectrum disorder or childhood apraxia of speech.

What does the full ASHA milestone chart look like, birth through age 5?

Here is a condensed version of ASHA's published milestones by age band.^[1] The table shows the key receptive, expressive, and speech-sound skills expected at each checkpoint.

Two things jump out of that table. Vocabulary explodes between 18 and 24 months, from roughly 10 words to 50 or more. The "word explosion" parents hear about is real, and it usually lands somewhere in that six-month window. If it hasn't started by 24 months, that is one of the clearest early warning signs in the whole framework.^[2]

Notice too how intelligibility climbs. A stranger should understand about half of what a 2-year-old says and about three quarters of what a 3-year-old says. Parents almost always understand their own kid far better than strangers do, so when you run an informal check, try to rate it through a stranger's ears.

What are the 18-month speech and language milestones specifically?

By 18 months, ASHA expects at least 10 different words used consistently, one-step commands followed without a gesture, and pointing to show you things. This checkpoint gets watched closely because it lands at a standard well-child visit and because it is the age when a real vocabulary delay becomes visible.^[2]

Here is what ASHA's 18-month milestones break down into.^[1]

Receptive side: the child follows a simple one-step command without a gesture ("give me the ball"), points to a couple of body parts when you name them, and understands around 50 words even if they aren't saying that many.

Expressive side: at least 10 different words, used more than once or twice. The list should reach past names. "Mama" counts, but you also want words like "more," "no," "up," or "ball." The child should point to share interest in something, not only to request it. Clinicians call that declarative pointing, and it is one of the earliest joint-attention behaviors.

Social communication side: the child makes eye contact during interactions, brings things to show caregivers, and responds to their own name most of the time.

A vocabulary below 10 words at 18 months is one of the criteria researchers use to identify a "late talker."^[2] That is a real threshold, not a rough guess.

The 18-month visit is also when pediatricians are supposed to run a formal developmental screen. The American Academy of Pediatrics (AAP) schedule calls for screening at 9, 18, and 30 months, plus any visit where a parent raises a concern.^[3] If your child's doctor skipped the screen at 18 months, asking for it is completely reasonable.

If your child is near 18 months and you want a structured home activity while you wait for an evaluation, a tool like Little Words can give you daily language input modeled by SLPs. It is a supplement, not a substitute for an evaluation.

How many words should a child say at each age?

Vocabulary size is one of the most-studied markers in early language, and one of the most anxiety-producing for parents, because it feels like a number you can count and compare. Here are the word-count benchmarks most often cited from ASHA's milestones and the supporting research.^[1][2]

A few honest caveats. Nobody has a reliable way to count a toddler's full vocabulary at home. Parents undercount, because they only remember the words their child used in the last few days, and SLPs often land on a different number on a formal assessment. The table shows population averages, and the normal range is wide. Steady growth matters more than any single number, and so does whether the child is combining words by 24 months.^[2]

Bilingual and multilingual children spread their words across two or more languages. A child who says 5 words in English and 6 in Spanish has 11 words total, and should be evaluated across both languages.^[4] Bilingualism does not cause speech delay. Do not let anyone tell you otherwise.

What are the red flags for speech delay at any age?

ASHA and the AAP both publish lists of behaviors that call for a referral now, not a "let's watch and wait."^[1][3] These are the signs that should push you to request an evaluation the same week, not at the next well-child visit.

By 12 months: no babbling, no pointing or other gestures, no response to name.

By 16 months: no single words.

By 18 months: fewer than 10 words, not pointing to share interest, not following simple commands.

By 24 months: fewer than 50 words, no 2-word combinations, not imitating words or actions.

At any age: losing speech or language skills the child already had. This is regression, and it always means get an evaluation now, not in six months.

There is one pattern that hides from simple word counts. A child who repeats phrases from TV shows or books without seeming to understand them, or who has a great memory for songs but doesn't use language to get things done, may look fluent on the surface. This is called echolalia, and it can point to autism spectrum disorder or other language differences even when the vocabulary count looks high.^[5]

The AAP also recommends autism-specific screening at 18 and 24 months, on top of the general developmental screens.^[3] The M-CHAT-R/F is the tool most pediatricians reach for, and it is free and public.

