CDC speech milestones: what every age should sound like

Last updated 2026-07-09

In February 2022, the CDC and the American Academy of Pediatrics rewrote the developmental milestone checklists that pediatricians use at well-child visits. ^[1] The old charts, in place since 2004, marked when 50 percent of children reached a given skill. The new ones mark when 75 percent do. That sounds like a small statistical tweak, but it changes what actually gets flagged at a checkup. A few milestones shifted earlier as a result. "First words by 12 months" stayed put, but the bar for 2-year-olds got noticeably stricter: the old chart treated 50 words at 24 months as a mid-range number, while the new one treats it as a floor that three-quarters of 2-year-olds have already cleared. ^[1] The AAP's reasoning was straightforward: catching kids sooner matters, because early intervention works far better than waiting it out. The revised checklist also spells out red flags more plainly. Instead of a vague "talk to your doctor if you're worried," it tells parents what to look for and when to act, which is a real shift for anyone who's been told for months that their child will catch up.

The milestones by age

Here's the full checklist from birth through age 5, taken directly from the CDC's 2022 update. ^[1] These reflect what roughly three-quarters of children can do by each age, not an average and not a ceiling.

Two patterns stand out in this table. Understanding almost always runs ahead of talking, so a child who understands plenty but says little is in a very different spot than one who doesn't seem to understand much either. And the 24-month row is the one pediatricians lean on most for referrals, since "50 words plus 2-word combinations" is concrete and easy to check against. ^[2]

At 12 months

By 12 months the CDC expects a child to say at least 1 or 2 real words, counting "mama" and "dada" only when used with intent rather than as general sounds. ^[1] The child should also be babbling with varied consonant-vowel combinations, not just vowel sounds.

Just as telling is what's happening around the words: the child should respond to their own name consistently, follow a simple direction paired with a gesture (like a held-out hand for "give me"), and point or gesture to communicate wants. A 12-month-old who points, waves, and shows objects is communicating even without words, and that's a good sign in itself. A 12-month-old with no words and none of those gestures either needs an evaluation now, not in three months. ^[2] The specific red flag the CDC names at this age is exactly that combination: no words and no gestures like waving or pointing.

At 2 years

The 24-month mark gets more attention, and more debate, than any other point on this chart. The CDC's 2022 checklist sets 50 words and 2-word original phrases (not memorized chunks like "thank you") as what's expected of 75 percent of 2-year-olds. ^[1]

The American Speech-Language-Hearing Association puts typical 2-year-old vocabulary at 200-300 words, with a wide range, but treats fewer than 50 words at 24 months as the clinical threshold for a "late talker" evaluation. ^[3] Those numbers aren't contradicting each other: 50 is the floor, 200-300 is closer to the middle of the range.

As for how much a stranger should understand: about half of a 2-year-old's speech. Parents typically follow more because they have context the stranger doesn't. If a stranger can make out almost nothing, that's worth writing down and mentioning to a doctor.

The phrases also need to be original combinations, not scripts. A child who says "thank you" and "all done" is repeating memorized phrases; a child who says "more cracker" or "mommy go" is putting words together on their own, which is the skill actually being measured. ^[3]

If a 2-year-old is showing delays, early intervention services under IDEA Part C are free through your state's program for children under 3, and you don't need a doctor's referral to request an evaluation. ^[4] Our guide to how early intervention works walks through that process in more detail.

At 3 years

By age 3, the CDC expects children to hold 2-3 sentence conversations, ask basic questions like "why" and "what," and be understood by strangers most of the time (ASHA cites roughly 75 percent intelligibility as the clinical benchmark ^[3]).

