Developmental Red Flags for Children Ages 3-5 (page 2)

By — Pearson Allyn Bacon Prentice Hall
Updated on Jul 20, 2010

How to Screen

Note level and quality of development as compared with other children in the group.

Speech and Language Development, Which Includes

  • Articulation (pronouncing sounds)
  • Dysfluency (excessive stuttering—occasional stuttering may occur in the early years and is normal)
  • Voice
  • Language (ability to use and understand words)

Red Flags

  • Articulation. Watch for the child
    • Whose speech is difficult to understand, compared with peers
    • Who mispronounces sounds
    • Whose mouth seems abnormal (excessive under- or overbite; swallowing difficulty; poorly lined-up teeth)
    • Who has difficulty putting words and sounds in proper sequence
    • Who cannot be encouraged to produce age-appropriate sound
    • Who has a history of ear infections or middle ear disorders

Note: Most children develop the following sounds correctly by the ages shown (i.e., don’t worry about a 3-year-old who mispronounces t).

2 years—all vowel sounds

3 years—p, b, m, w, h

4 years—t, d, n, k, h, ng

5 years—f, j, sh

6 years—ch, v, r, l

7 years—s, z, voiceless or voiced th

  • Dysfluency (stuttering). Note the child who, compared with others of the same age,
    • Shows excessive amounts of these behaviors:
      • repetitions of sounds, words (m-m-m; I-I-I-I-)
      • prolongations of sounds (mmmmmmmmmmmmmmm)
      • hesitations or long blocks during speech, usually accompanied by  tension or struggle behavior
      • putting in extra words (um, uh, well)
    • Shows two or more of these behaviors while speaking:
      • hand clenching
      • eye blinking
      • swaying of body
      • pill rolling with fingers
      • no eye contact
      • body tension or struggle
      • breathing irregularity
      • tremors
      • pitch rise
      • frustration
      • avoidance of talking
    • Is labeled a stutterer by parents
    • Is aware of her or his dysfluencies
  • Voice. Note the child whose
    • Rate of speech is extremely fast or slow
    • Voice is breathy or hoarse
    • Voice is very loud or soft
    • Voice is very high or low
    • Voice sounds very nasal
  • Language (ability to use and understand words). Note the child who
    • Does not appear to understand when others speak, though hearing is normal
    • Is unable to follow one- or two-step directions
    • Communicates by pointing, gesturing
    • Makes no attempt to communicate with words
    • Has small vocabulary for age
    • Uses parrotlike speech (imitates what others say)
    • Has difficulty putting words together in a sentence
    • Uses words inaccurately
    • Demonstrates difficulty with three or more of these skills:
      • making a word plural
      • changing tenses of verb
      • using pronouns
      • using negatives
      • using possessives
      • naming common objects
      • telling function of common objects
      • using prepositions

Note: Two-year-olds use mostly nouns, few verbs. Three-year-olds use nouns, verbs, some adverbs, adjectives, prepositions. Four-year-olds use all parts of speech.

How to Screen

  1. Observe child. Note when, where, how frequently, and with whom problem occurs.
  2. Check developmental history—both heredity and environment play an important part in speech development.
  3. Look at motor development, which is closely associated with speech.
  4. Look at social–emotional status, which can affect speech and language.
  5. Write down or record speech samples.
  6. Check hearing status.
  7. Note number of speech sounds or uses of language.
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