How to Use This Checklist
This checklist is based on ASHA (American Speech-Language-Hearing Association) milestones and CDC developmental standards. It is not a diagnostic tool. It is a parent tool for noticing patterns, preparing for pediatrician visits, and knowing when to request an evaluation.
Print this page. Bring it to your child's 12, 18, 24, and 36 month well-child visits. Check what your child is doing consistently, not just on a good day. Consistent means most of the time, in most settings.
12 Month Checklist
Communication: What to look for
- Responds to their own name reliably
- Turns toward a voice across the room
- Babbles using consonant-vowel combinations (ba-ba, da-da, ma-ma)
- Uses 1-3 true words with meaning (mama, dada, or another word used consistently for the same person or thing)
- Points to get something they want (imperative pointing)
- Points to show you something interesting (declarative pointing) — this is the most important item on this list
- Waves bye-bye
- Responds to simple requests (come here, give it to me)
Red flags at 12 months — act now if:
- No babbling
- No pointing of any kind
- Not responding to their name
- No words
- No back-and-forth communication (turn-taking, imitation of sounds)
- Loss of previously acquired skills
18 Month Checklist
Communication: What to look for
- 20+ words (not counting uh-oh, bye, hi as words — look for labels)
- Points to show you things they find interesting (this is still the most critical item)
- Follows simple two-step directions (go get your shoes and bring them here)
- Identifies 5-10 body parts when asked
- Uses words more often than gestures
- Strangers can understand some of what they say
Red flags at 18 months — act now if:
- Fewer than 20 words
- No pointing to share interest (not just to request)
- Not following simple directions
- Not imitating words or actions
- Only uses a few words and then stopped adding new ones
The 18-month mark is a critical evaluation window. If your child has fewer than 20 words at 18 months, do not wait for the 2-year checkup. Contact your pediatrician and ask for a referral to a speech-language pathologist. If your child is under 3, you can also contact Early Intervention directly without a referral.
24 Month Checklist
Communication: What to look for
- 50+ words
- Two-word combinations used spontaneously (more milk, daddy go, big dog)
- 50% of speech understood by strangers
- Asks for things using words
- Follows two-step related directions
- Points to pictures in books when named
- Uses words to get your attention (mama, look)
Red flags at 24 months — act now if:
- Fewer than 50 words
- No two-word combinations
- Significant regression in language
- Strangers understand very little of what they say
- Not following simple directions
36 Month Checklist
Communication: What to look for
- 200+ words
- Three-word sentences (I want juice, daddy go work)
- Strangers understand 75% of speech
- Asks who, what, where questions
- Follows two-to-three step unrelated directions
- Tells simple stories about recent events
- Uses plurals (dogs, cats)
- Uses pronouns (he, she, they) — may still make errors
Red flags at 36 months — act now if:
- Not using sentences
- Strangers cannot understand most of what they say
- Not asking questions
- Significant articulation problems beyond typical developmental errors
What to Do If Your Child Has Red Flags
First: do not wait and see. The evidence on early intervention is clear. Children who receive speech therapy in the first three years of life have significantly better outcomes than children who receive the same therapy at age 4, 5, or 6. The window is open now. Use it.
Under age 3: Contact your state's Early Intervention program. Federally funded. Free. No referral required. Evaluation within 45 days. Google your state plus Early Intervention to find the number.
Age 3 and older: Ask your pediatrician for a referral to a speech-language pathologist. Most insurance plans cover this. You can also self-refer at many hospital-based speech clinics.
Related Resources
The Speech Development Guide covers ASHA milestones from birth to age 5 in detail, including the 5 strategies with the strongest research support and a step-by-step evaluation pathway. The Talking Bundle adds baby sign language, first words milestones, communication activities, and parent scripts for $24.