If you answer yes to one the following fifteen problems, you should consider seeking a speech-language evaluation:
Your child is not engaging in social games nor following directions by age 1.
Your child is not talking by the age of two years.
Speech is very difficult to understand after age three.
Many beginning consonants are left off after the age of three.
Your child is three and still not using two-to-three word sentences.
Sounds are more than a years late in appearing in his speech according to their developmental sequence.
Vowels are mostly used in your child's speech.
Your child is five and word endings are mostly missing (e.g cat = ca_).
Your child is embarrassed or disturbed by his or her speech.
S/he is noticeably nonfluent after age 6. (says um, has many pauses, repeats himself a lot and/or stutters).
S/he is making speech errors other than /wh/ after the age of seven.
Your child's voice is monotone, too loud, too soft, or of a poor quality that may indicate hearing loss.
His or her voice is too high or too low for sex and age.
Your child sounds as if he always has a cold or is talking through his/her nose.
Speech has an abnormal rhythm, rate, and inflection after the age of five.
This list was modified from David Pushaw Teach Your Child to Talk, published
by CEBCO Standard Publishing, New York, NY.
Recommended reading: Apel, K. & Masterson, J.J. (2001). Beyond Baby Talk: From sounds to sentences - A parent's complete guide to language development. Prima Publishing. Sponsored by ASHA.