Please refer for a Speech-Language evaluation:
ü When a parent is concerned about speech or language development.
ü The child is not talking at all by age 18 months.
ü If there are medical, developmental concerns that may effect speech.
ü The child is embarrassed by his/her speech at any age.

At age 2 if:
· Hearing impaired and/or does not respond to quiet sounds or voices.
· Cleft palate or excessive nasal quality in voice.
· The child does not begin combining words by age 2.
· The child exhibits limited vocabulary development.
· The child is not responding to conversation speech.

At age 3 if:
· Nonfluent or thought to stutter.
· Absence of sentence structure.
· Speech is difficult for family to understand.
· There are many omissions of initial and final consonants.
· Speech limited to echoing other's statements, songs, rhymes, etc.

At age 4 if:
· Word endings are consistently dropped, or used inconsistently.
· Communication skills are inadequate for interaction in school environment.
· Sentence structure is noticeably faulty.

At age 5 if:
· The child is noticeably dysfluent, or parents express concern.
· Hoarse, harsh or unusual voice quality.
· Mispronounces any sounds.

At age 6 if:
· When a speech or language problem is present and speech therapy is unavailable in the school system or has a learning disability.