By the end of three months, your baby should be capable of:

• Smile at your appearance.
• Create cooing sounds.
• When spoken to, either remain silent or smile.
• Recognize your voice.
• Make different cries to meet different needs.

By the end of six months, your baby should be capable of:

• Make sounds while playing.
• Babble.
• Use her voice to express what she likes and dislikes.
• They shift their focus to sounds.
• Respond to changes in your tone of voice.
• Some toys make sounds.
• Consider music.

By the end of 12 months, your child should be able to:

• Try to replicate speech sounds.
• Say a few words, including "daddy," "mommy," and "oops."
• Understand simple commands like "come here".
• Know the names of common objects, such as "plate".
• Turns to listen to the sounds.

By the end of 18 months, your child should:

• Know the names of individuals, objects, and body parts.
• Follow simple commands given via gestures.
• Say up to ten words.

By the end of 24 months, your child should be capable of:

• Use simple phrases like "More milk".
• Ask one- or two-word questions, like "Daddy-daddy?".
• Follow simple instructions and understand simple questions.
• Speaks approximately 50 or more words.
• Speaks clearly enough that you or another caregiver can understand at least half of the words.

A child with speech impairment is unable to pronounce all of the sounds in words. This may make the child's speech difficult to understand. People might not understand the child in everyday situations. The cause of most children's speech disorders is unknown. Other speech disorders may be linked to cleft palate, dental issues, hearing loss, or difficulty controlling mouth movements.

Causes for Concern

• At 8-9 months old, the child does not babble with consonant sounds (particularly b, d, m, and n).
• After 18 months, the child communicates primarily through vowel sounds and gestures.
• Many people may not understand a three-year-old's speech.
• At the age of four and up, the child's speech becomes difficult to understand.

The voice is formed when air from the lungs rises and vibrates in the vocal folds. This is known as phonation. Voice disorders can cause the voice to become harsh, hoarse, raspy, intermittent, or drastically change pitch. Vocal nodules, cysts, papillomas, paralysis, and vocal fold weakness are all possible causes of voice disorders.

Causes for Concern

• The voice sounds hoarse, harsh, or choking.
• The voice is consistently too loud or too soft.
• The child's voice pitch is not appropriate for his or her age or gender.
• The voice frequently "breaks" or shifts pitch abruptly.
• Frequent loss of voice

Fluency denotes the natural "flow" of speech. Stuttering is the most common form of speech fluency disorder. Stuttering occurs when there is an excessive amount of repetition, hesitation, or prolongation in the flow of speech. Tension can also appear in the face, neck, shoulders, and fists. There are numerous theories explaining why children stutter. Currently, the cause is most likely due to underlying neurological differences in speech and language processing. Stuttering can be influenced, but not caused, by both the speaker's internal reactions and the external reactions of other listeners.

• Causes for Concern
• Parents are concerned about stuttering.
• The child exhibits an unusual number of repetitions, stutters, prolongations, or blocks in the natural flow of speech.
• When speaking, the child appears to be tense.
• The child avoids speaking due to a fear of stuttering.
• The child believes he or she is a stutterer..

Early intervention is crucial for children with speech disorders. The best time to begin treatment is when the child is a toddler or in preschool. These years are critical for normal language acquisition. Early skills required for normal speech development can be tested in infants. At this age, a speech therapist collaborates with parents to promote speech development at home. Individual therapy, or active treatment, typically begins between the ages of two and four.

If speech disorders are caused by cerebral palsy (CP) or organic brain damage, transcranial direct current stimulation (tDCS) is an effective treatment option.

If you are concerned about your child's communication skills, speak with your doctor. Your doctor will most likely refer your child to a speech-language pathologist, pediatric neurologist, child psychiatrist, or speech therapist for additional evaluation and treatment.

All children with speech and language disorders should have their hearing checked.