Received Date : 24-Aug-2016

Revised Date : 19-Dec-2016

Accepted Article
Accepted Date : 30-Dec-2016

Article type : Review Article

How to create a successful reader?

Milestones in reading development from birth to adolescence:

The contribution of language, cognition, and literacy to reading development

Tzipi Horowitz-Kraus, Rachelle Schmitz, John S. Hutton, and Jayna Schumacher

Pediatric Neuroimaging Research Consortium, Reading and Literacy Discovery Center,

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Short title: Milestones for reading development

Corresponding author:

Tzipi Horowitz-Kraus, PhD

Pediatric Neuroimaging Research Center

MLC 5033, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, United States

Phone: +1 513 803 5162 Fax: +1 513 636 3754

E-mail: Tzipi.Horowitz-Kraus@cchmc.org

Abstract

Reading is one of the most important academic abilities that establishes the foundation for a

child’s success in school. Therefore, early and accurate diagnosis of reading challenges is

crucial for prevention of later academic failure. One challenge in early detection of reading

This article has been accepted for publication and undergone full peer review but has not
been through the copyediting, typesetting, pagination and proofreading process, which may
lead to differences between this version and the Version of Record. Please cite this article as
doi: 10.1111/apa.13738
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 difficulties is that the ability to read typically is acquired explicitly when a child is 4-6 years of

age. However, reading ability relies on development of more basic abilities prior to reading
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acquisition, starting from birth. Conclusion: Language, cognitive control, and literacy

milestones can be evaluated and trained from birth to better acquire reading later in life.

Keywords: Cognitive control; Development; Language; Literacy; Reading

Key Notes:

 Language, cognition (executive functions abilities), and literacy play a crucial role in

intact reading development.

 Monitoring of the milestones in each reading-related domain is critical in early

childhood.

 Early evaluation of language, cognitive abilities, and literacy is beneficial for early

intervention when needed.

The importance and complexity of reading acquisition

Reading is a highly adaptive, complex skill that relies on intact language, cognition, and

literacy. Unlike other linguistic and cognitive abilities, reading must be explicitly acquired and

is one of the highest cognitive abilities that the human species has been able to achieve.

Due to specific neural circuits and brain structures developed during evolution, humans are

the only species capable of engaging basic language, cognitive abilities, and literacy into the

orchestra of reading. Reading acquisition depends on the appropriate development of these

foundational abilities. Due to the critical role of reading for both academic and occupational

success and evidence of reading difficulty in 5-15% of children in the US (1) and 5-12% of

children in Europe (2), it is crucial that pediatricians, clinicians, educators, and other

professionals have an efficient approach to measure the development of each of the

foundational domains in order to identify children with or at-risk for reading difficulties as

early as possible.

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 Children who suffer from reading difficulties demonstrate lower reading ability

(standard scores lower than -1) in one or more reading domains (i.e., word or nonword
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reading accuracy, word or nonword reading fluency, phonemic awareness test, contextual

reading fluency, comprehension), whereas individuals with reading disability (dyslexia) suffer

from much more severe impairment in their reading achievements (i.e., scores lower than -

1.5 standard scores in more than two reading tests) (3). More specifically, dyslexia is defined

as slow and inaccurate reading that continues into adulthood despite remedial intervention

and appropriate literacy exposure, and individuals with dyslexia experience phonological or

orthographic deficits (4). According to this diverse definition, several clinical groups may

suffer from reading difficulties, including children with developmental delays such as due to

dyslexia, attention deficit hyperactivity disorder (ADHD), and autism, neurological disorders

such as in children with epilepsy, psychiatric disorders, and others (see (5)).

How can we screen for reading ability, even before reading is actually acquired? First

and foremost, reading difficulty is heritable with reports of more impaired reading (and

related cognitive-control ability) in children of parents with reading difficulties (6). Therefore,

a simple screen for challenges in this area can be whether a parent or any other immediate

family member suffers from reading difficulties, which may contribute to the existence of

reading difficulties by means of a genetic component only or also due to a lack of home

literacy environment. Even without familial reading difficulties, the foundations of reading

may not be well developed. In this review, we outline language, cognitive, and literacy

developmental milestones that are key to reading acquisition and discuss the scientific

evidence of the development and engagement of relevant neural circuits and cognitive

processes that underlie reading ability.