How does ASHA define a speech delay versus a language delay?

A speech delay is about how a child produces sounds. A language delay is about the meaning system: vocabulary, grammar, sentence structure, and understanding. Parents and even some doctors use the terms interchangeably, but they can have different causes and different treatments.

A speech delay lives in the sounds. A child may talk a lot and still be hard to understand. Common causes include childhood apraxia of speech, phonological disorders, and structural issues like a cleft palate or tongue tie.

A language delay lives in the meaning. A child might have clear speech sounds but say very few words, fail to combine words for their age, or struggle to follow directions.

Most toddlers who show up for speech therapy have some mix of both. A formal evaluation by a licensed SLP sorts out which areas are affected and by how much.

Social communication disorder is a third category ASHA recognizes. A child with this profile uses language fine in some settings but struggles with conversational back-and-forth, indirect language, or shifting their style for different listeners. It shows up often in autism spectrum disorder, and it can also stand on its own.^[1]

None of this is something a parent can reliably sort at home. Knowing the distinctions lets you ask sharper questions at an evaluation. It does not let you diagnose your own child.

What should parents do if their child is not meeting ASHA's milestones?

Request an evaluation. Do not wait six months to see if things improve. The research on early intervention is consistent: earlier identification and treatment produces better outcomes than delayed help.^[6]

You have two main paths.

The first runs through your state's Early Intervention (EI) program, mandated under the Individuals with Disabilities Education Act (IDEA) Part C for children from birth through 35 months. You do not need a doctor's referral. Parents can self-refer by calling the state program directly. Evaluations under Part C are free regardless of income, and if your child qualifies, services are provided in natural environments (usually your home) at no cost.^[7] Federal rules give the program 45 days from referral to complete the evaluation, though some states move faster.

The second path runs through your pediatrician, who can refer you to a private SLP or a hospital-based speech clinic. Insurance coverage varies a lot by plan and state. Under the Affordable Care Act, pediatric speech therapy counts as an essential health benefit on children's plans, but the coverage limits differ from plan to plan.^[8]

If your child is 3 or older, the path shifts from IDEA Part C to Part B, run by your local school district. The district must evaluate any child you refer, for free, and if the child qualifies, services come through an Individualized Education Program (IEP).

While you wait, daily language-rich interaction at home genuinely helps. Narrate what you're doing. Read books that invite pointing. Respond to every communication attempt, not only the words. Follow your child's lead in play. None of this cures a delay, but these are the exact moves SLPs teach parents in coaching sessions, and the research backs them as a supplement to formal therapy.^[6]

What does an ASHA-certified SLP evaluation actually involve?

An evaluation by an ASHA-certified SLP usually takes 60 to 90 minutes for a young child, sometimes split across two sessions. It is not a test the child passes or fails. The SLP is building a profile of strengths and gaps across several language areas.

Most evaluations include a caregiver interview (the fastest way to get developmental and family history), structured play observation, formal standardized tests, and an analysis of a language sample. For young children, clinicians commonly use the Bayley Scales of Infant and Toddler Development, the Preschool Language Scales (PLS-5), or the MacArthur-Bates Communicative Development Inventories, choosing tools based on the child's age and the reason for referral.^[9]

You should walk away with a written report that includes standard scores, percentile ranks against age peers, a clear statement of whether the child qualifies for services, and specific recommendations. If the report is mostly jargon and no plan, it is fair to ask for a follow-up call to make sense of it.

Some families also pursue an evaluation by a developmental pediatrician or neuropsychologist, especially when autism, ADHD, or other developmental differences are on the table. An SLP evaluation and a developmental pediatrics evaluation work together; they are not redundant. When autism is being considered, autism spectrum speech therapy can look different from standard articulation work and may bring in AAC devices.

