Client and Family Resources


Articulation Milestones

Age Speech Sound Development
0-2 months Unintentional sounds
2-4 months Cooing – vowel-like sounds
3-6 months Babbling emerges – not well formed syllables
6-10 months Babbling – consonant-vowel combinations (i.e., “da”, “muh”, “bababa”
8-12 months Jargon – changes in vowels and consonants (i.e., “do-ba-di”. Vocalizes during play
12-18 months Consonant-vowel word shapes – “ma”, “no”. Reduplicated babble – “wawa” for water, “nana” for banana. Final sounds of words may be omitted – “be” for “bed”.
SOUNDS THAT HAVE EMERGED INCLUDE: m, n, d, b, y, w, p, t
18-24 months 70% of consonants are correct. Final sounds emerge and two syllable words emerge.
SOUNDS THAT HAVE EMERGED INCLUDE: m, n, d, b, y, w, p, t, h
24-36 months May omit one consonant of a consonant blend – “bue” for “blue”.
SOUNDS THAT HAVE EMERGED INCLUDE: m, n, d, b, y, w, p, t, k, g, h, s, f, v
36-48 months Substitution of “w” for “r” and “w” or “y” for “l” is common.
SOUNDS THAT HAVE EMERGED INCLUDE: m, n, d, b, y, w, p, t, k, g, h, s, f, v, sh, ch, j
48-60 months Very few errors remain developmentally appropriate. All sounds should be emerged. Some errors may remain on “r” and “th”.
Adapted from:
Sax, N. and Weston, E. Language Development Milestones. University of Alberta. January 2007.

Articulation Milestones (continued)

Age In Months Intelligibility
18 months 25% intelligible to an unfamiliar listener
24 months 50-75 % intelligible to an unfamiliar listener
36 months 75-100% intelligible to an unfamiliar listener
48 months 100% intelligible to an unfamiliar listener
Lynch, J.I., Brookshire, B.L, and Fox, D.R. (1980). A Parent-Child Cleft Palate Curriculum: Developing Speech and Language. CC Publications, Oregon. Page 102.

Articulation Quick Reference

Age 75% of Children Have Mastered 95% of Children Have Mastered
2 years p, b, t, d, k, g, m, n, ng, w, y, h, f p, d, m, n, w h
3 years v, s, z, sh, ch, l, r (vowel r) b, t, k, g
4 years r (consonant r) ng, l, f
5 years th v, s, z, sh, ch, j, l
6 years All sounds Consonant and vowel r

***It should be noted that over the age of 5, the likelihood of spontaneous development of sounds decreases significantly.

Adapted from: Clinical Assessment of Articulation and Phonology (2002)

Language Milestones

Age Receptive (Understanding) Language Expressive (Verbal) Language
0-3 months Follows a person with eyes; smiles to a voice; cries differently when tired, hungry, in pain; startles to loud noise; looks toward sound Attempts to use voice; begins blowing bubbles
3-6 months Responds to name by looking; smiles; laughs; cries when parents leave Begins vowel-like sounds, vocalizes in response to speech; imitates familiar sounds and actions
6-8 months Understands 5-50 words; begins to relate symbols to objects; understands simple commands Gestures and/or vocalizes to indicate wants; first true word emerges (although normal development for 1st word is up to 14 months); jargon and babbling present, vocalizes during play and to mirror; changes intonation
12-18 months Understands 200 words; words are understood outside of routine games; points to familiar or desired objects; follows one-step commands; uses nouns, verbs, possessives (mine), rejections (no), agents (names) Average spoken vocabulary of 50-100 words by 18 months; vocalizes with gestures; says “all gone”; can answer the question “what’s this?”; asks for “more”; imitates words; first 2-word phrase emerges
18-24 months Understands words for objects out of sight; listens to simple stories; follows directions involving spatial concepts Expressive vocabulary of 200-300 words; 2-word phrases predominate; responds to yes/no questions; uses verbs and adjectives; refers to self by name; marks a question with rising inflection
24-36 months Understands “wh” questions; follows a series of two-step commands; knows descriptive concepts (big, small); understands pronouns Combines 3-4 words; answers “wh” questions; uses possession; uses adverbs (here, now); uses “is”;uses a variety of grammatical endings
36-48 months Responds to 3-step commands; understands a variety of complex and compound sentence structures; understands color and shape; understands spatial concepts Produces 4-5 word sentences; uses complex and compound sentences; uses contractions; uses a variety of verb tenses; asks how and why questions; answers “what if” questions; tells events in sequence
48-60 months Knowledge of numbers; uses conjunctions Asks for the meaning of words; produces 8 word sentences; subject-verb agreement is accurate
Adapted From:
Sax, N. and Weston, E. Language Development Milestones. University of Alberta, January, 2007).

