Early Identification of Speech, Language, Swallowing, and Hearing Disorders

Are you worried about your child's speech, language, or hearing? Know the signs, and get help early.

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Identify the Signs

Children develop at their own rate. Some children walk and talk early. Others take longer. Most children learn skills within an age range, such as between 12 and 18 months. A child who takes longer to learn a skill may have a problem.

It is important that you know what to expect. Below are some signs of speech, language, and hearing problems. You'll see the expected age range next to each skill.

Learn more about what to expect from your child from birth to five years old. You can also learn more about how to Identify the Signs.

Feeding and Swallowing Disorders in Children

Feeding and swallowing disorders can lead to health, learning, and social problems. Feeding disorders include problems with sucking, eating from a spoon, chewing, or drinking from a cup. Swallowing disorders, also called dysphagia (dis-FAY-juh) are difficulties with moving food or liquid from the mouth, throat, or esophagus to the stomach. Feeding and swallowing disorders are often related to other medical conditions but may also occur without a known cause.

Signs of Feeding and Swallowing Disorders

Your child may have a feeding or swallowing problem if they:

  • arch their back or stiffen when feeding
  • cry or fuss when feeding
  • fall asleep when feeding
  • have problems breastfeeding
  • have trouble breathing while eating and drinking
  • refuse to eat or drink
  • eat only certain textures, such as soft food or crunchy food
  • take a long time to eat
  • pocket (which means to hold food in their mouth)
  • have problems chewing
  • cough or gag during meals
  • drool a lot or have liquid come out of their mouth or nose
  • get stuffy during meals
  • have a gurgly, hoarse, or breathy voice during or after meals
  • spit up or throw up a lot
  • are not gaining weight or growing

Not every child has every sign listed here. Your child may show a few signs or many of them. Your child may be at risk for:

  • dehydration or poor nutrition;
  • food or liquid going into the airway, called aspiration;
  • pneumonia or other lung infections; and
  • having negative feelings about eating. They may avoid eating or associate it with pain, frustration, or embarrassment.

Language Disorders

Language is made up of the words we use to share ideas and get what we want. Language includes listening, speaking, understanding, reading, and writing. A child with a language disorder may have trouble with one or more of these skills.

Signs of language problems include:

Birth–3 months Not smiling or playing with others
4–7 months Not babbling
7–12 months Making only a few sounds. Not using gestures, like waving or pointing.
7 months–2 years Not understanding what others say
12–18 months Saying only a few words
1½–2 years Not putting two words together
2 years Saying fewer than 50 words
2–3 years Having trouble playing and talking with other children
2½–3 years Having problems with early reading and writing. For example, your child may not like to draw or look at books.

You can help your child learn language by

  • Talking, reading, and playing with your child.
  • Listening and responding to what your child says.
  • Talking with your child in the language that you are most comfortable using.
  • Teaching your child to speak another language, if you speak one.
  • Talking about what you do and what your child does during the day.
  • Using a lot of different words with your child.
  • Using longer sentences, as your child gets older.
  • Having your child play with other children.

Speech Sound Disorders

Speech is how we say sounds and words. It is normal for young children to say some sounds the wrong way. Some sounds do not develop until a child is 4, 5, or 6 years old. Signs of a speech sound disorder in young children include:

1–2 years Not saying p, b, m, h, and w the right way in words most of the time 
2–3 years Not saying k, g, f, t, d, and n the right way in words most of the time. Being hard to understand, even to people who know the child well. 

You can help your child learn to say sounds by

  • Saying sounds the right way when you talk. Your child needs good speech models.
  • Not correcting speech sounds. It is okay if your child says some sounds the wrong way.


Most of us pause or repeat a sound or word when we speak. When this happens a lot, the person may stutter. Young children may stutter for a little while. This is normal and will go away over time. Signs that stuttering might not stop include:

2½–3 years
  • Having a lot of trouble saying sounds or words
  • Repeating the first sounds of words, like "b-b-b-ball" for "ball"
  • Pausing a lot while talking
  • Stretching sounds out, like "fffffarm" for "farm"

You can help your child by

  • Giving your child time to talk.
  • Not interrupting or stopping your child while he speaks.
  • Noticing if your child gets upset when stuttering. Pay attention to how she speaks. Children who stutter may close their eyes or move their face or body when talking.

Voice Disorders

We use our voice to make sounds. Our voice can change when we use it the wrong way. We can lose our voice when we are sick or after talking or yelling a lot. Signs that your child may have a voice disorder include:

  • Having a hoarse, scratchy, or breathy voice.
  • Sounding nasal, or like they talk through their nose.

You can help your child by:

  • Seeing a doctor if your child’s voice sounds different and it does not go away after a short time.
  • Telling your child not to shout or scream.
  • Keeping your child away from cigarette smoke.

Hearing Loss

Some children have a hearing loss at birth. Others lose their hearing as they get older. Some signs that your child may have a hearing loss include:

Birth–1 year Not paying attention to sounds
7 months–1 year Not responding when you call her name
1–2 years Not following simple directions
Birth–3 years Having speech and language delays

You can help your child by:

  • Making sure your child has a newborn hearing screening.
  • Taking your child to the doctor if he has an ear infection.
  • Seeing an audiologist if you worry about your child’s hearing.

Act Today

Getting help early is better than waiting. You may be able to get free or low-cost services for your child. Talk to your doctor or contact your local school. They can tell you about early intervention programs and other services. To learn more about communication and feeding skill development, visit ASHA's Developmental Milestones: Birth to 5 Years.

Finding Help

Speech-language pathologists, or SLPs, help children who have language, speech sound, stuttering, or voice problems. Audiologists help people who have trouble hearing.

Look for an SLP or audiologist who has earned the Certificate of Clinical Competence, or CCC, from ASHA. ASHA-certified SLPs have "CCC-SLP" after their names. ASHA-certified audiologists have "CCC-A" after their names.

To find a speech-language pathologist or audiologist near you, visit ProFind.

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