How do I know if my child needs speech therapy?
As a parent, you want the best for your child—including ensuring they reach important developmental milestones. But if your child isn’t meeting those milestones at the expected age, it can be confusing and even overwhelming to know when to seek professional support.
At On The Grow Speech Therapy, we specialize in pediatric speech therapy for children ages 2–12, including support for speech sound disorders, language delays, language disorders, gestalt language processing, and AAC (augmentative and alternative communication). We offer in-home speech therapy across Madison, WI and teletherapy across Wisconsin and Iowa to meet families where they are—literally and developmentally.
In this post, we’ll walk you through general developmental guidelines and signs that your child may benefit from speech therapy.
Speech & Language Development: What’s Typical?
Speech and language skills are essential for communication, learning, and social development. While all children develop at their own pace, here are general milestone guidelines by age. It’s important to note that these are just that—guidelines. We look at the whole picture when assessing a child’s communication, not just one missed milestone.
💬 By Age 2
✅ Expected Skills:
Says 50 words
Combines 2-word phrases (e.g., “more juice”)
Follows simple directions (e.g., “Give me the bubbles”)
Uses words to ask for help
⚠️ Possible Signs of Concern:
Not saying single words or less than 50 words
Not combining words
Difficulty imitating sounds
Difficulty following simple directions
💬 By Age 3
✅ Expected Skills:
Uses 3–4 word phrases
Follows 2 step directions
Asks questions including why and how (e.g., “What’s that?”)
Says /b, n, m, p, h, w, d/ sounds in words
⚠️ Possible Signs of Concern:
Frustration with communication
Struggles following known directions
Difficulty asking or answering basic questions
Not understood by familiar adults (e.g. mom, dad)
💬 By Age 4
✅ Expected Skills:
Speaks in complete, short sentences
Tells simple stories
Says /ɡ, k, f, t, ŋ, j/ sounds in words
Speech is understood by most people
⚠️ Possible Signs of Concern:
Speaks in words or short phrases
Difficulty telling simple stories or following conversations
Not generally understood by strangers
Limited interest in playing with others
💬 By Age 5
✅ Expected Skills:
Retells simple stories
Uses detailed 5-6 word sentences with correct grammar
Can engage in back-and-forth conversations
Says /v, ʤ, s, ʧ, l, ʃ, z/ and is clearly understood by others
⚠️ Possible Signs of Concern:
Difficulty retelling simple events/stories or explaining ideas
Struggles with grammar and sentence structure
Needs help talking to others
Difficulty being understood by others clearly
💬 6–12 Years Old
✅ Expected Skills:
Expands vocabulary and sentence complexity
Understands and uses figurative language
Organizes thoughts clearly in conversation and writing
Uses age-appropriate social communication skills
⚠️ Possible Signs of Concern:
Difficulty with articulation, fluency, or expressive/receptive language
Difficulty following classroom instructions
Difficulty with peer conversations or classroom participation
When Should You Reach Out?
If you’re noticing one or more of these signs—or simply feel something “isn’t quite right”—trust your gut. Early intervention can make a big difference, and a speech-language evaluation can provide clarity and peace of mind.
At On The Grow Speech Therapy, we provide personalized, neurodiversity-affirming pediatric speech therapy plans that support each child’s unique strengths, communication style, and developmental needs. We collaborate closely with families across Madison, WI, and throughout Wisconsin and Iowa—through in-home and teletherapy services—to support meaningful and lasting growth.