Sounds matter here too. Three-year-olds should have most vowels down, along with consonants like p, b, m, n, h, w, k, g, t, and d. Sounds such as r, l, s, z, ch, sh, and th aren't expected to be solid yet, so mistakes on those alone aren't a red flag. ^[5]

A 3-year-old who's still mostly using single words or short, incomplete phrases, and who's hard to understand even for parents, should get a speech-language evaluation. Some stuttering-like repetition of sounds or words is common and usually normal between ages 2 and 5, but if it comes with visible tension, eye-blinking, or the child avoiding talking altogether, that's worth bringing up with an SLP. ^[6]

Red flags at any age

A few warning signs matter no matter which birthday is coming up next. The clearest one is losing a skill the child already had: a child who was saying 10 words and drops to 3 needs evaluation right away, not a wait-and-see approach. The CDC specifically calls out regression as something to act on immediately. ^[1]

Beyond that, the age-specific flags to know are no babbling by 9 months, no words by 12 months, no 2-word phrases by 24 months, speech that strangers largely can't follow by age 3, and trouble following simple 2-step directions by age 3.

For children on the autism spectrum, communication differences often show up before speech does. Limited joint attention (looking back and forth between an object and another person), no pointing by 12 months, and no response to name by 9-12 months tend to appear earlier than any obvious speech delay. ^[7] Our guide to autism spectrum speech therapy goes into what evaluation and support look like for these kids.

One idea worth retiring: "boys talk later, so wait until 2." The research doesn't back this up. There's a real sex difference in early language, but it's small, girls average maybe 10-20 more words than boys at 24 months, which isn't a gap large enough to justify holding off on an evaluation. ^[8]

Using the checklist at home

The CDC's "Learn the Signs. Act Early." checklists are free, one page, and printable for ages 2 months through 5 years, and they're built to fill out before a well-child visit. ^[1] You can grab them at cdc.gov/ActEarly.

Bring the finished checklist with you to the appointment. Pediatricians move fast through short visits, and having something written down keeps the conversation focused so a real concern doesn't get glossed over.

Fill it out honestly: only check a box if you've actually seen the skill, more than once, not just if you suspect your child can probably do it. You can still check it if the skill shows up inconsistently, as long as you've genuinely observed it. Think of the checklist as a snapshot of where your child is right now, not a pass or fail grade.

If a pediatrician brushes off a concern you have, you don't need their sign-off to move forward. You can ask for a referral to a speech-language pathologist yourself, or contact your state's early intervention program directly if your child is under 3, no referral required. ^[4] Requesting that evaluation is your right.

Speech delay versus language delay: what's the actual difference?

Parents tend to use these two terms as if they mean the same thing, but clinically they don't.

Speech is about physically producing sound: articulation, fluency, voice. When a child's speech is unclear or inconsistent, or the sounds are physically hard to produce, that's a speech delay or disorder. Apraxia of speech and childhood apraxia of speech fall into this category: the issue is motor planning, not vocabulary or grammar.

Language is the system behind communication itself, things like words, grammar, understanding, and using language in social situations. A language delay shows up as a small vocabulary, trouble following directions, or not combining words into phrases on the expected timeline.

A child can have one problem without the other. Some kids communicate well but are hard to understand (a speech disorder). Others speak clearly but have very little vocabulary (a language delay). Most kids referred for speech concerns show some overlap of both, which is exactly why a full SLP evaluation looks at each separately.^[3]

If a language delay shows up alongside limited eye contact, repetitive behaviors, or unusual reactions to sensory input, autism spectrum disorder is one of the things an evaluation should look into.^[7]

What happens if a child doesn't meet CDC speech milestones?

Missing a milestone calls for an evaluation, not a crisis. Most kids who miss one have something treatable. Some catch up with therapy, some catch up on their own, and the kids with more complex needs benefit most from being caught early.

For children under 3, IDEA Part C guarantees a free evaluation and free early intervention services through the state if your child qualifies.^[4] States are required to serve children from birth to age 2 who have developmental delays, or conditions likely to lead to one. You can refer your own child by calling your state's early intervention hotline directly, no doctor's order needed.

Once a child turns 3, IDEA Part B takes over, and the responsibility for evaluation and services shifts to your local school district.^[4] Parents can request this in writing themselves.