In languages with alphabetic scripts, reading involves the translation of graphemes

(alphabetic letters) into their corresponding spoken language sounds (phonemes) and

therefore, reading has both visual and auditory components. To read, one must first visually

identify each letter and decode its corresponding phonological sound using auditory

components (see the ‘Parallel Distributed Processing’ model; (7)). Gradually, the process of

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 associating letters with the sound they make becomes automatic. Children start attributing

auditory components to a visual pattern that represents a specific word, which is decoding.
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Then, the ‘orthographic’ pathway develops: the child learns to recognize words holistically,

without the need to decode individual letters every time the same word is encountered (7),

which then sets the foundation for a child’s written mental lexicon to bypass the phonological

system. In parallel, the child relates the decoded word to the context and their experiences

based on their oral language in order to identify the meaning of what is being read, a

process known as semantics. The better the semantic abilities are, the easier it is to gain the

meaning of the written word (see ‘Construction Integration’ model (8)). Fluent reading, or the

ability to decode words automatically in context without compromising comprehension

depends on accurate, rapid decoding of words and relies on intact phonology, orthography,

and semantics, as well as basic cognitive abilities such as attention and other executive

functions (EF) for cognitive control (9).

Since reading is a phylogenetically new skill, reading acquisition depends on

reshaping (or “recycling”) established networks that are originally devoted to other cognitive

functions (10). Specifically, magnetic resonance imaging (MRI) studies suggest that reading

involves synchronous activation of brain regions related to auditory/phonological,

visual/orthographic, and semantic processing, mainly in the left hemisphere (11), together

with frontal regions related to EF (12). Major brain regions identified include the angular,

fusiform, and inferior frontal gyri for phonological, orthographic, and semantic processing,

respectively (see (13) for review). This neuronal recycling depends on both intrinsic

(language and cognition) and extrinsic (literacy) factors that develop from birth and continue

with aging.

Reading milestones: Intrinsic factors

Language

The ability to read begins with language development, long before the initiation of formal

instruction in reading (14). Language development, or the ability to listen to and comprehend

oral language, begins before birth as suggested by fetal preference for human voice and

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 responsiveness to specific sounds (15). Phonemes are the smallest perceptually distinct

units of sound in a language that can determine meaning (14). Almost all words consist of
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several phonemes blended together, and changing the phonemes affects the meaning (16).

For example, the word “cat” consists of three phonemes (/k/, /æ/, and /t/) and substituting

one phoneme for another (e.g., /h/ for /k/) changes the word. The ability of a fetus to

recognize vowels highlights the fact that the ability to process language is innate (17).

Infants detect native phonemes early in the first year of life and acquire a sense of what

sounds are present in their language. Speech perception in infancy (phonemic awareness) is

one aspect of phonological awareness, which encompasses several sound-related skills

necessary for learning to read and is the strongest independent predictor of reading ability

(18). These processes involve temporo-parietal brain regions, including the angular and

supramarginal gyri and the posterior aspect of the superior temporal gyrus (Wernicke’s Area)

(11).

Expressive language begins with cooing, or the production of vowel sounds without

formation of syllable units, within the first 2-3 months of life. Production of sounds containing

both vowels and consonants, or babbling, emerges at age 4 months and continues to

increase in quantity and complexity throughout infancy. First spoken words that typically

occur at approximately 1 year of age mark the beginning of a shift from mastery of sounds to

single-word semantics (understanding). New words are learned slowly between ages 12 and

18 months, followed by an explosion in words between ages 18 and 24 months. With

increased expressive vocabulary, typically developing 2-year-old children can construct two-

word combinations. Toddlers and preschoolers continue to develop their ability to assemble

words into increasingly complex sentences that follow language-specific grammatical and

structural rules. See Table 1 and Figure 1 for language milestones during development.

