Communication milestones from birth to three years, and when to ask for help

Speech and language milestones from six months to three years, red flags for referral, and what to do at home, from Cadabam's CDC speech therapists and developmental paediatrician.

Most children follow a similar path into speech: babbling at six months, one or two meaningful words and pointing by twelve months, about ten to twenty words by eighteen months, and fifty words with two-word phrases by twenty-four months. Every child has their own pace, but a missed milestone, or the loss of a skill a child already had, is a reason to ask a speech and language therapist or a developmental paediatrician. Waiting should come with a date.

The milestones at a glance

Age	What you should see
6 months	Babbles (ba-ba, da-da), responds to sounds and voices, smiles and makes sounds socially
12 months	Responds to their name, follows simple one-step instructions, uses gestures such as pointing and waving, says one or two meaningful words
18 months	About 10 to 20 words, identifies familiar objects and body parts, points to ask for something or to share interest
24 months	At least 50 words, combines two words, follows two-step instructions, names familiar objects
36 months	Three- to four-word sentences, asks simple questions, is understood by about three-quarters of unfamiliar listeners

Source: Blessy Yohannan, BASLP, RCI-registered Speech-Language Pathologist, Cadabam's Child Development Centre, in her talk "Spotting Speech and Language Disorders Early" at the IAP Karnataka State CME, 19 July 2026. Milestones are broad. Speech and language therapists and developmental paediatricians assess the whole child rather than relying on one number.

What counts as a meaningful word

Babbling is not the same as a word. A baby who says "amma" while looking at nothing in particular is babbling. A word becomes meaningful when the child says it to a person, for example looking at their mother and saying "amma". Rashmi R, Speech Therapist at Cadabam's CDC, puts it this way: by one year a child should have one or two true, meaningful words, and by the second birthday should be joining two words, such as "mama give" or "daddy go".

Gestures and play count too

Dr. Keerti Kilas Chaurasia, Consultant Developmental Paediatrician, asks parents to watch gestures as well as words: namaste, bye-bye, and copying what you do. Around eighteen months a child begins to copy daily actions, such as taking a comb and combing their own hair, to follow simple instructions such as "bring me a spoon", and to engage with other people. By twenty-four months she expects a growing vocabulary, two-word combinations such as "more milk", understanding, gestures and play.

A missed milestone, or a lost milestone, needs an assessment promptly.

To see what an assessment involves, read about what happens at a developmental assessment.

Red flags: when to refer

Ask for an assessment if you notice any of these:

no babbling by about nine months
no meaningful single words by about eighteen months
no spontaneous two-word phrases by about twenty-four months
any loss of speech, language or social skills at any age
a poor response to their name, or a worry about hearing
speech that is still very hard for others to understand after three years
difficulty understanding simple, age-appropriate instructions

An important point from Blessy Yohannan's talk: a child who understands poorly is more concerning than a child who only talks late, so ask the therapist to look at understanding as well as speech. See also speech delay in 2 year olds and speech delay or autism: key differences.

"He will talk when he starts school"

Parents are often told to wait, that boys talk late, or that a child will grow out of it. Dr. Keerti's reply: every milestone has a bracket, and if the bracket is crossed the child should be assessed whether a boy or a girl. Waiting should come with a date, not with hope. Early assessment is not overreacting; it is what a responsible parent does.

What you can do at home while you wait for the appointment

Rashmi R's advice is to make everyday routines the practice. Describe what you are doing in short, simple sentences during brushing, meals, bath time and play. Follow what the child is interested in. Pause for a second or two to give the child time to respond; if they do not, say the word and carry on. When a child says one word, expand it: "car", then "big car", then "the car is going on the road". Do not ask a child to sit down and say words on demand. For more, read about late talker or speech delay: four things to look at.

Where to go

Children from birth to six with any speech, language or developmental concern are best served at Cadabam's CDC, where speech and language therapists, behaviour therapists, occupational therapists and a developmental paediatrician work as one team. Book an appointment with the Book Appointment button or call 95355 85588, Monday to Saturday, 9 am to 7 pm. You can also use the speech delay screening.

Frequently Asked Questions

How many words should my child have at 18 months?

The milestone table from Blessy Yohannan's talk at the IAP Karnataka State CME gives about 10 to 20 words at 18 months, with the child pointing to ask for something or to share interest.

How many words should a two-year-old have?

At 24 months the same table gives at least 50 words, two-word phrases, and following two-step instructions. If your child has far fewer words or no two-word phrases, ask for an assessment.

What is the difference between babbling and a meaningful word?

Babbling is repeated sounds such as ba-ba. A word is meaningful when the child uses it to a person, for example looking at their mother and saying amma. Rashmi R, Speech Therapist at Cadabam's CDC, gives one or two true words by one year as the marker.

My son is a boy and talking late. Should I wait?

Dr. Keerti Kilas Chaurasia says being a boy is not a reason to dismiss a speech delay. If the milestone bracket is crossed, the child should be assessed, and waiting should come with a date.

What should I do if my child loses words they used to say?

A loss of speech, language or social skills at any age is a red flag. Book a developmental assessment promptly.

Does pointing matter?

Yes. By 12 months a child usually points and waves, and by 18 months points to ask for something or to share interest. Gestures such as namaste and bye-bye also count.

Which professional should I see first?

A speech and language therapist or a developmental paediatrician. Cadabam's CDC has both, and they work together with behaviour and occupational therapists.

Support at Cadabam's CDC

Speech and language therapists, behaviour therapists, occupational therapists and a developmental paediatrician work together at our three centres, JP Nagar, Kalyan Nagar and Kanakapura Road. Book an appointment or call 95355 85588, Monday to Saturday, 9 am to 7 pm.

This article shares the perspective of Cadabam's CDC professionals. It is general information and does not replace an assessment.

Communication milestones from birth to three years, and when to ask for help | Cadabam's CDC