Fine Motor Milestones

  • hands most often remain closed
  • has grasp reflex (grasps objects involuntarily if placed in palm)
  • reaches for (“swipes at”) objects inaccurately
3-3 1/2 MONTHS
  • clasps hands together often
3 1/2- 4 MONTHS
  • begins purposeful, visually directed reaching
  • can hold small objects in hand
  • can transfer objects from one hand to the other
  • can pick up cube/medium sized object easily
  • develops accurate forward and side reach
  • “rakes” or “scoops” small objects to pick them up (i.e. using fingers/palm/whole hand to scoop up Cheerios, raisins etc.
  • intentionally able to drop/release objects (get ready for the “watch-me-drop-this-watch-mommy/daddy-pick-it-up-AGAIN” game!)
  • able to pick up small objects using thumb and finger/fingers
  • pokes and/or points with index finger
12-18 MONTHS
  • holds crayon with whole hand, thumb up
  • holds crayon with thumb and all fingers, forearm turned so thumb is pointing down
  • puts on shoes, socks, and shorts; takes off shoes and socks
  • can use a spoon by himself, keeping it upright
  • can draw and copy a vertical line
2 1/2- 3 YEARS
  • strings large beads
  • snips paper with scissors
  • rolls clay/playdoh into “snake”
  • can draw and copy a horizontal line
3-3 1/2 YEARS
  • able to complete simple puzzles
  • can build a tower of nine small blocks or more
  • can get himself dressed/undressed independently; only needs help with buttons; still confuses front/back of clothes, and right/left shoes
  • can feed himself with little or no spilling, drinks from a cup/glass with one hand
3 1/2- 4 YEARS
  • can pour his own drink from a pitcher if not too heavy
  • can place small pegs into small holes
  • able to string small beads
  • can hold a pencil with a “tripod grasp” (3 fingers), but moves forearm and wrist to write/draw/color
4-4 1/2 YEARS
  • can use scissors to follow and cut both straight and curved lines
  • can manage buttons, zippers, and snaps completely
  • can draw and copy a cross (one vertical and one horizontal intersecting lines)
4 1/2- 5 YEARS
  • can hold fork using his fingers
  • can feed himself soup with little or no spilling
  • folds paper in half, making sure the edges meet
  • puts a key in a lock and opens it
  • can get dressed completely by himself, and usually tie shoelaces
  • cuts square, triangle, circle, and simple pictures with scissors
  • uses a knife to spread food items (jelly, peanut butter, mayo etc.), uses a dull knife to cut soft foods
  • able to draw and copy a diagonal line
  • uses a “tripod grasp” on writing utensils (thumb & tips of 1st two fingers) and uses fingers only (because small muscles of hand have developed) to write/draw/color
5 1/2- 6 YEARS
  • can build a five block “bridge”
  • sufficient bilateral hand coordination to cut out complex pictures, accurately following the outline
  • able to copy a sequence of letters or numbers correctly
  • able to complete complex puzzles
Therefore, by 6 years old, a child’s fine motor skills have developed sufficiently enough to complete writing, dressing, and feeding tasks properly and efficiently. A child will now have adequate dexterity, bilateral coordination, and eye-hand coordination to complete writing and cutting tasks. Children will continue to develop and refine these skills, but the foundation is developed and laid down within the first six years. This is precisely WHY a child will need toys, games, and activities to practice and enhance these skills during his early childhood.