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11 Questions Pediatricians should be asking Parents at 36-60 months

1. Does your child hear you when you call from another room? A problem with hearing will most likely result in speech issues.

2. Does your child answer simple “who?”, “what?”, “where?”, and “why?” questions? A big red flag is little response to questions or directions from a 3-year old.

3. Does your child talk about school activities or a visit to a friend’s home – show an ability to tell a basic story? Lack of interest in other children or only talking about himself may be a symptom of social/pragmatic language challenges. The intability to recount the day may signify expressive language issues or memory problems.

4. Do people outside your family understand your child’s speech? Be aware of unintelligible speech and limited consonants in 3-year old children.

5. Does your child use a lot of sentences that have 4 or more words? A red flag is the overuse of short 1-2 word utterances. Expect 4-year old children to regularly use 4-5 word sentences.

6. Does your child ask for or direct attention to objects by naming them? The child’s vocabulary should exceed 1000 words and they should have no trouble in naming and asking for common objects.

7. Does your child follow 2-3 step commands, such as, “Go get your shoes, put them by the door and then put on your socks.”? Little response to questions or directions is a red flag, as the child may not be processing the information in order to act, or could possibly have memory or attention issues.

8. Does your child ask many questions including, “who?” and “why?”? Inquisitiveness is expected in 3- and 4-year olds, though excessive questioning, lack of eye contact or aggressive language may indicate social/pragmatic language issues.

9. Does your child understand and verbalize spatial concepts (e.g., on, under, next to, etc.)? Expect to see this skill in 4-year old children, as they should have an understanding of basic spatial concepts by this age.

10. Does your child use past tense correctly, such as, “I played in the rain yesterday.”? Children at this age, especially 4-year olds, should understand this concept and use past tense in everyday language.

11. Has your child experienced any regression in speech, language or social skills? This is a red flag at any age.

If your child has any of these symptoms, or if you have seen any regression in your child’s speech, language or social skills, consider talking to a licensed speech pathologist to make sure the child is not at risk for serious language or articulation issues.

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