Know the Signs! Act Early!

Know the Signs! Act Early! Refer!

As a parent, you may have questions about your child’s speech and language skills. First Words is here to help you.

Take a few minutes to fill out the First Words Communication Checkup, an online screening tool. In less than 20 minutes, you will obtain results and receive the next steps to follow. You will immediately know if you need to complete a referral for assessment and intervention services.

This free tool is available for families of preschool children in the Ottawa area. It can be used from the age of 6 months until admission to kindergarten.


  • The best time to affect brain and behavioral growth is between the ages of 0 to 30 months. Early cognitive development is primarily driven by biology.
  • Whether a child is 6 months or 24 months, a child under the age of 2 can be referred for a First Words assessment.   Referral and intervention before the age of 30 months have better and faster outcomes for the child.  Complete the Communication Checkup to see how your child is doing in terms of their speech, language, social, and other development.
  • A child should communicate for the same reasons as adults do by age 1. By 12 months, infants should use communication to show, to label, to protest or refuse, to interact – just like adults do. But infants will use the tools they have: sounds, babbling, smiles, facial expressions, gestures, and some words.
  • A child must babble by 12 months. A child with limited sounds or who doesn’t babble (ex: bada) by 12 months continues to have fewer words at 18 months, 24 months and even, 36 months. Refer early!
  • A child at 24 months uses 100-150 words and 2-4 word sentences. Research shows that 50% of children who do NOT show these milestones at 24 months have persistent delays at age 3.

Check here for a list of red flags indicating that a child may need support to further their development.


Recent advances in brain research show how the environment impacts a young child’s brain. Stimuli in early life switch on genetic pathways, including those of the sensory neurons (language, vision, sound, etc.), which create connections and growth in response to such stimulation. This critical period of growth – influenced by environment and early experience – has the greatest potential to influence the child’s developing brain during the first few years of life. Early experiences affect brain structure because the brain operates on a “use it or lose it” principle (Carnegie Task Force on Meeting the Needs of Young Children, 1994; Ounce of Prevention Fund, 1996). If a child does not have adequate emotional, physical, cognitive, and language stimulation, neurons can be lost permanently.

Brain pathways associated with language develop early. The brain pathways that affect language, literacy, behaviour, and health are made early in life. Ages 0 to 3 provides the greatest window of opportunity to affect neurological and behavioral growth (Rossetti, 2001). Early intervention provides better and faster outcomes for the child because of the biological relationship of early experiences affecting brain structure.

Early identification and intervention provide better and faster outcomes. With an early referral and intervention, we take advantage of that critical learning period. An early referral prevents a cumulative delay and/or decrease the severity of language delays in preschoolers. An early referral enhances school readiness and increases later academic success in school.

Early treatment impacts social, learning and behaviour skills. When a child is talking very little, others may communicate less with that child. The interaction of ‘less talk, less input’ has long term negative effects. Parent education, early experiences and early intervention can prevent cumulative developmental delays and/or related social, learning and behavior issues.


References: Carnegie Task Force on Meeting the Needs of Young Children, 1994; Ounce of Prevention Fund, 1996; Early Years Study, Final Report Reversing the Real Brain Drain. Hon. Margaret Norrie McCain and J. Fraser Mustard, Publications Ontario, Toronto,1999; The Early Years Study Three Years Later. Hon. Margaret Norrie McCain and J. Fraser Mustard, The Founders’ Network, 2002)