As clinicians working with children on their speech development journey, it’s important to stay up-to-date with the latest resources and tools. The American Speech-Language-Hearing Association (ASHA) provides guidance through their developmental milestones, offering a framework for understanding typical communication development from birth to five years old. Whether you’re a Speech Therapist or BCBA, referencing the ASHA developmental milestones can offer valuable insights during pediatric therapy.
Understanding ASHA Developmental Milestones
The ASHA milestones encompass four crucial areas of communication development, with each area playing a vital role in a child’s overall ability to interact with the world around them:
Social Communication
This refers to the ability to interact with others effectively. It includes skills like:
- Turn-taking: Understanding the concept of waiting for one’s turn to speak and listen attentively to others.
- Sharing: Willingness to share toys, materials, and attention with others.
- Responding to others’ emotions: Recognizing and reacting appropriately to the emotions of others, such as offering comfort or showing empathy.
Pragmatics
This involves using language effectively in different contexts and situations. It encompasses skills like:
- Understanding different communication styles: Recognizing the difference between formal and informal language, adjusting communication style depending on the setting and audience.
- Following social rules of conversation: Using greetings and farewells appropriately, maintaining eye contact during communication, taking turns speaking and listening.
- Using language to achieve specific goals: Asking questions, making requests, providing information, expressing wants and needs.
Receptive Language
This entails understanding spoken language, including the ability to:
- Follow instructions: Comprehending and carrying out simple and complex directions, such as “Put the ball on the table” or “Go wash your hands and come back here.”
- Identify objects and actions: Understanding and pointing to named objects, following simple commands that involve actions (e.g., “touch your nose”).
- Comprehension of concepts: Grasping basic concepts like size, color, shape, location (in, on, under), and time (before, after).
Expressive Language
This involves using spoken language to communicate needs, wants, and ideas. This area includes skills such as:
- Vocabulary development: Building an age-appropriate vocabulary of words to express oneself effectively.
- Using different sentence structures: Constructing simple and complex sentences, using proper grammar and syntax.
- Storytelling: Retelling familiar stories or creating their own narratives, sequencing events logically.
ASHA Developmental Milestones by Age
Here’s a more detailed breakdown of key ASHA milestones across different age groups, highlighting specific skills within each category:
Birth to 3 Months
- Social Communication: Alerts to sound, responds to familiar voices, quiets or smiles when spoken to.
- Pragmatics: May not be applicable at this stage.
- Receptive Language: Turns or looks toward voices or people talking, recognizes loved ones and familiar objects.
- Expressive Language: Coos, makes sounds back and forth with you, makes sounds that differ depending on their emotional state.
4 to 6 Months
- Social Communication: Responds to facial expressions, enjoys social interaction (giggles, laughs).
- Pragmatics: May not be applicable at this stage.
- Receptive Language: Looks at objects of interest and follows them with their eyes, reacts to toys that make sounds.
- Expressive Language: Vocalizes different vowel sounds, sometimes combined with a consonant (e.g., “ooooo,” “ooooooh,” “bababa”), vocalizes during play or with objects in mouth, blows raspberries.
7 to 9 Months
- Social Communication: Enjoys playing with others, may show separation anxiety.
- Pragmatics: May not be applicable at this stage.
- Receptive Language: Understands simple words and gestures like “no”, Turns head to find hidden object, reaches for objects.
- Expressive Language: Babbles long strings of sounds (e.g., “mamamama,” “babababa”), may use some early words like “mama” or “dada.”
10 to 12 Months
- Social Communication: Shows interest in interacting with others, points to objects and pictures to share interests.
- Pragmatics: Starts using gestures to communicate (waving, pointing).
- Receptive Language: Understands simple commands like “bye-bye” or “come here”.
- Expressive Language: Says first words (“mama,” “dada”), uses simple gestures like shaking head for “no”.
13 to 18 Months
- Social Communication: Plays alongside others (parallel play), may start showing empathy.
- Pragmatics: Uses gestures consistently to communicate needs and wants, points to familiar body parts.
- Receptive Language: Follows simple instructions (e.g., “Give me the ball”), understands questions with gestures.
- Expressive Language: Uses 10+ words, imitates sounds, may start using jargon (made-up words).
19 to 24 Months
- Social Communication: Engages in pretend play, shows interest in other children’s play, expresses emotions verbally.
- Pragmatics: Uses simple phrases to request objects or actions.
- Receptive Language: Follows instructions with 2-4 steps, attempts simple questions like “what’s that?” and “where is it?”, uses more complex sounds and starts combining consonants and vowels, expresses a wider range of emotions verbally.
- Expressive Language: Combines words into short phrases (e.g., “more juice” or “go outside”), starts using pronouns (“me,” “you”).
2 to 3 Years
- Social Communication: Plays cooperatively with others (may involve some arguing), shows affection and empathy towards others, enjoys pretend play (e.g., dolls or stuffed animals).
- Pragmatics: Starts using communication to greet others and share experiences.