The neurodevelopment of language networks reflects the described speeded change

in verbal ability and proceeds from diffused to localized and from bilateral to left-lateralized

with age and ability (19). Language processing in newborns involves bilateral fronto-

temporal activation, with gradual left shift throughout early childhood (18). Kuhl and

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 colleagues used magnetoencephalography or MEG to show that infants process novel

language sounds by applying “analysis by synthesis”, activating auditory (superior temporal)

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and motor (inferior frontal gyrus, cerebellum) brain areas to first decode and then recode

sounds to gradually discern how they are produced (20). Brain activation supporting

receptive (superior temporal gyrus) and expressive (inferior frontal gyrus) language has

been shown as early as at 3 months of age (20). A left-lateralized pattern is relatively stable

by age 4 or 5 years, though a diffuse pattern reemerges during reading acquisition that is

attributed to the difficulty of reading compared to oral language in early stages (21).

Interestingly, developmental changes are accompanied by an increased use of brain regions

involved in cognitive control during language processing (i.e., narrative comprehension) and

along development (22). The researchers suggested that during a story-listening task, better

reading ability was related to greater engagement and therefore activation of regions related

to cognitive control (e.g., the anterior cingulate cortex, part of the cingulo-opercular network).

This demonstrated the critical role of cognitive control in both reading and auditory language

processing.

Cognition

In addition to intact language development, reading acquisition relies on genetically and

environmentally influenced prerequisite capacities, such as intelligence, EF, and social

cognitive skills (joint attention) (12). The cognitive skills gathered under the umbrella term

“executive functions” include a wide range of conscious processes involved in monitoring

and optimizing performance, such as working memory, speed of processing,

switching/shifting attention, planning, inhibition, and error monitoring (see (23) for the

correspondence between reading and EF). Reading performance has been suggested to

correlate with EF skills (9). Many studies have focused on specific aspects of EF related to

reading: attention shifting and inhibition (24), working memory and speed of processing (9),

verbal fluency (or verb-generation ability) (25) that were all found to be correlated with

reading ability (25). These studies suggest that reading utilizes neural circuits supporting EF

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 and impaired reading, such as in dyslexia or ADHD, is caused in part by an altered activation

or connectivity in brain regions related to EF (26, 27).

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The primary critical abilities that extensively develop until a later age than other

abilities are EF (28). The abilities to keep information in memory, focus attention for longer

periods of time, and draw conclusions based on a text develop gradually and are critical for

intact reading (28). Corresponding to the gradual cognitive development supporting reading

outlined in Table 1, an extensive neurobiological development occurs. Neurobiologically, EF

originate in the prefrontal cortex (29), and there is strong evidence supporting the continued

anatomical and functional maturation of the prefrontal cortex related to development of these

skills (30). Despite the main role of the prefrontal cortex in supporting EF, advanced

neuroimaging techniques provide insights regarding several other neural networks also

supporting EF (e.g., the frontal-parietal and cingulo-opercular networks) (31). These

networks, which are found in young children ages 5-7 years and in older individuals (21

years of age) (31), are engaged during reading and positively correlate with reading skill and

age (10). See Table 1 and Figure 1 for details.

Reading milestones: Extrinsic factors

Literacy

Emergent literacy is the developmental stage when children acquire the foundations of

reading and writing, and it refers to the code-based skills essential for understanding the

concept that each letter has a corresponding sound in the spoken language (32).

Development of skills and knowledge critical to early reading development, such as

phonological awareness, oral language, and print awareness, are improved by an enriched

home literacy environment (33) with access to books, parent-child shared reading and

literacy activities, verbal interaction, and exposure to written language.

As outlined in Table 1 and Figure 1, during the first 2 years of life, infants and

toddlers master phonemic awareness and other oral language skills that lay the foundation

for later phonological awareness. In enriched home literacy environments, infants become

familiar with books during their first year of life by initially chewing on books and, as cognitive

