II. Red Flags: Immediate speech therapy evaluation indications

  1. No babbling by 12 months
  2. No pointing or gestures by 12 months
  3. Does not use at least 3 words by 15 months
  4. Does not say mama, dada or other names by 18 months
  5. At least some speech not understandable by 24 months
  6. Does not use at least 25 words by 24 months
  7. No 2-word spontaneous phrases by 30 months (includes noun-verb phrases)
  8. Does not use at least 200 words by 36 months
  9. Does not ask by name for objects by 36 months
  10. Repeats phrases in response to questions (Echolalia) at 36 months
  11. Regression of skills at any age
    1. Loss of language or babbling
    2. Loss of social skills

III. Screening: Rule of Fours

  1. Start with child's age in years divided by 4
  2. The calculation represents the percentage of a child's speech understandable by a stranger
    1. Age 1 year: Speech is 25% understable
    2. Age 2 year: Speech is 50% understable
    3. Age 3 year: Speech is 75% understable
    4. Age 4 year: Speech is 100% understable

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