Kaplan + Sadock's Synopsis of Psychiatry, 11e

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Chapter 31: Child Psychiatry

Table 31.4a-1 Normal Development of Speech, Language, and Nonverbal Skills in Children Speech and Language Development Nonverbal Development 1 year Recognizes own name Stands alone Follows simple directions accompanied by gestures (e.g., bye-bye) Takes first steps with support Speaks one or two words

Uses common objects (e.g., spoon, cup)

Mixes words and jargon sounds

Releases objects willfully

Uses communicative gestures (e.g., showing, pointing)

Searches for object in location where last seen

2 years

Uses up to 300 words

Walks up and down stairs alone, but without alternating feet Runs rhythmically, but is unable to stop or start smoothly

Names most common objects Uses two-word or longer phrases

Eats with a fork

Uses a few prepositions (e.g., in, on), pronouns (e.g., you, me), verb endings (e.g., -ing, -s, -ed) and plurals (-s), but not always correctly

Cooperates with adult in simple household tasks

Enjoys play with action toys 3 years Uses up to 1,000 words

Follows simple commands not accompanied by gestures

Rides tricycle

Creates three- to four-word sentences, usually with subject and verb but simple structure

Enjoys simple “make-believe” play

Follows two-step commands

Matches primary colors

Repeats five- to seven-syllable sentences

Balances momentarily on one foot Shares toys with others for short periods

Speech is usually understood by family members

4 years Uses up to 1,600 words

Walks up and down stairs with alternating feet

Recounts stories and events from recent past

Hops on one foot Copies block letters Role-plays with others

Understands most questions about immediate environment

Uses conjunctions (e.g., if, but, because) Speech is usually understood by strangers

Categorizes familiar objects

5 years Uses up to 2,300 words

Dresses self without assistance Cuts own meat with knife

Discusses feelings

Understands most prepositions referring to space (e.g., above, beside, toward) and time (e.g., before, after, until)

Draws a recognizable person Plays purposefully and constructively Recognizes part-whole relationships

Follows three-step commands

Prints own name

6 years Defines words by function and attributes

Rides a bicycle

Uses a variety of well-formed complex sentences Uses all parts of speech (e.g., verbs, nouns, adverbs, adjectives, conjunctions, prepositions) Understands letter-sound associations in reading 8 years Reads simple books for pleasure Enjoys riddles and jokes Understands indirect requests (e.g., “It’s hot in here” understood as request to open window) Produces all speech sounds in an adult-like manner Verbalizes ideas and problems readily

Throws a ball well

Sustains attention to motivating tasks Enjoys competitive games

Understands conservation of liquid, number, length, and so forth

Knows left and right of others

Knows differences and similarities Appreciates that others have different perspectives Categorizes same object into multiple categories

(Adapted from Owens RE. Language Development: An Introduction . 4 th ed. Needham Heights, MA: Allyn & Bacon; 1996, with permission.)

comprehension) or expressive skills (ability to use language) can occur. Expressive language disturbance often appears in the absence of comprehension difficulties, whereas receptive dysfunction generally diminishes proficiency in the expression of language. Children with expressive language disturbance

acquired during childhood (e.g., secondary to a trauma or a neu- rological disorder), although less frequently, or it can be devel- opmental; it is usually congenital, without an obvious cause. Most childhood language disorders fall into the developmental category. In either case, deficits in receptive skills (language