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 control develops, they learn to visually focus on large and bright pictures in books and begin

to turn pages. Between ages 1 and 2 years, children are able to point to and name familiar
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objects, characters, or actions in books and recognize familiar books by their cover. Between

the ages of 2 and 3 years, children recognize symbols and signs in the community and are

able to identify some letters, such as the letters in their name. At the same age, they start

enjoying looking at books on their own, pretending to read familiar books, naming and

describing familiar characters and pictures, and recalling simple story lines. Phonological

awareness emerges between the ages of 3 and 4 years, including sensitivity to syllables in

words, awareness of rhymes, and the ability to identify some letter-sound associations. This

is coupled with print awareness, understanding that pictures are connected in a story and

recognizing familiar words such as their name in print. Children often begin making up

stories at age 3 years and become able to expand on the action in a written story beyond

accompanying pictures. Between the ages of 5 and 6 years, children can appreciate story

sequence and character motivation and, by the age of 6 years, children should be able to

identify and write upper- and lower-case letters and recognize some sight words. Between

the ages of 6 and 7 years, depending on conditional or explicit teaching, children begin to

decode independently, read with grade-level fluency, and use reading strategies such as

rereading, predicting, use of context clues, and asking questions. Most children are proficient

in decoding by the age of 7 years and, by the 3rd grade in the United States, the academic

emphasis shifts from learning to read to reading to learn. See Table 1 for a detailed

summary of these milestones.

The one-on-one interaction during dialogic reading between caregiver and child,

coupled with genetics, is strongly associated with how well a child will perform academically

(34). Language networks provide critical support for emergent literacy, and a critical factor

fueling literacy is the level of verbal stimulation. As stated previously, young readers in

homes that are enriched for reading and verbal communication are empowered to

discriminate between sounds more effectively than those who are not similarly stimulated

(33).

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 Few studies have examined how home literacy environment is reflected in the

growing brain. Utilizing fMRI during a stories-listening task, Hutton and colleagues provided
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the first association between home reading environment and increased neural activation

(33). Children from more stimulating home reading environments with higher reading

exposure (i.e., with access to books, frequent shared reading, and variety of books read)

showed increased neural activation of the left-sided parietal-temporal-occipital association

cortex, which supports semantic processing and mental imagery and is later integrated into

the reading network. Similar beneficial effect of the home literacy environment on neural

circuits related to phonological processing was determined by Powers and colleagues

(35).The researchers showed that children at pre-reading stage with a familial history for

dyslexia who had higher scores in the home literacy environment questionnaires, showed

greater activation in the left precental gyrus related to phonological processing and

articulation, as part of a compensatory mechanism (35). It is also important to note that the

occipital lobe, particularly the fusiform gyrus (“Word Form Area”), is stimulated and tuned

from an early age to respond to non-linguistic stimuli, such as faces and objects. The

activation of this region at a very young age is important for its future use for letters and

words processing (36). Interestingly, the fusiform gyrus is “tuned” to recognize letters and is

anatomically close to regions related to objects and facial recognition, which may explain the

relatively similar performance found in these tasks within individuals (37).

When things go wrong

Based on the several components contributing to reading success (Table 1), there are

several reasons that underlie a failure in reading acquisition resulting from deficits in each of

the described domains.

Orthographic and phonological deficits, possibly coupled with EF impairment

During the past 20 years, an extensive body of research has been conducted to identify

neural biomarkers for dyslexia. Several behavioral and neuroimaging studies confirm that

children with dyslexia show decreased abilities and brain activation in three main domains,

as outlined in Table 1; 1) language, i.e. phonological processing (38), as well as narrative

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 comprehension and semantic processing (39) and 2) cognitive abilities or EF (12), and 3)

visual processing (40). The specific case of dyslexia demonstrates the critical role of several
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key EF in reading development (speed of processing, working memory, and visual attention),

all of which were found to be impaired in children with dyslexia (41) (42). Therefore, reports

of the positive effect of EF training (43) or even video games exposure (44) on reading

abilities are not surprising and may be the key for intervention or even prevention for children

who are at genetic risk for developing reading difficulties, as also has been suggested by

Ozrenov-Palchik and Gaab (45). In his multivariate model for dyslexia, Pennington

strengthens the tight relationship between phonological processing deficits and additional

cognitive alterations (i.e., naming difficulties, speed of processing, attention, and others)

contributing to the severity of symptoms and likely also to subtypes of characteristics in

dyslexia (46).

Isolated EF deficits without impairment in phonological or orthographic processes

can cause reading difficulties, as is often found in children with ADHD (47). An estimated 18-

45% of children with ADHD have reading difficulties (47). Several hypotheses have been

proposed to explain the comorbidity of ADHD and reading difficulties (see (47) for review),

and at least some cognitive deficits are shared between the two conditions (see “cognitive

subtype hypothesis” (48)). Impairments in several EF, such as speed of processing (48) and

verbal working memory (49), characterize both disorders.