Private speech therapy is also available at any age, whether through insurance or paid out of pocket. ASHA runs a "Find a Professional" directory at asha.org.^[3] Our guide to speech therapy and speech therapists covers how to find and vet a provider.

If you want a low-key way to practice speech goals between sessions, an app like Little Words offers structured, play-based language activities built for neurodivergent kids. It won't replace therapy, but daily practice at home is something SLPs consistently recommend, and you can take a quick quiz to see whether it fits your child's situation as part of our early intervention guide.

Are the CDC milestones accurate for bilingual children or children with autism?

Bilingual children reach language milestones at the same pace as monolingual children, as long as you count vocabulary across both languages.^[8] A child with 30 words in Spanish and 25 in English has 55 words total, and isn't behind. An assessment that only looks at one language will undercount that vocabulary and can flag a delay that isn't real. If your child is bilingual, make sure whoever evaluates them checks both languages.

Autism is a different story, because the CDC milestones are population norms and autism follows its own communication profile. Some autistic children talk early but struggle with the social side of language. Others are late talkers. Some develop words and then lose them, a pattern called regression that changes how the evaluation proceeds.^[7] Echolalia, repeating phrases from TV or other people instead of generating original speech, shows up often in autism and isn't just a delay. It's a different form of communication and needs different support. Our article on echolalia goes into more detail.

Milestones are a screening tool, not a diagnosis. Missing one means it's time for an evaluation. Only a full evaluation from a qualified team can actually diagnose anything.

How do CDC milestones compare to what speech therapists actually use?

SLPs treat the CDC checklist as a starting point, then lean on standardized assessments that go well beyond what a one-page checklist can capture.

For toddlers, two common tools are the MacArthur-Bates Communicative Development Inventories (CDI), a parent-report vocabulary checklist with strong data from thousands of children^[9], and the Preschool Language Scale (PLS-5), a direct assessment with norms broken down by age in months.^[10] These produce percentile scores instead of a simple pass or fail, which helps tell a mild lag apart from a real delay.

After the 2022 revision, the CDC milestones sit around the 25th percentile: the point where 75 percent of kids have the skill and 25 percent don't yet. A child just under that CDC line is in a different situation from a child who scores two standard deviations below the norm on a standardized test. Both should be evaluated, but the results point toward different recommendations.

One thing SLPs assess that the CDC checklist mostly misses is pragmatic language: the social side of communication, like asking for things, commenting, sharing attention, and taking turns in conversation. These skills matter a great deal and are often where autism-related language differences show up first.^[7]

When should I call a doctor or speech therapist?

Honestly, sooner than most parents do, and sooner than a lot of pediatricians will prompt you to.

The AAP recommends developmental screening at 9, 18, and 30 months, plus autism-specific screening at 18 and 24 months using validated tools.^[2] But screening isn't the same as evaluation. A failed screen means the next move is a full evaluation, and both the CDC and ASHA agree that shouldn't be put off.

Call your pediatrician now if your child has lost skills they used to have, at any age; isn't babbling by 9 months; has no words by 12 months; has fewer than 50 words or no 2-word phrases by 24 months; or is still hard for you to understand by age 3.

If your pediatrician tells you to wait without scheduling a follow-up or referral, you can call or self-refer to early intervention yourself if your child is under 3. Requesting a state evaluation is your legal right.^[4]

For kids 3 and older, write to your school district to request a special education evaluation under IDEA Part B. Districts generally have 60 days to complete it, though timelines vary by state.^[4]

Earlier really is better here: research on early intervention shows kids who get services before age 3 tend to have meaningfully better outcomes than those who start later.^[11] A Little Words quiz can also help you get a clearer picture of your child's communication profile before or between professional evaluations: start here.

Frequently asked questions

What are the CDC speech milestones for a 18-month-old?

The CDC's 2022 checklist expects an 18-month-old to use at least 10 words, point to familiar things when named, and point to at least 1 body part when asked. They should also try to say words you say and look at a book with you. Fewer than 10 clear words at 18 months is a reason to refer for a speech evaluation, not to wait until 24 months.

