Red flags* for language delay

Age	Red flag	Type of skill
Birth or any age	Does not respond to sounds, particularly parent's voice	Receptive language
6 to 9 months	Does not babble	Expressive language
12 months	Does not use "mama," "dada," or "papa" to call parent	Expressive language
15 months	Does not use specific single word or word approximation other than "mama," "dada," or "papa" to request or comment	Expressive language
15 months	Does not use a point to request something out of reach	Gestural communication
18 months	Does not have at least five words used spontaneously to make requests or to comment on or label objects (assessed by asking: "How does she let you know what she wants?" or "What words does she use to ask for things?")	Expressive language
	Does not follow familiar one-step direction without gesture	Receptive language
	Does not point to something in order to share enjoyment or excitement with another person (joint attention)	Gestural communication
24 months	Uses fewer than 50 words	Expressive language
24 months	Does not combine two words together to create new meaning. (See caution below.)^¶	Expressive language

* Typically the age at which 90 percent of typically developing children have attained the skill.
¶ Parents may report stock phrases (eg, "let's go," "all done," "good job") or compound nouns ("dump truck," "Tyrannosaurus rex," "baby doll") as examples of this skill. These do not count as novel two-word combinations. Ask parents for specific examples, and probe further if these types of examples are the only ones provided.

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Red flags* for language delay