Frequently Asked Questions2019-10-18T11:49:24+00:00
How can I be sure my child needs therapy?2019-10-18T10:24:23+00:00

Below are Caroline Bowen’s ‘Ages and Stages’ of speech and language development. These are general guidelines only and are not to be used as diagnostic tools. If you have any queries or concerns regarding your child’s speech or language development please feel free to contact me to discuss these concerns further. As a general rule I advise that if you have a niggle that your child’s communication skills may be behind for their age, get it checked. If there is an issue, no matter how small, the earlier it’s addressed the better.

Ages and Stages Summary – Language Development 0-5 years



Language learning starts at birth. Even new babies are aware of the sounds in the environment.

They listen to the speech of those close to them, and startle or cry if there is an unexpected noise. Loud noises wake them, and they become “still” in response to new sounds.

0-3 months

Astoundingly, between 0-3 months babies learn to turn to you when you speak, and smile when they hear your voice. In fact, they seem to recognise your familiar voice, and will quieten at the sound of it if they are crying.

Tiny babies under three months will also stop their activity and attend closely to the sound of an unfamiliar voice. They will often respond to comforting tones whether the voice is familiar or not.

Your baby smiles at you when you come into view. He or she repeats the same sound a lot and “coos and goos” when content. Cries “differentiate”. That means, the baby uses a different cry for different situations. For example, one cry says “I’m hungry” and another says “I have a pain”.


4-6 months

Then, some time between 4 to 6 months babies respond to the word “no”. They are also responsive to changes in your tone of voice, and to sounds other than speech. For example, they can be fascinated by toys that make sounds, enjoy music and rhythm, and look in an interested or apprehensive way for the source of all sorts of new sounds such as the toaster, birdsong, the clip-clop of horses’ hooves or the whirr of machines.

Gurgling sounds or “vocal play” occur while you are playing with your baby or when they are occupying themselves happily.

Babbling really gets going in this age range, and your baby will sometimes sound as though he or she is “talking”.

This “speech-like” babbling includes many sounds including the bilabial (two lip) sounds “p”, “b” and “m”.

Your baby can tell you, using sounds or gestures that they want something, or want you to do something. He or she can make very “urgent” noises to spur you into action.


7-12 months

The 7 to 12 months timeframe is exciting and fun as the baby now obviously listens when spoken to, turns and looks at your face when called by name, and discovers the fun of games like: “round and round the garden”, “peep-oh”, “I see” and “pat-a-cake” (These simple games and finger plays will have regional names and variants).

It is in this period that you realise that he or she recognises the names of familiar objects (“Daddy”, “car”, “eyes”, “phone”, “key”) and begins to respond to requests (“Give it to Granny”) and questions (“More juice?”).

The sound of your baby’s babbling changes. This is because it now includes more consonants, as well as long and short vowels. He or she uses speech or other sounds (i.e., other than crying) in order to get your attention and hold on to it. And your baby’s first words (probably not spoken very clearly) have appeared! (“MaMa”, “Doggie”, “Night Night”, “Bye Bye”)


1-2 years

Now your child points to pictures in a book when you name them, and can point to a few body parts when asked.

He or she can also follow simple commands (“Push the bus!”, “Don’t touch; it’s hot!”) and understand simple questions (“Where’s the bunny?”, “Who likes Miffy?”, “What’s in your purse?”).

Your toddler now likes listening to simple stories and enjoys it when you sing songs or say rhymes.

This is a stage in which they will want the same story, rhyme or game repeated many times.

Now your baby is accumulating more words as each month passes. He or she will even ask 2-word questions like “Where ball?” “What’s that?” “More chippies?” “What that?”, and combine two words in other ways to make a variety of simple sentence types (“Birdie go”, “No doggie”, “More push”). Words are becoming clearer as more initial consonants are used in words.


2-3 years

By now your toddler will understand two stage commands (“Get your socks and put them in the basket”) and understand contrasting concepts or meanings like hot / cold, stop / go, in / on and nice / yuccy. He or she notices sounds like the telephone or doorbell ringing and may point or become excited, get you to answer, or attempt to answer themselves.

Your two or three year old’s vocabulary is exploding!

He or she seems to have a word for almost everything. Utterances are usually one, two or three words long and family members can usually understand them.

Your toddler may ask for, or draw your attention to something by naming it (“Elephant”) or one of its attributes (“Big!”) or by commenting (“Wow!”).

3-4 years

Your three or four year old understands simple “Who?”, “What?” and “Where?” questions, and can hear you when you call from another room. This is an age where hearing difficulties may become evident. If you are in doubt about your child’s hearing, see a clinical audiologist.

Sentences are becoming longer as your child can combine four or more words. They talk about things that have happened away from home, and are interested in talking about pre-school, friends, outings and interesting experiences. Speech is usually fluent and clear and “other people” can understand what your child is saying most of the time. In fact, sometimes “other people” hear things you wish they had not!

