Typical Development From Birth to 3

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Since this month is all about early intervention, we wanted to take some time to talk about typical development of speech/language in both monolingual and bilingual/multilingual children. We will also mention some milestones children typically meet in the occupational therapy realm!

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Speech and language development

Did you know your child begins communicating with you before they say their first words?

All children develop at their own rate, but what milestones will most children reach from birth to 3? And what can you, as a parent or caregiver, do to help?

When we are talking about language acquisition, there are two different categories we must consider. Language development involves hearing and understanding while speech development is considered the “talking” part of the equation. In order to acquire language, there must be a balance of hearing, understanding, and talking.

The American Speech-Language-Hearing Association (ASHA) provides great parent handouts for different age ranges. For your convenience, I’ve included snapshots from the handouts with what to expect at each age-range. Keep in mind these are based on monolingual language learners, but we will talk about bilingual/multilingual norms later in this blog.

Birth-3 Months

Some tips for this age range can be summed up by TEACH! TALK! MIRROR! READ!

  1. TEACH your baby how to talk by talking to them, pausing, and waiting for your baby to coo or smile, then repeat! This teaches turn-taking which is necessary for conversational speech. A lot of parents tend to use baby-talk (e.g. typically a combination of silly sounds and words that often use incorrect grammar); however, “parentese” utilizes real words and fully grammatical sentences, just with a slower, more exaggerated pace plus repetition and has been shown to have a positive impact on language development.
  2. TALK as much as possible during the day be sure to respond to your baby’s communication attempts. You can do this by looking at them and imitating the sounds they make. What should you talk about? You can talk about what you are doing, where you are going, what you see on walks, animal sounds, etc.
  3. MIRROR your baby’s facial expressions, laughter, and sounds. Your baby’s coos are more than cute, they are vowels! By practicing, your baby figures out which sounds are important to learn to talk.
  4. READ even though you may think they do not understand, babies can benefit from storytime from day one! Books with bright colors and the sound of your voice are very motivating for your little one. Reading aloud every day slowly stretching out the sounds in a fun way and responding to the sounds your baby makes is very powerful!

Some of you may be wondering… “What about baby sign?” Based on research, baby signing and baby gesture both suggest positive outcomes in infancy by providing a stepping stone to verbal communication, but there is a lack of empirical evidence to detangle parental linguistic and interactive variables.

4-6 Months

Some tips for this age range can be summed up by KEEP TALKING! KEEP READING! LISTEN! RESPOND!

  1. KEEP TALKING! You can talk about what you are doing and what your baby is doing. This will help your baby associate words with actions, objects, and feelings you describe. Don’t forget how powerful imitating their vocalizations and gestures can be. You can also sing songs, and recite nursery rhymes. Variations in pitch and loudness capture their attention.
  2. KEEP READING! Your baby is beginning to focus and is gaining interest in the world around them, that’s why it’s good to choose books with different textures, and pictures. Don’t be afraid to read and repeat! Babies love routines and familiarity. Reading with expression is so important because, at this age, babies are tuned in to the sound of your voice and pick up on emotions.
  3. LISTEN and show excitement when your baby vocalizes, imitates sounds, mouth movements or uses new sounds! Positive reinforcement is very valuable at this age (and every age!).
  4. RESPOND to your baby’s efforts to communicate. It doesn’t matter if it’s crying or just vocal sounds, follow their lead and talk about objects, people, and activities that capture their attention.

7-12 Months

Some tips for this age can be summed up by BUILD! MODEL! ENCOURAGE! And of course KEEP READING!

  1. BUILD that vocabulary! You can do this by naming objects around and talking about your actions during activities such as meals, bathing, and dressing. Help your baby learn their name by looking in a mirror together and saying their name. Use descriptive words to talk about colors, shapes, and sizes of objects. You can also call attention to different sounds, such as clapping, splashing, or a dog barking.
  2. MODEL good speech. Practice that “parentese” mentioned earlier! That means to speak clearly and naturally and use correct speech sounds. Remember it’s okay if your child makes some mistakes with their sounds, they are still learning!
  3. ENCOURAGE your new talker! Respond to and imitate your child’s sounds and words to teach conversation skills!
  4. KEEP READING! Sturdy board books and soft cloth books are great choices. Let your baby explore the books by holding them and flipping pages! It’s okay if your baby moves around while you’re reading. Follow them and keep on reading!

