Concerned about a delay in development? We can help

Is my child a late talker?

Though every child is different, most children are able to meet certain speech and language milestones by certain ages.

We’ve highlighted below some of the common Language and Communication milestones from the CDC. Click on the age of your child below to see videos and descriptions for the milestones.

Language and Communication Milestones

Language and Communication Milestones

  • 1 Year Old

    Says “mama” and “dada” and exclamations like “uh-oh!” (e.g. seen in this video)


    Responds to simple spoken requests (in this video, child listens when Mom says “Give me the book”)


    Makes sounds with changes in tone (in this video, child makes sounds, but is not yet using words)


    Tries to say words you say (in this video, child repeats Mom who says “Dante”)


    Uses simple gestures, like shaking head “no” or waving “bye-bye” (e.g. seen in this video)

  • 18 Months Old

    Says several single words (e.g. as seen in this video)


    Says and shakes head “no” (e.g. as seen in either of the two parts of the video)


    Points to show someone what he wants (e.g. in this video, child points to a truck he wants his teacher to get him)

  • 2 Years Old

    Says sentences with 2 to 4 words (e.g. child in this video saying a short sentence)


    Repeats words overheard in conversation (e.g. child in this video repeating words he hears)


    Points to things or pictures when they are named (e.g. child in this video points to an object when asked to)


    Knows names of familiar people and body parts (e.g. child in this video can say “mouth” and “ears”)


    Follows simple instructions (e.g. child in this video follows instructions to “go get it”)

  • 3 Years Old

    Carries on a conversation using 2 to 3 sentences (e.g. as seen in this video)


    Says words like “I,” “me,” “we,” and “you” and some plurals (cars, dogs, cats) (e.g. as seen in this video)


    Understands words like “in,” “on,” and “under” (e.g. as seen in this video)


    Can name most familiar things (e.g. as seen in this video)


    Follows instructions with 2 or 3 steps (e.g. child follows a 2-step instruction in this video)


    Talks well enough for strangers to understand most of the time (e.g. as seen in this video)


    Names a friend (e.g. as seen in this video)

  • 4 Years Old

    Tells stories (e.g. as seen in this video)


    Sings a song or says a poem from memory such as the “Itsy Bitsy Spider” or the “Wheels on the Bus” (e.g. as seen in this video)


    Knows some basic rules of grammar, such as correctly using “he” and “she” (e.g. as seen in this video)

  • Is it just speech delay or something more?

    Some children may have only a delay in language but not other areas. Many of these children will “catch up” with other children as they receive therapy and age. Some may regress and seem to lose previous skills.

    Other children may have a broader developmental condition with delayed milestones in other areas beyond just language. For instance, children with autism often have delays in language, which may be the first but not the only sign of autism. Some potential signs of a broader developmental condition include:

      • Repetitive behaviors, including flapping hands, rocking their body, or intensely insisting on routines and activities
      • Avoiding eye contact
      • Losing previously acquired speech skills
      • Showing challenges in social interaction

    There are a broad range of potential developmental conditions involving a language delay, including autism and other conditions (e.g. hearing loss).

    For those families wondering about autism, the infographic below some of the typical signs of autism in children under 5.

    You can also take a online screening test for autism, called the M-CHAT, on our website here. It is intended for toddlers 16-30 months of age.

    The Signs of Autism

    The Biology of Autism (current understanding)

    Genetic changes

    Atypical brain development and connections

    Characteristic features of autism

    6
    months

    • Few or no big smiles
    • Limited or no eye contact

    9
    months

    • Little or no back-and-forth sharing of sounds, smiles, or facial expressions

    12
    months

    • Little or no babbling
    • Little or no back-and-forth gestures (pointing, showing, reaching, or waving)
    • Little or no response to name

    16
    months

    • Very few or no words

    24
    months

    • Very few or no meaningful two-word phrases (not including imitating or repeating)

    Have delayed speech and language skills, or lose previously acquired speech

    Avoid eye contact and want to be alone

    Get upset by minor changes

    Have trouble understanding other people’s feelings

    Repetitive behaviors (flap their hands, rock their body, or spin in circles)

    Restricted interests

    Soar-Health-59 - trimmed2 (1)

    What should I do as a parent?

    If your child has a language delay or is missing developmental milestones, or if you are concerned about their development, you should talk to your pediatrician or a specialized healthcare provider like Soar.

    As a first step, you can also take an online screening test for autism here on our website.

    There is a wide body of research that shows the importance of early child development and acting early. And if your provider does not seem concerned or advocates to watch and wait, it is okay to ask for a second opinion.

    For families based near Denver, we have a team of clinicians at Soar who can provide an assessment as well as provide therapy services for children. This includes a child psychologist to evaluate for autism and other developmental conditions. In addition, we have a Speech-Language Pathologist and Occupational Therapist with multiple years of experience working with young children with delayed speech.

    If you would like to learn more about our testing and assessment services, you can contact us at 720-706-3396 or click on “Schedule a Call” on the Get Started page.

    For children under the age of 3, Early Intervention services may also be helpful. In Colorado, these are available through a set of Community Centered Boards. You can find more information about your local Board here.