Does late talking always mean a developmental disorder?

No. And the research here is genuinely nuanced.

About 13 to 17 percent of 2-year-olds meet the "late talker" criteria (fewer than 50 words or no word combinations by 24 months).^[2] Of those, roughly 50 to 70 percent catch up to peers by age 4 without formal intervention, the group researchers call "late bloomers." The hard part: nobody has a reliable way to tell in advance which late talkers will catch up on their own and which won't.

Better odds of catching up go with strong receptive language (the child understands a lot even if they say little), heavy gesture use, and a family history of late talking that turned out fine. Worse odds go with receptive delays alongside expressive ones, low gesture use, few consonants in babble, and concerns in other developmental areas.

"Wait and see" used to be standard pediatric advice. The AAP stepped back from it as a default because early intervention is low-risk and the downside of waiting for a child who actually needs help is real.^[3] The current thinking runs closer to this: if you're worried, refer early and evaluate. If the child turns out to be a late bloomer, the therapy won't hurt, and you get useful interaction strategies out of it anyway.

That is the whole point of the milestone framework. It exists not to label children but to give parents and clinicians a shared reference point, so somebody notices when something deserves attention.

How do ASHA milestones apply to bilingual or multilingual children?

Bilingual children develop language at the same overall rate as monolingual children when you assess everything they know across all their languages.^[4] This is one area where outdated clinical advice did real harm. For decades, SLPs and pediatricians told families to drop to one language at home to avoid "confusing" a child who was already behind. The evidence does not support that.

A bilingual child may have a somewhat smaller vocabulary in each single language than a monolingual peer, but their combined conceptual vocabulary is comparable. An evaluation that counts only English words in a Spanish-English home will underestimate that child's language every time.

ASHA's guidance says bilingualism does not cause language disorders and that children should be assessed in all the languages they hear.^[1] If the SLP evaluating your child speaks only English and your child is being raised in another language or a bilingual home, ask for an interpreter or a bilingual SLP. ASHA treats this as a quality-of-care issue, not a preference.

Here is the tell. A true language disorder shows up across all of a child's languages. A child who is simply growing up bilingual shows age-appropriate skills in at least one language, or strong total skills across both.

How can parents support speech development at home between therapy sessions?

Speech therapy at home is not flashcard drills at the kitchen table. The strategies SLPs recommend are built around relationships and conversation, and most of them fold into daily routines with no separate "practice time."

Self-talk and parallel talk. Self-talk means narrating your own actions out loud ("I'm washing the dishes, the water is warm"). Parallel talk means narrating what your child is doing ("You're stacking the blocks, up, up, up"). Both pour language into the child with no pressure to respond. Studies of caregiver interaction consistently link the amount and quality of input to vocabulary growth.^[6]

Expanded imitation. When your child says a partial or wrong version of a word, repeat it back correctly and add a little, without making it feel like a correction. Child says "buh" for bus, you say "yes, bus! A big bus." This is a core technique in the well-studied Hanen program, It Takes Two to Talk.^[10]

Follow the child's lead. Talking about what your child already cares about grows vocabulary faster than steering their attention to what you want to teach. That is more than a philosophy; it holds up in studies of caregiver-child interaction in everyday settings.

Cut the questions, add comments. Many parents lean on "what's that?" and "what color is it?" Questions demand a response and can feel like a quiz. Comments ("that block is really red") give the same language input without the pressure, and they tend to draw out more vocalizing in return.

Apps built around speech modeling, like Little Words, can keep language exposure steady between appointments. They work best as a supplement to SLP-guided therapy, not a replacement for it.

For children who need more than speech alone, AAC devices (augmentative and alternative communication tools) are an evidence-based option. They support communication while spoken language develops, and they do not slow speech down.

What is the difference between ASHA milestones and CDC milestones?

Both ASHA and the Centers for Disease Control and Prevention (CDC) publish speech and language milestone resources for parents. They are not identical, and the differences come from different purposes.

