Speech and Language Red Flags for Referral

• Decreased eye contact during interactions
• Decreased/absent response to sounds and voices
• Is not babbling by 9 months
• Does not/can not imitate sounds or simple words by 12 months
  
• Does not imitate simple gestures/actions by 12 months
• Does not point to/identify familiar objects by 15 months
• Demonstrates any “loss” of language/words
• Does not use 25 words consistently by 18 months
• Does not/can not imitate words regularly by 18 months
• Continues to use more gestures than words at 18 months
• Less than 100 words by 24 months
• No combinations of words into 2- and 3-word phrases by 24 months
• Not able to follow directions by 24 months
• Family members understand less than 50% at 24 months
• Is not consistently combining words into short sentences by 30 months
• Family members understand less than 85% at 36 months
• Unfamiliar listeners have difficulty understanding child at 42+ months
• Difficulty engaging with peers in pretend/imaginative play at 3-4 years
• Does not develop more complex grammatical concepts between 3-5 years