1-2 Years Old

Some tips for this age can be summed up by TALK! GESTURE! EXPLAIN! And surprise… KEEP READING!

  1. TALK to your child uses a variety of words… even BIG words! Children are fascinated by new and unusual words.
  2. GESTURE as you speak. Name, describe and point to objects and people. Ask your little one to point too!
  3. EXPLAIN what you and your child are doing using longer sentences. This helps your child use one- and two-word expressions like, “Uh-oh,” “Read book,” and “More juice.”
  4. KEEP READING! Did you know between ages 1-2 children quadruple the number of words in their vocabulary? That’s why reading aloud is a great way to introduce new words and concepts that may not come up every day. Point to pictures while introducing new words to help your child make connections. Your child’s reading skills are developing, so try to let them pull the books out for you to read and turn the pages themselves!

Don’t forget, listening is learning and repetition is key! Help develop an awareness of sounds in your child by talking about the sounds you hear and pointing your child in the direction of sounds. You can also talk about animals and what sounds they make. Keep telling stories, singing songs, and reciting nursery rhymes! You can also play word and gesture games like pat-a-cake! Again, don’t worry if they love reading the same book, singing the same song, or playing the same game over and over again. Children love repetition and familiarity at this age.

2-3 Years Old

At this age, some tips include: DESCRIBE! ASK! ENCOURAGE! And you guessed it… KEEP READING!

  1. DESCRIBE objects with different sizes, colors, and textures. You can use words to compare such as hard vs. soft.
  2. ASK your kiddo to name and point to different body parts (head, shoulders, knees, and toes is a great song for this!).
  3. ENCOURAGE them to answer who, what, where, and when questions!
  4. KEEP READING! It’s a great idea to find a special time to read with your child every day. Since books are great vocab builders, at this age you can begin pointing to pictures and describing them in detail. You can ask questions about the story and encourage your child to ask questions too! Remind your child there are words everywhere! You can read signs, menus, and even words on your phone!

As mentioned above, listening is learning! This is a great age to ask you child to imitate sounds they hear such as clapping, whistling, humming, snapping your fingers, etc. And don’t forget, even if your child doesn’t say all of their sounds correctly, use the correct sounds in your own speech. Ask your child to repeat words if you don’t understand them; however, sometimes this can lead to frustration so if you still don’t understand after 2-3 attempts, you may want to ask them to use a different word to explain.

What about bilingual/multilingual speech/language development from birth – 3?

Children can learn to speak more than one language. There is a common misconception that learning multiple languages early on can be a detriment to typical speech/language development. This is not the case. Some children can speak both languages easily, but sometimes they know one language better than the other. Your child’s dominant language is the language they know better which may change over time. Like any other skill, speaking two languages requires a lot of practice to do it well.

So, how do children learn more than one language? If your child is learning a second language before age 3, it is called simultaneous acquisition. Children learning two languages simultaneously go through the same developmental stages as monolingual children but may start talking slightly later than monolingual children. From the very beginning, simultaneous bilinguals go through speech/language developmental stages for each language. Although it may seem as if their vocabulary is smaller in each language, their combined total number of words in both languages typically matches typical development. Usually, bilingual children are able to differentiate their two languages and have been shown to switch based on who they are communicating with. Research talks about a brief “silent period” after acquiring a second language; however, this is typically seen in children who begin learning a second language after 3 years old in which case it’s called sequential acquisition.

What about occupational therapy developmental norms?

We can’t leave OT out of the mix! Did you know motor development begins in the womb? That’s right. Your baby is already stretching, moving, practicing reach and grasp, in utero! The push and pull felt as an expecting mother was your baby gaining strength and sensory input. Motor development continues after birth. While milestones mentioned below are a good guideline, don’t forget each child is different and reaches these milestones at their own rate. So when it comes to developmental milestones, the important thing to remember is that your child is progressing. In addition, the time frame may shift if a baby is born prematurely.