    FAQs

    Identification

  • What can cause speech delay in toddlers?

    There are a wide range of causes of a speech delay. Some children may have only a delay in language, for which many children “catch up” as they get older and undergo therapy. Other children may have a more general developmental condition where speech delay is one sign of a broader condition, such as autism. Still other children could have other issues such as a hearing impairment. If you notice speech delay in your toddler, you should speak to your pediatrician or a specialized healthcare provider about your concerns.

  • When should you worry if your child is not talking?

    If your child is not meeting common developmental milestones, you should mention this to your pediatrician or another specialized healthcare provider like Soar. Examples of common milestones by age related to language are shown above on our website. You can also check out the CDC’s website on Milestones in Action to see a complete set of videos related to developmental milestones. For those families interested in an assessment or testing for a child, you can read more about our child psychologist Dr. Banks on the Testing page or reach out to us at 720-706-3396 to schedule an appointment.

  • Is delayed speech a sign of autism?

    Possibly but not necessarily. About 10% of preschool children have a language delay, but only 2% of children have autism. This means that the majority of children with delayed speech do not have autism. Autism is often accompanied by other signs beyond speech delay. See our infographic on the signs of autism at the bottom of this page to learn more about a broader list of potential signs of autism.

  • Why is early identification important?

    A wide body of scientific research supports that early detection of speech delays and early intervention is beneficial to young children. Indeed, the CDC has a campaign called Learn the Signs, Act Early to encourage early detection of potential delays in young children.

  • What if my partner doesn't think anything is wrong?

    Try listening to your partner’s reactions without judgment — these feelings are completely normal and everyone processes a developmental concern differently. Remember that seeking services early for your child is the most impactful way you can help them.

  • What if my partner is handling things differently than I am?

    Seek to understand your partner’s perspective and see if there is a common ground — everyone processes a developmental concern differently. You can also consider seeking therapy services and support from a licensed counselor to help if needed.

  • What if my doctor or other healthcare provider doesn't think anything is wrong?

    Some providers may have been trained during a time when a “watch and wait” approach for developmental concerns was used. Today, leading medical societies including the CDC strongly advocate for early intervention to support a child’s long-term health. If you are in this situation, talk to your provider about your concerns and see if they can be addressed. You can also consider switching to another provider or asking for a second opinion. You are the ultimate advocate for your child!

  • What if I'm getting services through Early Intervention already? Do I need more?

    Early Intervention (EI) is a government-run program focused on helping young children under the age of 3. EI programs and services covered by health insurance offer complementary approaches to helping a child. Some families access only EI services, other families access only health insurance-based services, and some access both. If you think your child needs more than what they are getting in EI, talk to your provider or pediatrician about ways to supplement that care.

  • Testing for autism

  • How is autism tested for and diagnosed?

    It typically involves a test or assessment from a child psychologist or clinician who specializes in autism. If you are concerned that your child may have autism or have been told by a healthcare professional to seek out an autism assessment, call us at Soar Autism Center at 720-706-3396 or ask your pediatrician for a recommendation.

  • How do I get my child evaluated or tested for autism?

    Typically a child psychologist or other clinician who specializes in autism testing and assessments can perform an evaluation. We offer this service at Soar Autism Center with our psychologist Dr. Sarah Banks. We also have a list of other diagnostic providers in the greater Denver area for parents in our new parent kit.

  • What happens at an autism assessment?

    Usually a standardized assessment or test is used in combination with a clinician’s independent judgment. During the assessment, the clinician will play with the child and watch for certain characteristics seen in children with autism. Assessments should be fun, and a child shouldn’t know they are being tested. The specific assessment used will vary depending on who evaluates your child, but examples of common assessments used in the US include the Autism Diagnostic Observation Schedule-2nd edition (ADOS-2), Autism Diagnostic Interview-Revised (ADI-R), Childhood Autism Rating Scale-2nd edition (CARS-2), and Gilliam Autism Rating Scale (GARS).

  • How much does an autism test cost?

    Autism tests are typically covered by most health insurance plans, including Medicaid. The specific cost will vary based on the details of your health insurance plan (e.g. co-pays, deductibles). If you are wondering about the cost of an assessment with us, call us at 720-706-3396 and we can check your insurance benefits for you.

  • I'm not sure if my child needs an evaluation or not, what should I do?

    Call us at 720-706-3396 and talk to one of our intake specialists who can help assess if an evaluation with Dr. Banks is a good fit for your child. You can also talk to your pediatrician or other healthcare provider for their recommendations.

  • Is there an autism symptoms checklist or signs of autism checklist I can use with my child?

    Check out the signs of autism infographic that is on our Screening page. It shows different signs and symptoms of autism by age, as well as symptoms that can show at many different ages. We also have videos of normal development from the CDC.

  • What is the M-CHAT or M-CHAT-R/F?

    The M-CHAT is also known as the Modified Checklist of Autism in Toddlers. It is a screening test used to identify children who may be at risk for autism, and is focused on toddlers (typically 16 to 30 months of age). It consists of a series of questions that the parent answers about their child and is often done at a well-child visit with a pediatrician. It does not officially diagnose a child with autism but indicates possible risk of autism and that a diagnostic assessment may be beneficial for the child. You can take it online on our website here.

