by Tamiko Teshima, M.A, CCC-SLP
Practice Owner & Speech-Language Pathologist
Duncan Lake Speech Therapy, LLC
If you’re a parent, you may have noticed that the CDC updated their developmental milestones, including speech and language benchmarks, in 2022. Their apparently “goal” was to make the milestones easier to understand. The updates shifted many milestones to later ages and removed others entirely, sparking concern among the speech pathology community. The previous set of CDC Milestone were set at the age at which 50% of children reach a specific skill. Now, the milestones are set to the age at which 75% of children reach a specific skill. While the changes may seem helpful at first glance, they simply delay children from receiving help that they need.
What Changed?
Here are some key updates to the speech milestones:
- Two-word phrases: Previously expected by 24 months, now pushed to 30 months.
- Pointing to communicate: A critical skill for early communication, this milestone was removed.
- Single words: Expected by 15 months, but the guidelines don’t clarify how many words are typical by this age.
These shifts lower the bar for what’s considered “typical,” potentially normalizing delays and encouraging a “wait-and-see” approach (and, as you know, we’re not about that here at DLST). Insert the longest and most dramatic eye-roll from every SLP ever.
Why It’s a Problem
- Delays Are Treated as Typical
Waiting until 30 months for two-word phrases could mean a child is already significantly behind before anyone steps in. The earlier we address a delay, the better the outcomes, so this change is a step backward. - Fewer Early Referrals
Removing milestones like pointing, which indicates early communication intent, risks overlooking kids who need help. Speech and language development isn’t just about words; it’s about all the ways kids communicate. - Missed Critical Windows
Early intervention works because young brains are incredibly adaptable. By delaying referrals, we miss the opportunity to make the most progress during this critical period of development.
Also, I would just like to point out that speech-language pathologists were NOT consulted in the creation of these “new” norms. Not even the higher-ups at the American Speech-Language-Hearing Association were consulted.
What Can Professionals Do?
These milestones are just guidelines—not a replacement for clinical judgment. As professionals, it’s our responsibility to educate families about typical development and advocate for their children. A parent’s concern should never be dismissed because their child hasn’t reached threshold that is, apparently, arbitrary to the CDC.
The Bottom Line
While the CDC’s updated milestones were meant to “clarify developmental expectations,” they risk delaying intervention for children with speech and language delays. At Duncan Lake Speech Therapy, we believe in acting early to empower kids and families. If you’re worried about your child’s speech development, contact your friendly, neighborhood SLP for more information!