Extrinsic deficits

Reading challenges due to extrinsic deficits can result in an “environmental illiteracy” for

children who suffer from reading difficulties due to inadequate home literacy environment.

Disparities in literacy at school entry stem, in part, from large social-class differences in the

quality and frequency of early literacy experiences (50). Children who suffer from reading

difficulties due to environmental reasons compose the majority of children with reading

difficulties in the United States (51). With the increasing use of technology, the possible

trade-off of less time spent reading a book or shared child-parent reading prompted the

American Pediatric Society to limit on-screen time for children under 5 years of age (52).

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 Although promising biomarkers for reading impairments have been identified (11), there is

currently no objective way to differentiate children with dyslexia from children who suffer
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from reading difficulties due to inadequate home literacy environment. However, accurate

diagnosis is crucial to determine appropriate intervention. Interventions for children with

dyslexia involve rehabilitating impaired emergent literacy abilities, such as letter-sound

knowledge, but children with environmental illiteracy require more comprehensive and

increased exposure to oral and written language (e.g., through shared reading) to develop

literacy skills (53), and since the source of their difficulty in not biological, it may be reversed

if treated in time.

Closing remarks, recommendations, and conclusions

The complexity of reading acquisition and reliance on intact language, cognition, and literacy

often means that the etiology of reading difficulty is multi-factorial. A child presenting with

reading difficulty may have several co-morbid developmental, neurological, and

psychological conditions. The high rate of co-occurrence between ADHD and dyslexia is a

case in point. Therefore, identifying and addressing deficits that may be contributing to

reading difficulty often require the combined expertise of several professionals, including

educators, psychologists, physicians, and researchers. Akin to other chronic childhood

health problems, early identification allows for early intervention and increased benefit. One

way to improve a child’s literacy, even before reading is officially acquired, is by utilizing the

principles of shared or dialogic reading. Dialogic reading is a method of shared book reading

in which the child actively participates that has been shown to convey moderate to significant

benefits for expressive vocabulary, oral language, print concepts, and home reading

behaviors (34). Reach Out and Read is one dialogic reading program that aims to improve

home literacy environments via distribution of books at well-child visits and modeling of

dialogic reading and has been shown to positively affect parental attitudes and activities to

encourage early literacy and promote receptive and expressive language skills through

kindergarten in families with low socioeconomic status (54). In these activities, the book is a

catalyzer for a conversation between the parent/care giver and the child and a tool that can

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 pinpoint the child’s level in the development of literacy skills (see Table 1). In this way, when

an infant receives a book at 1 year of age, for example, literacy awareness can be measured
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by examination of what the child is doing with the book (e.g., chews or flips pages). Children

with reading difficulty are not typically identified until school-age years, even though reading

development begins long before formal reading instruction. Depending on their role,

clinicians may find specific milestones within each category to be more salient to their

practice. Based on the increasing number of children with reading difficulties due to either

internal or external reasons, we think there is a need for checkup points to evaluate the

development of these milestones in the pediatrician’s clinic. We therefore suggest that an

ongoing developmental screening and surveillance in each domain is key.

Acknowledgements

The authors thank J. Denise Wetzel for review and editing of the manuscript.

No specific funding. The authors declare no conflict of interest related to this work.

Abbreviations used

ADHD, attention deficit hyperactivity disorder

EF, executive functions

MRI, magnetic resonance imaging

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Figure Legends

Figure 1. Milestones in reading acquisition (0-8 years). Milestones in reading acquisition

during ages 0-8 years in the different domains that underlie reading: language (green),

cognitive ability (or executive function; red), and literacy abilities (blue) along age (X axis).

Brain areas corresponding to language, cognitive ability and literacy development are noted

in the left (for more information see (33).

Figures

Figure 1.

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ccepted Articl
Table 1. The information is provided according to age for the benefit of pediatricians, educators, professionals, and parents. The bolded

milestones can be used as “relatively easy to assess” abilities to screen for developmental delays or difficulties in each domain (Language,

Cognition, Literacy).

