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Chapter 31: Child Psychiatry
Table 31.4a-1
Normal Development of Speech, Language, and Nonverbal Skills in Children
Speech and Language Development
Nonverbal Development
1 year
Recognizes own name
Stands alone
Follows simple directions accompanied by gestures (e.g.,
bye-bye)
Takes first steps with support
Speaks one or two words
Uses common objects (e.g., spoon, cup)
Mixes words and jargon sounds
Releases objects willfully
Uses communicative gestures (e.g., showing, pointing)
Searches for object in location where last seen
2 years
Uses up to 300 words
Walks up and down stairs alone, but without alternating feet
Names most common objects
Runs rhythmically, but is unable to stop or start smoothly
Uses two-word or longer phrases
Eats with a fork
Uses a few prepositions (e.g., in, on), pronouns (e.g., you,
me), verb endings (e.g., -ing, -s, -ed) and plurals (-s), but
not always correctly
Cooperates with adult in simple household tasks
Enjoys play with action toys
Follows simple commands not accompanied by gestures
3 years
Uses up to 1,000 words
Rides tricycle
Creates three- to four-word sentences, usually with subject
and verb but simple structure
Enjoys simple “make-believe” play
Follows two-step commands
Matches primary colors
Repeats five- to seven-syllable sentences
Balances momentarily on one foot
Speech is usually understood by family members
Shares toys with others for short periods
4 years
Uses up to 1,600 words
Walks up and down stairs with alternating feet
Recounts stories and events from recent past
Hops on one foot
Understands most questions about immediate environment
Copies block letters
Uses conjunctions (e.g., if, but, because)
Role-plays with others
Speech is usually understood by strangers
Categorizes familiar objects
5 years
Uses up to 2,300 words
Dresses self without assistance
Discusses feelings
Cuts own meat with knife
Understands most prepositions referring to space (e.g., above,
beside, toward) and time (e.g., before, after, until)
Draws a recognizable person
Plays purposefully and constructively
Follows three-step commands
Recognizes part-whole relationships
Prints own name
6 years
Defines words by function and attributes
Rides a bicycle
Uses a variety of well-formed complex sentences
Throws a ball well
Uses all parts of speech (e.g., verbs, nouns, adverbs,
adjectives, conjunctions, prepositions)
Sustains attention to motivating tasks
Enjoys competitive games
Understands letter-sound associations in reading
8 years
Reads simple books for pleasure
Enjoys riddles and jokes
Understands conservation of liquid, number, length, and so forth
Verbalizes ideas and problems readily
Knows left and right of others
Understands indirect requests (e.g., “It’s hot in here”
understood as request to open window)
Knows differences and similarities
Appreciates that others have different perspectives
Produces all speech sounds in an adult-like manner
Categorizes same object into multiple categories
(Adapted from Owens RE.
Language Development: An Introduction
. 4
th
ed. Needham Heights, MA: Allyn & Bacon; 1996, with permission.)
acquired during childhood (e.g., secondary to a trauma or a neu-
rological disorder), although less frequently, or it can be devel-
opmental; it is usually congenital, without an obvious cause.
Most childhood language disorders fall into the developmental
category. In either case, deficits in receptive skills (language
comprehension) or expressive skills (ability to use language)
can occur. Expressive language disturbance often appears in
the absence of comprehension difficulties, whereas receptive
dysfunction generally diminishes proficiency in the expression
of language. Children with expressive language disturbance
