Referral Guidelines for speech delay

Age (mos)

12, No differentiated babbling or vocal imitation
18, No use of single words
24, Single word vocab of less than 10 words
30, Fewer than 100 words; no evidence of two-word combinations; unintelligible
36, Fewer than 200 words; no use of telegraphic sentences, clarity <50%
48, Fewer than 600 words; no use of simple sentences, clarity <80%

Nelson 16th Ed, p.1943

Nelson 16th Ed, p.1943
Myth: boys, younger siblings and children with persistent ear infections can have language delay.
Truth: boys may show slightly delayed speech development, though they normally won’t lag more than 6 months behind; they may show some delay but it’s usually below the level of clinical attention. Older siblings “doing all the talking” for younger siblings is also an invalid excuse for developmental delay. Children have a strong motivation to speak whenever they can and as soon as they can. Normal development cannot be suppressed. Finally, middle ear effusion from otitis media has not been shown to affect language development.

Pediatric News. Jan 2009.
N Engl J Med 2007;356:248-61