Did the CDC change the speech milestones in 2022?

Yes. In February 2022, the CDC and AAP revised the milestone checklists for the first time since 2004. The biggest change: milestones now reflect what 75 percent of children can do (not 50 percent), which moved some benchmarks earlier. The 24-month vocabulary threshold of 50 words became more explicit, and the checklists added clearer language about when to act rather than wait.

Is it normal for a 2-year-old to not talk much?

If "not much" means fewer than 50 words or no 2-word combinations, it's outside what the CDC and ASHA consider typical for 75 percent of 2-year-olds. That doesn't mean something is seriously wrong, but it does mean evaluation is appropriate rather than waiting. Some late talkers catch up quickly; others have underlying delays that respond well to early therapy. Waiting past 24 months before evaluating reduces the window for the most effective intervention.

What is the difference between a speech delay and being a late talker?

"Late talker" is an informal term for a toddler (usually 18-30 months) with fewer words than expected but otherwise typical development: good comprehension, normal hearing, and typical social skills. A speech or language delay is a clinical finding from an evaluation. Some late talkers catch up without intervention; research suggests about 70-80 percent of 2-year-old late talkers do. The rest have persistent delays that benefit from speech-language therapy.

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

Children under 3 are covered by IDEA Part C. Contact your state's early intervention program directly; no doctor referral is needed. The evaluation is free by law. For children 3 and older, contact your local school district in writing and request a special education evaluation under IDEA Part B. That evaluation is also free. Private evaluations through insurance or out-of-pocket are a parallel option at any age.

Are CDC milestones the same for boys and girls?

The CDC uses a single set of milestones regardless of sex. Research does show girls, on average, say slightly more words than boys at 24 months, but the difference is small (roughly 10-20 words) and doesn't justify using a lower threshold for boys. A boy with fewer than 50 words at 24 months meets the criteria for evaluation, same as a girl. "Boys talk later" is not a clinically valid reason to delay referral.

Can I use the CDC milestones for bilingual kids?

Yes, with one adjustment: count words from both languages together. A bilingual child who has 25 words in English and 30 in Spanish has 55 total words and is not delayed. When seeking an evaluation, find an SLP who can assess in both languages or who uses parent-report tools that account for dual-language exposure. Evaluating only in one language tends to underestimate a bilingual child's true vocabulary.

What should a 3-year-old be saying?

By age 3, the CDC expects most children to have conversations using 2-3 sentences, ask why and what questions, say their first name when asked, and be understandable to strangers most of the time. ASHA sets intelligibility at roughly 75 percent for unfamiliar listeners by age 3. Sounds like r, l, s, and th don't have to be perfect yet; errors on those are still typical at this age.

Does watching TV or using tablets affect speech milestones?

The AAP recommends no screen media other than video chatting for children under 18 months, and limited high-quality programming for ages 2-5, watched with a caregiver who talks about what's happening. Background TV and passive screen time are associated with reduced parent-child conversation, which is the primary driver of vocabulary growth. Screens aren't the cause of every speech delay, but high screen time combined with low conversational exposure is a real risk factor.

What if my child was premature? Do the CDC milestones still apply?

For premature babies, most clinicians use corrected age (subtracting weeks of prematurity from chronological age) for milestones through 24 months, sometimes through age 3 for very preterm infants. A baby born 10 weeks early who is 12 months old by calendar is developmentally closer to 10.5 months corrected. Ask your child's neonatologist or pediatrician which age to use when checking milestones, and note that preterm infants are at higher risk for language delays regardless.

What is the CDC's "Learn the Signs. Act Early." program?

"Learn the Signs. Act Early." is a CDC public health campaign that provides free developmental milestone resources for parents and healthcare providers, including the printable milestone checklists updated in 2022. The materials are available at cdc.gov/ActEarly in English and Spanish. The program focuses on early identification of autism and other developmental differences, encouraging action rather than waiting when a milestone is missed.