  • My child had a high M-CHAT score, what do I do next?

    You should consult a healthcare provider, including your pediatrician and/or a specialized provider who can evaluate for an autism assessment. We offer this service at Soar Autism Center, and we also have a list of other Colorado providers who perform diagnostic testing in our new parent kit. 

  • How do you diagnose for autism during the Covid-19 pandemic?

    See our Covid-19 FAQs for more details on our processes for maintaining safety during the Covid-19 pandemic.

  • Overview of autism

  • What is Autism Spectrum Disorder (ASD)?

    Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that leads to characteristic differences in socialization and communication as well as characteristic behaviors (as defined by DSM-5). It is a spectrum disorder meaning that there is a highly varied set of symptoms among people with autism and varying degrees of severity.

  • What’s the difference between ASD and Autism?

    They refer to the same thing. The formal term used by healthcare professionals is Autism Spectrum Disorder, or ASD, which many people will use shorthand as autism.

  • What Is Asperger's syndrome?

    Asperger’s syndrome used to be a separate diagnosis from autism, but has been brought under the umbrella of Autism Spectrum Disorder (ASD) in recent definitions of ASD in the DSM-5. Asperger’s tends to refer to people on the less severe side of the autism spectrum, and though the term is no longer used in healthcare settings, some people may still use it from time to time to describe more mild forms of autism.

  • What causes autism?

    The underlying biology in the brains of people with autism is not fully understood by researchers and scientists, and a single underlying process in the brain has not been found. The general consensus among scientists is that genetic factors cause changes in brain structure and connectivity, which in turn affects socialization and communication skills and causes the characteristic behaviors in people with autism. A significant amount of research time and funding is ongoing to better understand the biology of autism. We have additional details on the biology of autism and links to research in our new parent kit. 

  • How do you get autism?

    There is no one single cause of autism that scientists have identified. Scientists believe there is likely a strong genetic contribution to the development of autism. The role of environmental factors in the development of autism is less clear, and scientists are studying the topic further. Vaccinations are not associated with the development of autism based on large-scale population data. We have additional details on the biology of autism and links to research in our new parent kit.

  • What are the main signs of autism?

    We’ve highlighted some of the signs of autism on the infographic near the bottom of this page. It’s important to note that the initial signs of autism in children can vary significantly for each child.  Different children will often show different signs—some children may show many signs and other children may show few signs. The time course can also vary by child, with some children showing signs at a very young age (first few months of life), others showing signs after 1-2 years of life, and still other children appearing to have a normal development for their first couple of years and then appearing to regress and lose abilities they used to have (such as losing communication skills). And it is also possible to have some of the symptoms of autism but not have autism spectrum disorder. Because of this complexity, a specialized health care provider is needed to establish a diagnosis of autism.

  • How do autistic toddlers behave?

    See our infographic near the bottom of this page for additional detail on the signs of autism.

  • What are the different severity levels of autism?

     The severity level is intended to capture the level of support and services required by a person with autism. The severity level can also change over time. The three levels are:

    • Level 1: Requiring support
    • Level 2: Requiring substantial support
    • Level 3: Requiring very substantial support
  • At what age does autism typically show up?

    The time course varies by child. Some children show signs at a very young age (first few months of life), others show signs after 1-2 years of life, and still other children appearing to have a normal development for their first couple of years and then appearing to regress and lose abilities they used to have (such as losing communication skills).

  • Does autism ever go away?

    For the majority of people, autism is a lifelong condition. Said otherwise, children with autism become adults with autism. There are some reports of children who have received early intensive services and later no longer meet the diagnostic criteria of autism spectrum disorder. Such children may still need additional support (e.g. educational supports) relative to their neurotypical peers.

  • Is autism more common in boys or girls?

    It is more common in boys. For instance, in Colorado, boys were 4.5 times as likely to be identified with autism than girls based on data from the CDC.

  • Can autism go unnoticed?

    Yes, it is possible to miss a diagnosis of autism – for instance, if a child has a milder presentation or does not receive appropriate access to care in his or her early years. If you’re concerned at a diagnosis of autism in your child, you should talk to a healthcare professional about having your child evaluated. We also offer this service at Soar Autism Center, as do several other providers in Colorado.

  • What are other possible causes for your child’s behavior if not autism?

    There are other possible conditions that can share some of the features of autism (e.g. changes in social communication or characteristic behaviors). These conditions can either cause autism-like symptoms and be confused for autism, or can co-occur alongside with autism. A specialized healthcare provider can help differentiate between autism and other conditions in a comprehensive evaluation.

  • What resources do you recommend for parents looking to learn more about autism?

    We’ve put together a resource guide for parents which is available for download on our website. It provides a starting place for many parents at the beginning of their journey and has lists of local resources in Colorado as well as tips from other parents.

  • How is autism treated?

    See our FAQs on the Our Approach for a detailed overview of autism therapy. 

  • See all Our Approach FAQs HERE

    See all Family Resources FAQs HERE

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