| General: |
- Concern expressed by parent/caregiver, teacher, or other professional regarding speech and/or language development
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| Abnormal developmental milestones: |
- Loss of milestones
- Slowed or stagnant speech and language development
- No babbling by 9 months
- No first words by 15 months
- No consistent words by 18 months
- No word combinations by 24 months
- Language is difficult for caregivers to understand at 24 months
- Language is difficult for strangers to understand at 36 months
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| Cognitive or expressive language dysfunction: |
- Dysfluencies (eg, stuttering) consist of more than tension-free, whole-word repetitions
- Child acquires vocabulary and sentence structure but does not use language appropriately for communicative purposes
- Language is unusual, confused, or ideas are not expressed clearly
- Child cannot follow instructions without supplemental visual cues
- Poor memory skills at 5 to 6 years
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| Behavioral manifestations: |
- Child is frustrated by difficulties with communication
- Child is teased by peers for "talking funny"
- Child avoids situations that require talking
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| Neurological manifestations: |
- Excessive drooling
- Difficulty sucking, chewing, or swallowing
- Difficulty coordinating movements of lips, tongue, and jaw
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