Skip to Main Content

Welcome to

Together is a new resource for anyone affected by pediatric cancer - patients and their parents, family members, and friends.

Learn More

Language and Speech Skills for Children Ages 4-5 Years

Speech and language skills develop quickly during the early years of a child’s life, especially in the first 3 years of life. These skills progress at slightly different rates for every child.  However, language usually follows natural stages or milestones based on a child’s age. 

Language milestones

At 4 to 5 years, your child should be able to:

  • Speak easily with children and adults and hold a conversation
  • Understand most of what is said at home and at school
  • Know letters and numbers
  • Give details in simple sentences with correct grammar
  • Pay attention to short stories and answer simple questions about them
  • Stay on topic when explaining something or telling a story
  • Put ideas together in the correct order
  • Follow directions that ask for several actions
  • Answer simple "why" questions
  • Use more action words
  • Make all the sounds in words, but it might be hard for them to repeat some sounds
  • Use speech that is easy to understand, although your child may say some words incorrectly

How to help your child learn language and speech

  • When your child is speaking, give them your full attention when possible.
  • Get your child’s attention before you talk to them and listen when they respond.
  • Tell your child what new words mean and how to use them. For example, say, "This vehicle is riding on the road. It is a car. A bus is another kind of vehicle. So are a train and an airplane."
  • If your child does not understand a word, help them ask questions about it.
  • Tell your child the arrangement of objects (between, under, and over). Encourage them to use these words when they speak.
  • Point to things that are the same or different and explain why.
  • Sort objects into categories. Then sort them again using smaller differences. For example, sort rocks into big and small. Then, sort them by smooth and rough. Ask your child why an item does not belong in a group.
  • Read or tell stories that are easy to follow. Ask your child what they think will happen next in the story.
  • Act out stories. You can use objects like dolls and puppets, and make these objects talk to each other.
  • Ask your child to draw a picture about a part of a story, video, or TV show. Ask who, what, when, where, and why questions.
  • Play games with your child that make them recall and use words. For example, “I spy something round on the wall that tells the time”.
  • Let your child help plan daily activities or events. Ask them to help you make a list of needed items.
  • Ask your child for their opinion. What kind of fruit do we need from the store?"
  • Read books with words that rhyme. Ask your child to think of words that rhyme.

Signs of speech or language problems in your child

In some cases, children with illnesses may reach language milestones later than usual. This may be due to changes in their environment, routine, or social interactions. Or, the illness or treatment might harm hearing, learning, processing, and social skills.

Your child may have a speech or language problem if they have:

  • Difficulty understanding or expressing language
  • Avoid talking or activities that involve speaking
  • Cannot be understood by others
  • Problems interacting with new people
  • Delay in developmental milestones
  • Problems sucking, chewing, or swallowing
  • Have problems making their lips, tongue, or jaw move properly

Signs of hearing loss in children

Hearing loss can slow or prevent the development of language and speech. Look for signs that your child’s hearing is developing normally. If your child can hear, they usually will:

  • Respond when you say their name
  • Wake up from sleeping when there is a loud noise
  • Look for the source of noise when they hear it
  • React to sounds or voices
  • Be able to hear electronic devices such as the phone, TV, or computer
  • Imitate familiar sounds
  • Understand what people are saying
Child holding his ears

Children can often get frustrated if they are unable to hear, and may shout because they do not know they are loud.

Pay attention to ear problems and infections, especially when they happen often. Contact your doctor if you have questions. Your doctor may refer you to an audiologist to have your child's hearing tested. An audiologist is a health care provider who specializes in the diagnosis and treatment of hearing problems. If your audiologist says your child needs a hearing aid, your child must use it to help their language and speech skills.

Find more information on Audiology and Hearing Care.

Therapy for speech and language problems

If your child has problems with speech or language, your care provider may recommend speech therapy.

A speech therapist or speech-language pathologist is a care provider who can help your child with speech and language problems. A speech therapist or pathologist models correct sounds and syllables for your child. They also give ideas and homework for you and your child to do at home. This provider may also recommend additional tests or testing to better develop a plan for your child.

Learn more about Speech-Language Therapy.

Key points

  • The early years of your child's life are important for learning speech and language.
  • Most children develop speech and language skills in stages (milestones).
  • Your child should know their numbers and letters, talk with more adult-like sentences, put sentences together to tell a story, and carry on a conversation with others.
  • Help your child learn new words and how to use them.
  • Watch for any signs of hearing loss and other problems with speech and language.

For more information

See for more information on related topics:

If you have questions about language development, call your health care provider.

Reviewed: September 2022