ASHA's milestones are built for clinical reference. They come with finer age bands, more specific skill descriptions across multiple areas, and detailed guidance for SLPs on evaluation and treatment. They are the standard most speech-language pathologists use to describe what is typical.

The CDC's "Learn the Signs. Act Early." milestones were revised in 2022 to reflect what 75 percent of children can do by a given age, a deliberate move away from the older 50th-percentile benchmarks. The stated goal of the revision, developed with the American Academy of Pediatrics, was to catch children who need evaluation earlier, not to raise the bar arbitrarily.^[11] The CDC materials are written for parents and primary care providers, so they run shorter and simpler.

The practical takeaway: ASHA and CDC milestones agree on the core messages. Both say 10 words by 18 months, 50 words and 2-word combinations by 24 months, and both treat regression at any age as a red flag. The CDC's revised 2022 version is actually a touch more conservative (catches concerns earlier) than the versions many parents saved from an older child or an outdated web page.

If a checklist tells you "50 words by 24 months isn't typical until 30 months," it is probably out of date.

Frequently asked questions

What words should a child say by 18 months according to ASHA?

ASHA's 18-month milestone calls for at least 10 different words used consistently. These should include a mix: names of people or objects, action words like "up" or "more," and social words like "no" or "bye." A child who says only one or two words at 18 months, or who has lost words they previously used, should be referred for an evaluation rather than monitored for another few months.

Is it normal not to talk at 18 months?

Some children say fewer than 10 words at 18 months and turn out to be late bloomers who catch up without intervention. But ASHA and the AAP agree that fewer than 10 words at 18 months is a referral flag, not a "wait and see" situation. An evaluation is low-risk and free through your state's Early Intervention program. Waiting until age 2 or 3 to see if a child catches up is no longer the standard of care.

How many words should a 2-year-old say?

By 24 months, ASHA's milestones call for at least 50 different words and the beginning of 2-word combinations like "more milk" or "daddy go." The 50-word threshold and the onset of word combinations both matter: a child who has 50 words but is not yet combining them, or who is combining words but has far fewer than 50 in their vocabulary, is worth discussing with an SLP.

What causes a child to have a speech delay?

Speech and language delays have many possible causes, including hearing loss (which is why an audiological evaluation is usually the first step), structural differences like cleft palate or tongue tie, neurological differences including autism spectrum disorder, childhood apraxia of speech, developmental language disorder, or simply being a late bloomer with no identifiable cause. In a significant share of cases, no single cause is found. A thorough evaluation looks at all of these.

Does watching TV or using tablets cause speech delay?

Passive screen time (background TV, solo tablet use) is linked to less caregiver-child interaction, which is the likely mechanism, not something the screen does directly to a child's brain. Interactive video chat does not show the same negative link. The AAP recommends avoiding solo screen time before 18 to 24 months and limiting it for ages 2 to 5. That is different from saying screens cause delays. It reflects that time on screens displaces time in conversation.

Can bilingual children be late talkers?

Yes, but bilingualism itself does not cause late talking. Bilingual children should be assessed across all their languages combined. A child who says 6 words in English and 6 in Spanish has 12 total words and is meeting the 18-month benchmark when evaluated appropriately. A true language delay in a bilingual child appears in all languages, not only the one being tested. ASHA states plainly that bilingualism does not cause speech or language disorders.

How do I get a free speech evaluation for my toddler?

For children under 36 months, contact your state's Early Intervention program directly. You do not need a doctor's referral; parents can self-refer. Evaluations are free under IDEA Part C, and if your child qualifies for services, those are also provided at no cost. Federal rules require the evaluation be completed within 45 days of referral. For children 3 and older, contact your local public school district, which must evaluate and serve eligible children under IDEA Part B.

What is the difference between a speech delay and autism?

Speech delay is a symptom, not a diagnosis. Autism spectrum disorder involves speech and language differences but also social communication differences, restricted interests, and repetitive behaviors. A child can have a speech delay without autism, and not all children with autism share the same speech profile. Some have advanced vocabulary with social communication difficulties; others have minimal verbal speech. The CDC and AAP recommend autism-specific screening at 18 and 24 months on top of general developmental screening.