Age Language Cognition Literacy

0-12 months Responds to differences in speech Focuses on caregiver’s face Looks at books
sounds. Turns head when person enters a room Makes sounds during familiar songs
Turns toward noise Reaches to touch objects 3-12 months:
Responds with gestures when a care Explores toys Chews and pats on books
giver states “up!” or “bye-bye” Tries to find hidden objects Focuses on large and bright pictures in
Enjoys communicative games, songs, Signs “more” books
and finger plays Pushes buttons on a toy to make Begins to imitate body language in familiar
1 month: objects pop up or make a sound songs and finger plays
Cries, burps, coughs, sneezes Repeats actions to get an effect Looks at and touches picture books with
2-3 months: Bangs objects to make a noise adults
Cooing (55, 57) (56)
4-6 months:
Engages in vocal play, such as
raspberries, squealing, growls, vowel-like
sounds
7-12 months:
Babbles consonant-vowel syllables
(55, 56)
12-24 months Emergent use of inflectional morphemes Looks closely at small objects Enjoys being read to and explores books
Age-appropriate Mean Length of Participates in symbolic play by turning pages
Utterance (i.e., utters two-word Puts shapes in a box with the different Recognizes familiar books by their cover
sentences) shape openings Points to and names familiar objects and
Points to pictures in books when objects Stacks blocks and objects characters in books
are named Points at or talks about animals or Holds crayons and makes marks on paper
12-18 months: insects Turns pages in books
Uses single words Pours, scoops, and explores sand and (56, 58)
Begins using the pronoun “I” and “it” water
24 months: Crawls into, around, and on objects
Uses two-word phrases Nests three to four cups of different
Produces a variety of consonants sizes
Recognizes the names of familiar objects Takes objects out of containers
Follows simple requests Asks, signs, or gestures to be picked up
50-100 expressive words by age 2 to reach something
years (57)