Can a speech therapist help a child who isn't talking at all?

Yes. SLPs work with children who are entirely pre-verbal as well as those with partial language. For very young or minimally verbal children, therapy often focuses on building the foundation for communication: joint attention, gesture use, play skills, and understanding of language. For some children who aren't developing speech reliably, augmentative and alternative communication (AAC) can be introduced alongside speech goals, not instead of them. See our guide to AAC devices for more.

How accurate are the CDC speech milestones for children with autism?

The CDC milestones are population norms, and autism involves a different developmental profile, so the milestones work as a screening prompt rather than a complete picture. Autistic children may show early social-communication differences (limited pointing, reduced response to name, less back-and-forth) before speech differences are obvious. Missing milestones prompts evaluation. Only a full assessment by a qualified team can diagnose autism or rule it out.

What is the earliest age speech therapy can start?

Speech-language therapy can start from birth if there's a clinical indication, such as feeding and swallowing difficulties in a newborn. For speech and language delays, early intervention services under IDEA Part C can begin from birth through 36 months. The earlier therapy starts for most language delays, the better the outcomes, based on what we know about the brain's sensitivity to language input in the first three years of life.

Sources

1. CDC, Learn the Signs. Act Early., Developmental Milestones (2022 revised checklists): CDC and AAP revised milestone checklists in February 2022 to reflect when 75 percent of children reach each skill; checklists cover ages 2 months through 5 years
2. 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
3. American Speech-Language-Hearing Association (ASHA), Late Blooming or Language Problem: ASHA describes fewer than 50 words at 24 months as the clinical threshold for late talker evaluation; typical 2-year-old vocabulary is 200-300 words; strangers should understand roughly 50 percent of 2-year-old speech
4. U.S. Department of Education, IDEA Individuals with Disabilities Education Act, Parts B and C: IDEA Part C guarantees free developmental evaluation and early intervention services for children birth through age 2; Part B covers children 3 and older through the local school district; parents can self-refer without a doctor's order
5. ASHA, Speech Sound Disorders: Articulation and Phonology: Consonant sounds p, b, m, n, h, w, k, g, t, d expected by age 3; r, l, s, z, ch, sh, th develop later and errors not a red flag in isolation at age 3
6. ASHA, Stuttering: Disfluency is common and often normal between ages 2 and 5; physical tension, eye-blinking, or avoidance of talking alongside disfluency warrants SLP evaluation
7. CDC, Autism Spectrum Disorder, Signs and Symptoms: Limited joint attention, no pointing by 12 months, and inconsistent response to name by 9-12 months are early communication signs associated with autism spectrum disorder; regression of language skills is a specific finding that changes the evaluation pathway
8. Byers-Heinlein K & Lew-Williams C (2013), Language and Bilingualism, Perspectives on Psychological Science: Bilingual children reach language milestones at the same rate as monolingual peers when vocabulary is counted across both languages; sex differences in 24-month vocabulary are real but small (approximately 10-20 words)
9. MacArthur-Bates Communicative Development Inventories, CDI Advisory Board: MacArthur-Bates CDI is a validated parent-report vocabulary tool with normative data used clinically to assess toddler vocabulary
10. Zimmerman IL et al., Preschool Language Scales, Fifth Edition (PLS-5), Pearson Clinical: PLS-5 is a direct assessment tool with norms by age in months used by SLPs to measure receptive and expressive language skills in children
11. National Institute on Deafness and Other Communication Disorders (NIDCD), NIDCD Fact Sheet: Speech and Language Developmental Milestones: Children who receive speech-language services before age 3 have meaningfully better outcomes than those who start later; early identification and intervention are recommended
12. American Academy of Pediatrics, Media and Young Minds (Council on Communications and Media, 2016): AAP recommends no screen media other than video chatting for children under 18 months; for ages 2-5, limited high-quality programming watched with a caregiver is recommended; background TV is associated with reduced parent-child conversation