Receptive and expressive language

What is receptive and expressive language?
Receptive language refers to how your child understands language. Expressive language refers to how your child uses words to express himself/herself.

Young children with language difficulties may have:

  • Poor eye contact
  • Difficulty interacting with other children
  • A limited spoken vocabulary (less than 50 words at two years of age)
  • Difficulty following directions (two-step directions at two years of age)
  • Difficulty communicating wants and needs

Preschool-aged children with language difficulties may have difficulty:

  • Retelling stories at four years of age
  • Using the right words (ex. using “me” for “I” such as “me want it” for “I want it”)
  • Producing new/novel sentences – likes to repeat words or phrases from movies, T.V. shows, etc., to communicate with others
  • Answering questions about themselves (ex. “What is your name?”, “How old are you?”)
  • Interacting with peers

School-aged children with language difficulties may have difficulty:

  • Using correct grammar
  • Putting words in the correct order for questions and sentences
  • Answering “wh” questions (ex. who, what, when, where, why)
  • Completing academic tasks such as memorizing facts, sequencing stories and organizing verbal information
  • Interacting with peers

When is a speech-language evaluation recommended?
If a family is concerned about their child’s communication development, a consultation with a speech–language pathologist is recommended. General guidelines for when to schedule an evaluation include when a child:

  • Does not use single words by 15 months
  • Does not use 50 words or 2-word phrases (ex. “more cookie”) by 24 months
  • Does not follow two-step directions (ex. “Get your coat and shoes”) by two years of age.
  • Is not understood 90% of the time when speaking by four years old or is easily frustrated because others cannot understand him/her
  • Has difficulty interacting with peers
  • Has difficulty with memory or problem solving skills
  • Demonstrates stutter-like tense repetitions of words or sounds (ex. “I I I I wa- want a cookie”) or produces words that sound “stuck” or “pushed,” especially if these behaviors last 6 months or longer and/or if the child has a negative reaction to his/her speech
  • Has a rough, breathy, or strained voice
  • Sounds “nasally” or too much air is leaking though the nose when talking

What to expect during a language evaluation
During a 60-minute language evaluation, the speech-language pathologist will collect information about your child’s medical history, developmental milestones, and your current concerns. Depending on your child’s age and communication skills, the speech-language pathologist may also:

  • Collect a language sample while your child is playing
  • Engage your child in conversation
  • Ask your child to follow directions of increasing complexity
  • Ask your child to answer questions about stories he/she read or was read to him/her
  • Administer standardized language testing which typically involves identifying pictures, following directions, answering questions, and describing pictures.
  • Assess your child’s articulation skills

Results and recommendations will be discussed at the end of the evaluation. If appropriate, language therapy will be recommended and home activities will be discussed and demonstrated.

What to bring to a language evaluation

  • Speech-language intake packet
  • Copies of previous evaluations, including the IEP/IFSP if your child is receiving services through the Birth to Three program or school.
  • Results from a recent hearing test (if available)

What to expect during language therapy
Based on the results of your child’s evaluation, language therapy may be recommended. During treatment the speech-language pathologist may work on:

  • Following directions
  • Understanding conversation
  • Answering questions
  • Understanding stories
  • Using correct verb tenses, pronouns, plurals, etc.
  • Understanding and responding appropriately to social situations
  • Fast ForWord

Depending on your child’s age and abilities, activities may be completed during play or in more structured ways such as seated at a table.

At Children’s, we believe that it is very important for families to be involved in all aspects of their child’s care. Depending on the child’s needs, parents are encouraged to view the sessions via monitors, observation mirrors, or in the therapy room. In addition, your child’s speech-language pathologist will discuss progress, provide worksheets for home practice, and demonstrate beneficial therapy techniques to ensure maximum benefit is received from therapy.

Speech-language milestones

Please click on the following links for information about speech-language milestones for young children and activities for promoting communication development:


Find additional information on language development, as well as diagnoses commonly associated with language disorders: