What is the difference between speech and language?
- Speech refers to the "articulation" or production of sounds, such as correctly articulating the /b/ or /k/ sound in words and sentences.  We also use the word "fluency" when talking about how smoothly you speak (difficulty with smooth speech is called dysfluency or stuttering) and we use the word "voice" when talking about how a voice sounds (pitch, tone, volume).
- Language is much broader.  The term language refers to your ability to listen and comprehend (receptive language) and your ability to express yourself in a meaningful way (expressive language).  
- Although difficulties in speech and language differ, they frequently overlap. A child with a language problem may be able to pronounce words well but be unable to put more than two words together. Conversely, another child's speech may be difficult to understand, but he or she may use words and phrases to express ideas. Another child may speak well but have difficulty following directions.

What are some common causes of speech and language delays?
Often we see children who had hearing difficulties due to ear infections during speech sound development. Some children have developmental delays, autism, or cerebral palsy. Other children may have a learning system that is not processing information as effectively as it should. Some children come from a home situation that does not encourage talking with children.  Many times there is no known physical cause. 

Why is early referral important for speech and language delays?
Delays in speech and language skills may significantly impair communication skills, social/emotional development and pre-academic skills. A child's overall speech pattern will usually become more understandable as he matures, but some children will need direct treatment to eliminate speech errors. Approximately 10% of all children demonstrate such a delay. Language delays can affect academic skills, such as reading, writing and math comprehension. 

What are some warning signs that my child might need additional help?
Please review the chart of Developmental Speech & Language Milestones below.  If your child is demonstrating difficulty with any of those skills, they may need speech and/or language therapy.  Children develop speech/language skills at different rates.  Sometimes siblings within the same family develop speech and language skills at a different rate than their brothers and sisters.  This does not mean that there is a problem, but a screening of your child's skills can determine if further evaluation is needed.  

Hearing and Understanding	Talking
1-2 Years Points to a few body parts when asked. Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?"). Listens to simple stories, songs, and rhymes. Points to pictures in a book when named.	1-2 Years Says more words every month. Uses some 1-2 word questions ("Where kitty?" "Go bye-bye?" "What's that?"). Puts 2 words together ("more cookie," "no juice," "mommy book"). Uses many different consonant sounds of the beginning of words.
2-3 Years Understands differences in meaning ("go-stop," "in-on," "big-little," "up-down"). Follows two requests ("Get the book and put it on the table."). Identifies several body parts Understands most things said to him/her	2-3 Years Uses 2-3 word "sentences" to talk about and ask for things. Speech is understood by familiar listeners most of the time (50-70% intelligible). Often asks for or directs attention to objects by naming them. “Explosion of vocabulary”; 50-250 spoken words
3-4 Years Hears you when call from another room. Vocabulary of approximately 1200-2000 words. Understands simple, "who?" "what?," "where?” questions. Follows simple 2-3 step directions	3-4 Years Talks about activities at school or at friends' homes. People outside family usually understand child's speech. Uses a lot of sentences that have 4 or more words. Asks many questions. Vocabulary of 800-1500 spoken words
4-5 Years Pays attention to a short story and answers simple questions about it. Hears and understands most of what is said at home and in school. Understands numbers to 3. Understands simple prepositions (under, inside). Vocabulary of 2800 or more words.	4-5 years Uses sentences that give lots of details (e.g. "I like to read my books"). Tells stories that stick to topic. Communicates easily with other children and adults. Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th. Uses the same grammar as the rest of the family.
5-6 Years ·          Understands some time concepts (first, last, before). ·          Identifies 6 basic colors and 3 basic shapes. ·          Begins to identify when words rhyme. ·          Uses simple, phonetic spelling (PTE= pretty) ·          Identifies several alphabet letters and numbers	5-6 Years ·          Asks questions with “how?”. ·          Names simple opposites (big/little, hot/cold). ·          Counts to 30. ·          Tells nursery rhymes and simple poems ·          Names several alphabet letters