Major speech, language, and communication milestones*

Age	Expressive language skill	Receptive language skill	Gestural communication skill
Birth to 2 months	Cries	Turns toward sound	–
2 to 4 months	Coos (makes open vowel sounds: "ooh"; "aah")	Social smile	–
		Watches faces intently
6 months	Babbles (repetitive consonant-vowel combinations: "bababa"; "mamama")	Responds to name	–
12 months	Says first word/word approximation	Follows 1-step verbal command with gesture (eg, "Give me the ball")	Visually follows adult's pointing
	Uses jargon/babbles with inflection	Responds to "no" (eg, stops activity)	Points to request (12 to 14 months)
	Repeats sounds or gestures to get attention		Starts to use gestures (eg, shaking head "no")
15 to 18 months	Points to common body parts when named	Follows 1-step verbal command without gesture	Points to share attention/enjoyment with another person (not just to request things)
			Shows objects to another person
18 to 24 months	Uses^¶ 2-word phrases ("Mommy milk"; "go outside")	Points to objects or people when named	–
24 to 36 months	Answers simple questions ("What's your name?"; "Who's that?")	Follows 2-step verbal command	–
	50% intelligible
36 to 48 months	Uses 4- to 5-word sentences	Understands placement in space (on, in, under)	–
	Uses pronouns and some plurals
	75% intelligible
48 to 72 months	Uses full sentences with grammatical markings (eg, plurals, verb endings)	Follows 3-step verbal command	–
	100% intelligible

* A general knowledge of skills that are typical for age (milestones/50^th percentile skills) is important in order to conduct general developmental surveillance in primary care. However, milestones are not particularly helpful in making decisions about which children may require more formal evaluation or closer monitoring. This is because of the significant variability in the normal range of development of different skills in young children. Red flags (usually the 90^th percentile for skill attainment) are more helpful in clinical decision-making^[1].
¶ Young children's use of words implies spontaneous expression of words or word approximation to communicate a request or to interact with another person. Echoing or immediately repeating words spoken by a caregiver does not constitute having or using words in the meaning of the milestone.

Reference:

Sices L. Use of developmental milestones in pediatric residency training and practice: Time to rethink the meaning of the mean. J Dev Behav Pediatr 2007; 28:47.

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Major speech, language, and communication milestones*