Dr Mom medical mom blog explores child development and child language development red flags.

When Madi was 15 months old, we were at a play area and we met a little girl who was 16 months old. This little girl was speaking at a 3 year old level!  She was speaking in almost full sentences and knew her first and last name. At 15 months, Madi could only say “Mama,” “Dada,” “Boo-boo” (her nickname), “toys” and a few body parts. I had never worried about Madi’s speech as I knew that at 15 months she is only expected to have 5 words, so I thought her language development was right on track.  However I will say I was very “shook” after meeting that little girl.

Once we got home, I started pointing to multiple objects around the house and tried to quickly improve Madi’s language. Within a week, I realized that I was over-reacting and that each child develops differently and that Madi was exactly where she should be.

Language development and literacy skills (the ability to read and write) in children occurs in stages, over time.  It is an ongoing process. It is also normal, to some extent, for each child’s development to occur at different stages, different ages, and in different ways. 

You might notice that when you go to your family doctor or pediatrician for a “check-up” that they ask about the abilities of your child to walk, talk, read, write, and do certain tasks.  These are known as “developmental milestones.”  

Important “red-flag” milestones in child’s speech and language development.

Red flag milestones are developmental milestones that if your child does not reach, this may indicate a delay in development. It is important to be aware of these milestones, so that you can see your doctor if you are worried:

  • Difficulty with hearing
  • No babbling by 9 months
  • No first words by 15 months
  • No word 2-combinations by 24 months
  • Speech is difficult for parents to understand at 24 months
  • Speech is difficult for strangers to understand at 36 months
  • Vocabulary is growing very slowly
  • Stuttering
  • Regression or loss of speech

Furthermore, if your child is finding it hard to communicate, is getting frustrated by their communication difficulty, is being teased by peers for talking funny, or avoids having to talk, these could also be signs your child is struggling with speech or language development.

Please see your health care provider if you have concerns as early intervention leads to better outcomes for children with speech-language delays.

This post was co-authored by Suzanne Black, MD, BSc and Stephanie Liu, MD, MSc, CCFP, BHSc.


Coplan J. Normal speech and language development: an overview. Pediatr Rev 1995; 16:91.

Johnson CP, Blasco PA. Infant growth and development. Pediatr Rev 1997; 18:224.


  1. Hi Stephanie,

    I understand what you are trying to say but I the find post is a little difficult to follow. Some of the advice is vague. Some of the wording is redundant and confusing. The long sentences make it hard to follow.

    examples would be:

    – I’m not sure I get what you mean by “red flag milestones”

    – At the very end of the post there is a long sentence where you summarize. It sounds like you are essentially saying that if your child is having language issues it may be a sign they have language issues.

    I think you are doing great work and by no means am trying to be abrasive! I just wanted to let you know that if it was more polished and easy to interpret it would be helpful!

    • Hi Carrie. Thank you for your comment!

      Red flag milestones are development milestones that if you child has not reached them by a certain age, that it is a warning sign that they may need to see a doctor for extra monitoring or a medical workup. I hope that clarifies your question!

  2. What would literacy skills be for my 15 month old? Is there a difference between their speech and language development or are they the same thing?

    I need to know what I should be looking for.

    • Hi Julie! Thank you for your comment!

      Speech refers to spoken language (with sound). Language refers to a whole system of words and symbols (both written and spoken, or used with body parts) to communicate meaning. Speech is a part of language that we often use to gauge development.

      Would you be interested if we wrote a post on 15 month old milestones?


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