What is echolalia and is it a red flag?

Echolalia is repeating words or phrases heard from other people, TV, or books, without apparent communicative intent. Some echolalia is developmentally normal up to about age 2.5. Persistent echolalia after that, or echolalia that makes up most of a child's communication, is worth discussing with an SLP. It is common in autism spectrum disorder but also appears in other language differences. You can read more in our article on echolalia.

What is childhood apraxia of speech?

Childhood apraxia of speech (CAS) is a motor speech disorder where the brain has trouble planning and coordinating the movements needed for speech. Children with CAS often make inconsistent errors, do better on a first attempt than on repetitions, and show a gap between what they seem to want to say and what comes out. It needs a specific type of speech therapy, different from treatment for other speech delays. Our article on childhood apraxia of speech covers what to look for and how it is treated.

At what age is speech delay no longer a concern?

There is no age at which speech and language development stops mattering clinically, but the window of fastest change and highest intervention benefit is birth through age 5. Children with unresolved language delays at school entry (age 5 to 6) face elevated risk for reading difficulties, because reading depends heavily on oral language foundations. Older children and adults can still make meaningful gains in speech therapy, but the early-intervention research shows larger effect sizes for younger children.

Should I be worried if my child talks a lot but is hard to understand?

ASHA's intelligibility norms say a 2-year-old should be about 50 percent understandable to an unfamiliar adult, a 3-year-old about 75 percent, and a 4-year-old close to 100 percent. If your child is well below those thresholds, an SLP evaluation is appropriate even if the child is talkative. Poor intelligibility in a verbal child can signal a phonological disorder, childhood apraxia of speech, or other articulation differences that respond well to early treatment.

Sources

1. ASHA, Speech and Language Developmental Milestones: ASHA's published milestones by age band for receptive language, expressive language, speech sounds, and social communication from birth through age 5
2. Rescorla, L. (2011). Late Talkers: Do Good Predictors of Outcome Exist? Developmental Disabilities Research Reviews, 17(2), 141-150.: 13 to 17 percent of 2-year-olds meet late talker criteria; roughly 50 to 70 percent catch up by age 4; at least 10 words by 18 months as the vocabulary threshold
3. American Academy of Pediatrics, Developmental Surveillance and Screening: AAP recommends developmental screening at 9, 18, and 30 months and autism-specific screening at 18 and 24 months
4. ASHA, Bilingual Service Delivery: Bilingualism does not cause language disorders; children should be assessed across all languages; bilingual children may distribute vocabulary across languages
5. ASHA, Autism Spectrum Disorder: Echolalia as a feature of autism spectrum disorder; social communication disorder as a distinct diagnostic category
6. Hanen Centre, It Takes Two to Talk Program Research: Language-rich caregiver interaction, expanded imitation, and following the child's lead are evidence-based home strategies; early intervention produces better outcomes than delayed intervention
7. U.S. Department of Education, IDEA Part C Early Intervention Program: IDEA Part C mandates free evaluations and services for children birth through 35 months; evaluations must be completed within 45 days; services provided in natural environments
8. HealthCare.gov, Essential Health Benefits: Pediatric speech therapy is an essential health benefit under the Affordable Care Act for children's health plans
9. Zimmerman, I.L. et al. Preschool Language Scales (PLS-5). Pearson Assessments.: PLS-5 is a commonly used standardized assessment tool in SLP evaluations for young children
10. Hanen Centre, Research Basis for It Takes Two to Talk: Expanded imitation and caregiver responsiveness techniques as taught in Hanen's It Takes Two to Talk program
11. CDC, Learn the Signs. Act Early. Milestone Revisions 2022: CDC revised its developmental milestones in 2022 to reflect what 75 percent of children can do by a given age, in collaboration with the AAP, to identify children needing evaluation earlier