- Receptive Language: Follows complex instructions with multiple steps, understands basic concepts like time and size, comprehends short stories.
- Expressive Language: Uses three- and four-word phrases, asks “why” questions, understands prepositions like “in,” “on,” and “under.”
3 to 4 Years:
- Social communication: Plays cooperatively with other children, takes turns and shares readily.
- Pragmatics: Uses language effectively to get things done, understands basic rules and routines.
- Receptive language: Follows complex instructions with multiple steps, understands basic concepts like same and different, comprehends longer stories.
- Expressive language: Uses full sentences to express thoughts and ideas, asks various questions, starts using “wh” questions (who, what, where, when, and why).
4 to 5 Years:
- Social communication: Engages in complex pretend play, participates in group activities with peers.
- Pragmatics: Uses language effectively in different social settings, understands and follows rules in games and activities.
- Receptive language: Understands complex instructions, comprehends stories with multiple characters and plot lines.
- Expressive language: Tells stories with a beginning, middle, and end, uses correct grammar and sentence structure most of the time, engages in conversations and asks questions.
It’s important to remember that these are just general guidelines. Individual children may develop at their own pace, and some variations are expected. Although not meant for diagnosis, these milestones provide useful information on what to expect and when to consider seeking further assessment. If you have any concerns about a child’s progress, consulting with a speech-language pathologist (SLP) is recommended.
The Role of Technology in Pediatric Therapy
Technology can be a powerful tool to enhance your clinical practice by streamlining workflows, facilitating data collection, and providing valuable insights into a child’s progress. Here’s how two specific software solutions can support your work with ASHA developmental milestones:
- Fusion’s EHR Software: Designed specifically for PT, OT, and speech therapists, Fusion’s EHR software allows you to effortlessly manage your clinical workflow. You can efficiently document therapy sessions, assessments, and progress reports, all while seamlessly integrating ASHA milestones into your documentation. This ensures your notes are relevant, comprehensive, and aligned with established developmental benchmarks.
- WebABA’s Practice Management Software: Designed for ABA providers, WebABA streamlines scheduling, billing, and client management, fosters secure communication and collaboration within your team, and equips you with robust reporting tools for data-driven decision making. Ultimately, WebABA empowers you to measure and communicate developmental milestones effectively within the unique context of ABA practice.
- Catalyst’s Data Collection Software: Catalyst’s data collection software offers a user-friendly platform for collecting, analyzing, and visualizing client data. This can be particularly beneficial for tracking a child’s progress towards ASHA milestones. By charting specific skills and observing progress over time, you can gain valuable insights into the effectiveness of your interventions and make data-driven decisions to optimize your approach. Best of all, Catalyst’s data collection software integrates seamlessly with Fusion and WebABA; allowing for a comprehensive care management approach.
By leveraging the strengths of different software solutions, you can enhance efficiency, streamline communication, and make data-driven decisions that benefit the children you serve.
Additional Resources and Tips
Beyond technology, consider these resources to stay updated on ASHA developmental milestones:
- ASHA’s website: The ASHA website provides comprehensive information on developmental milestones, including detailed charts and resources for professionals. https://www.asha.org/public/developmental-milestones/
- Professional development opportunities: Participate in workshops, conferences, or online courses to deepen your understanding of ASHA milestones and their application in clinical practice.
- Collaboration with colleagues: Regularly discuss observations and concerns with other professionals working with the same child to gain different perspectives and ensure a coordinated approach.
Remember, early intervention is crucial for children experiencing delays in meeting ASHA milestones. By staying informed, utilizing available resources, and collaborating with other professionals, you can play a vital role in supporting their communication development and helping them reach their full potential.
Technology Resources
Fusion EHR
Designed for physical, occupational, and speech therapists, Fusion boasts a suite of features designed to make your life easier. From appointment scheduling and intake forms to secure messaging and electronic billing, Fusion EHR streamlines your administrative tasks, freeing up valuable time to focus on what matters most – your clients. Schedule a demo of Fusion’s EHR.
WebABA Practice Management Software
WebABA, designed by BCBAs for ABA providers, is a cloud-based practice management software offering features like scheduling, billing, documentation, patient portal, and HR management to streamline workflows, improve efficiency, and deliver better client care. Additionally, WebABA offers features tailored to ABA practice, such as managing intervention plans, tracking behavior patterns, and monitoring progress specific to ABA therapy. This comprehensive solution empowers ABA providers to focus on delivering exceptional client care while managing their practice efficiently. Schedule a demo of WebABA.
Catalyst Data Collection Software
Catalyst is a cloud-based software that facilitates data collection. It enables users to gather data on their clients via any device, track their progress through various metrics, and generate automatic reports that come with customizable graphs. Additionally, Catalyst seamlessly integrates with Fusion and WebABA, unlocking powerful features such as enhanced tracking, streamlined scheduling, and automated billing. By eliminating manual data entry, it creates a unified system for improving data analysis and managing client care. Schedule a demo of Catalyst.