Below are some Fine Motor/Social/Self-Care Developmental Milestones that most children reach from birth – 3 years old.

0-3 mos-Brings hands to mouth
-Easily takes breast or bottle
-Follows a face
-Looks at you
-Smiles at you
-Quiets when comforted
3-6 mos-Plays with hands and feet
-Holds a toy (3 months)
-Looks at a toy and reaches (4-6 months)
-Transfers toys from hand to hand
-Tracks (watches) objects moving in all directions
-Attempts to hold bottle
-Props on forearms when on stomach
-Lifts and holds up when on stomach
6-9 mos-Uses index finger to poke
-Holds an object in each hand to play with both
-Begins to sit while using hands to play
-Feeds himself finger foods
9-12 mos-Uses thumb and index fingertips to grasp
-Drops and picks up toys
-Uses both hands to play with a toy
-Able to support himself on his hands and knees
-Begins to use a spoon
-Begins to hold a cup with two hands
12-18 mos-Is able to sit and play with toys using both hands
-Pulls apart pop beads
-Stacks blocks
-Learns to put small toys into a container
-Scribbles
-Begins to play alone
-Helps put things away
-Learns to eat with a spoon
-Learns to drink from a cup
-Removes socks and helps put on pants and shirt
18-24 mos-Turns pages of a book
-Draws lines on paper with pencil, crayon, or marker
-Imitates peer and adult play
-Helps take off pants and shirt
-Stacks blocks
-Begins to put puzzle pieces in
-Learns to roll, kick, and throw a ball
-Drinks from and open cup
2-3 y/o-Learns to string beads
-Starts to build with blocks
-Can play for long periods with toys
-Will watch other children play but not join in
-Participates in a simple group activity
-Defends his own possessions
-Learns to catch a medium-sized ball
-Begins to dress himself
-Opens a door by turning the handle
-Begins to draw lines and a circle
-Shows an interest in toilet training

More OT resources…

To find more information on the first year of gross motor development click here! This blog post from “Mama OT” provides more information on tummy time, playtime on the back, sitting, rolling, sitting, crawling, standing, cruising, and walking as well as several helpful tips and resources for each!

Another wonderful resource is from The OT Toolbox which explains that occupational therapy for babies uses play as their primary occupation to work on specific skills in addition to guiding therapy. Just a reminder, some babies may be at different developmental levels and activities suggested in this resource are not intended as treatment or a replacement for OT!

Also from The OT Toolbox, this blog post is about baby and toddler brain-building activities. Because babies love to take things out and put them back into containers, a fun activity is to grab a bunch of different colored and sized balls, and 2 muffin tins. They can transfer the balls from one to the other or take them out of a box and place them in the muffin tins to work on fine motor skills!

Another fun activity she mentions is to cut holes in a cereal box big enough for the balls, so your toddler can have fun putting a few balls in and taking different ones out after moving the box around! It’s great for building neural pathways of the brain. Activities don’t have to be complicated or expensive to help!

What if my child has not met these milestones?

Don’t fret. As mentioned, there is significant variability at this age. However, if your child does not seem to be progressing or is significantly behind, it never hurts to talk to your pediatrician. Typically early intervention is preferred because the brain’s ability to form new connections is greater than ever between birth and 3 years old. Your pediatrician may refer you to a speech-language pathologist or an occupational therapist. If so, reach out to Worldwide Speech for a free 20-minute consultation. While telemedicine is new for many practices, Worldwide Speech has 10 years of experience in delivering online services to children around the world!

Resources

https://www.asha.org/public/speech/development/chart/

https://leader.pubs.asha.org/do/10.1044/new-free-toolkit-for-parents-of-young-children-and-members-who-interact-with-them/full/

https://leader.pubs.asha.org/doi/full/10.1044/leader.FTR5.15132010.np

http://www.hanen.org/helpful-info/articles/bilingualism-in-young-children–separating-fact-fr.aspx

https://spokanecpt.com/occupational-therapy-developmental-milestones/