4-5 years


Children in this age range enjoy stories and can answer simple questions about them. He or she hears and understands nearly everything that is said (within reason) at home or at pre-school or day care.

Your child’s ability to hear properly all the time should not be in doubt. If you are in doubt about your child’s hearing, see a clinical audiologist. If you are in doubt about language comprehension, see a speech-language pathologist / speech and language therapist.

Your child speaks clearly and fluently in an easy-to-listen-to voice.

He or she can construct long and detailed sentences (“We went to the zoo but we had to come home early because Sally wasn’t feeling well”).

He or she can tell a long, involved imaginative story sticking to the topic, and using “adult-like” grammar.

Most sounds are pronounced correctly, though he or she may be lisping as a four year old, or, at five, still have difficulty with “r”, “v” and “th”.

Your child can communicate easily with familiar adults and with other children.

Your child may tell fantastic, dramatic, inventive, “tall stories” (sometimes even scaring themselves!) and engage strangers in conversation when you are out together.


Ages and stages of speech development


Typical Speech Sound Development for children




2 years

m, n, p, h, b, d,

3 years

f, g, k, t, w

4 years


5 years

6 years

7 years





All children make mistakes when they are learning to speak and many of these errors are very normal and nothing to be concerned about. We call these errors phonological processes. On occasions, children can carry on using these errors in their speech long after they should typically outgrow them. Below is a list of some of these errors and the approximate age children should outgrow them.

Elimination of Phonological Processes in Typical Development

Phonological processes are typically gone by these ages (in years ; months)

Pre-vocalic voicing pig = big


Word-final de-voicing pig = pick


Final consonant deletion comb = coe


Fronting car = tar
ship = sip


Consonant harmony mine = mime
kittycat = tittytat


Weak syllable deletion elephant = efant
potato = tato
television =tevision
banana = nana


Cluster reduction

spoon = poon
train = chain
clean = keen


Gliding of liquids

run = one
leg = weg
leg = yeg


Stopping /f/ fish = tish


Stopping /s/ soap = dope


Stopping /v/ very = berry


Stopping /z/ zoo = doo


Stopping ‘sh’ shop = dop


Stopping ‘j’ jump = dump


Stopping ‘ch’ chair = tare


Stopping voiceless ‘th’ thing = ting


Stopping voiced ‘th’ them = dem



Bowen, C. (1998). Developmental phonological disorders. A practical guide for families and teachers. Melbourne: ACER Press.

Grunwell, P. (1997). Natural phonology. In M. Ball & R. Kent (Eds.), The new phonologies: Developments in clinical linguistics. San Deigo, CA: Singular Publishing Group, Inc


As a more general guide:

By 18 months a child’s speech is normally 25% intelligible
By 24 months a child’s speech is normally 50 -75% intelligible
By 36 months a child’s speech is normally 75-100% intelligible

Lynch, Brookshire & Fox (1980), p. 102, cited in Bowen (1998).


What are the likely options following assessment?2019-10-18T10:25:11+00:00
  • In the case that the assessments indicated age-appropriate speech and language skills, no further action will be required and you/your child will be discharged from the service.
  • You may request a written report
  • Individual therapy- these sessions may be weekly, fortnightly or on a review bases
  • Home and/or school programmes
  • Home visits
  • School visits
  • Liaison with other relevant Health Professionals
  • Onward referral e.g. hearing assessments
Is my child too young for speech and language therapy?2019-10-18T10:25:46+00:00

Speech Therapists have a lot of ways to teach communication to babies as young as 6 months to one year old, especially if they have an underlying diagnosis such as Down’s Syndrome, Cerebral Palsy, Hearing loss or a developmental delay.

Parents unknowingly attribute speech and language delays to gender difference (Oh! Its because he is a boy!) or Family Trees (I know why he’s late…It’s because my sister/dad/cousin etc. spoke late). But the truth is that irrespective of the gender or family, your child should be communicating by one year of age using gestures or words!. And if that is not the case, then you must seek the help of a Speech Therapist.

Do I need a Doctors referral?2019-10-18T10:26:14+00:00

No. You can refer your child directly for Speech and Language Therapy. If you are covered by Health insurance, they may request a referral letter from a G.P. so I advise for you to contact your health insurance provider to find out what you are covered for and what documentation you may need for them.

Can I avail of private Speech Therapy while attending other Speech therapy services2019-10-18T10:26:50+00:00

Absolutely. Dual service provision is there in order to provide the optimal level of service for your child. With parental consent, I work collaboratively with the HSE Speech Therapists to ensure all areas of your child’s speech and language needs are met. It is important to remember however that your child does need breaks from therapy and attending two services is not always in the best interest of your child.

If you have any other general questions you think may be useful, please forward them on to me.