When to Make a SLP Referral for Language Concerns


By 1 year does not:

  • Understand simple questions
  • Look at familiar people when named
  • Maintain eye contact with speaker
  • Begin to imitate words
  • Say 1–2 words independently

By 2 years does not:

  • Identify basic body parts
  • Understand simple commands like “give me”  without gestures
  • Demonstrate action words (e.g., eat)
  • Speak using 1–2 words at a time
  • Use new words frequently; use at least 50 words

By 3 years does not:

  • Use short sentences (e.g., “Car go up”)
  • Relate experiences verbally
  • State own first and last name
  • Count to 3

By 4 years does not:

  • Understand comparisons
  • Make inferences
  • Use short but grammatically correct sentences

By 5 years does not:

  • Understand complex directions
  • Understand concepts
  • Use complex sentences
  • Respond to “why” questions with a reason


When to Make a SLP Referral for Speech Sound Concerns


By age 3 years cannot:

  • Be understood by family and/or caregivers
  • Correctly produce vowels and sounds such as p, b, m, and w  in words
  • Repeat when not understood without becoming frustrated

By age 4 years cannot:

  • Be understood by individuals with whom they do not associate regularly 
  • Be understood by family and/or caregivers
  • Correctly produce t, d, k, g, f
  • Be asked to repeat without becoming sensitive

By age 5 years cannot:

  • Be understood in all situations by most listeners
  • Correctly produce most speech sounds
  • Be asked to repeat without exhibiting frustration