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ccepted Articl Starts to use question forms such as
“What’s that?”
Seeks attention, requests,
rejects/protests, greets, and labels
(55, 56)
2-3 years Begins to sing along to familiar songs
Begins to produce real and non-real
rhyming words
95% mastery of the following speech
sounds: /p, d, m, n, w, h/
Imitates caregiver vocal sounds
Follows two-step commands
27-30 months:
Uses pronouns such as “my”, “me”,
“mine”, and “you”
Mean Length of Utterance is 2.0-2.5
(begins to use grammatical
morphemes and “in” and “on”)
30 months:
Uses approximately 400 words (55, 56)
31-34 months:
Uses the words “your”, “she”, “he”,
“yours, and “we”
Mean Length of Utterance is 2.5-3.0
(begins to use ‘is’ ‘am’ ‘are’, with
questions, use of helping verbs)
Initiates turn-taking by saying “me” or
“my turn”
Begins to talk to other peers during play
Combines words to make simple
sentences (noun +verb)
Recognizes and names people and
animals
3-4 years 36 months:
Uses approximately 1000 words (55, 56)
Masters 95%of the following speech
sounds: /b, t, k, g/
By 36 months, combines three to four
words in simple sentences
Communication partners: understands
approximately 75% of what the child
says35-40 months:
Mean Length of Utterance is 3.0-3.75
41-46 months:
Mean Length of Utterance is 3.75-4.5
Asks for clarification
Uses the pronouns they, us, hers, his,
them, her, my, me, mine, you
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Asks for the names of new objects or
people
Turns puzzle pieces to complete a
puzzle
Climbs to reach objects
Begins to count objects while pointing
to each one and saying the number (57)
Watches and copies the behavior of
other children during play
Matches colors and shapes and sorts
toys or objects that are alike by at least
one feature (ex. Color, shape, or size)
Shows interest in mixing colors of water
or paint
Pushes/pulls riding toys to make them
move
Plays Hide-n-Seek
Imaginative play
Applies counting and numbers to real
life situations (Ex. Counting the number
of books on the table)
(57)
Asks and talks about objects in nature
Observes and discusses changes in
Enjoys looking at books on their own
Pretends to read familiar books and asks
to have them read to them
Names and describes familiar characters
and pictures in books
Recalls familiar characters and simple
story line from books
Recognizes symbols and signs in the
community (e.g., the golden arches for
McDonald’s)
Begins to make lines and circles
Identifies some letters (e.g., the first
letter or letters in their name) (56)
Points to and talks about pictures in a
book
Protests if pages or storyline is skipped by
adult reading
Begins to make up stories
Begins to understand the appropriate
direction of reading and turning pages
Recognizes familiar words such as
their name in print
Identifies some letters and their sounds
(ex. Letters and sounds in their name)
Begins copying letters
Phonological awareness skills: sensitivity
to words and syllables begins to develop
(ex. Clapping words in sentences and
syllables in words)
Participates in rhyming gamesBegins to
ccepted Articl Uses present progressive –ing, past
tense –ed, and possessives (dog’s ball)
Talks about and describes the functions
of objects
(55, 56)
Consistent use of inflectional morphemes
(56, 58)
48 months:
Average expressive vocabulary of 4,000
plus words
Tells how an object is used
Uses plurals and possessives
Asks WH questions (why, where, what,
when, who)
Uses quantity concepts
Follows three-step directions
Participates in short conversations95%
mastery of the following speech
sounds: /ng, j, f/ (55, 56)
4-5 years Approximately 90% intelligible
47 months and older:
Mean Length of Utterance is 4.5+
5 years:
95% mastery of the following speech
sounds: /v, s, z, sh, ch, dz, l/
Uses conjunctions, such as “when”, “so”,
“because”, “if”
Uses pronouns correctly
Responds to WH questions appropriately
Repeats four-syllable words
Repeats four digits
(56)
5-6 years Speech is clearly understood by most
(Kindergarten) people
Uses qualitative and time concepts
Retells a story or talks about events
Uses regular and irregular past tense
verbs
Defines common objects
Uses many descriptive words including
adverbs and adjectives
6 years:
95% mastery of the following speech
sounds: /prevocalic r, postvocalic r/
(56)
6-7 years 7 years:
(First grade) 95% mastery of the following speech
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weather
Names basic colors and shapes
Copies simple patterns
Experiments with objects during play
Repeats actions/ practice to improve
results
Completes simple jigsaw puzzle
Negotiates turn-taking with other
children
Compares and sorts objects using
one or two features
Uses tools to measure items
(57)
Represents self in drawings (57)
Recognizes other people’s perspective
Perceives and sequences events
accurately
Understands how child’s behavior can
effect another person’s behavior (57)
Thinks or formulates thoughts regarding
abstract concepts (57)
attend to, learn, and produce letter names
Tells what happens next in a book
(55, 56)
Mean age of 60 months (5 years old):
Identifies the letters in their name (58)
Understands story sequence
Forms more letter forms than scribbles
(56)
Writes full first name (59)Between 5-5 ½
years old: Able to name 25 objects and
26 colors in one minute
Recognizes letters and letter-sound
matches
5:06-6:00 years: *Names 30 objects and
colors in one minute (60)
Looks at print from left to right and up to
down
Attempts to spell words when writing
Prints first and last name
Identifies and writes upper and lower case
letters (by the end of Kindergarten)
Recognizes some sight words (60)
6:00-6:06 years:
Names 32 objects and 34 colors in one
ccepted Articl sounds: /voiced th/
Answers complex questions
Retells stories in sequential order
Asks and responds to all complex
questions
Gives directions
(56)
7-8 years 8 years:
(Second grade) 95% mastery of the following speech
sounds: /unvoiced th/
Uses complex sentences
Clarifies and explains ideas
Gives 3- to 4-step directions
Uses language to inform, persuade, and
entertain
Understands analogies (57)
8-9 years Speaks clearly with appropriate voice
(Third grade) Uses subject related vocabulary
Summarizes a story
Explains what has been learned
Uses compound and complex sentences
Carries on conversations at an adult
level
All speech sounds have been mastered
(57)
9-11 years Explains relationships between words
(Fourth grade) Makes an oral presentation
Participates in class discussion
Summarizes main points (57)
12-14 years
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minute
6:6-6:11 years:
*Names 36 objects and 38 colors in one
minute
Begins to decode independently
Uses reading strategies such as
rereading, predicting, use of context clues,
and asking questions
Reads and retells familiar stories
Sounds out and spells phonetically
End of 1st grade: recognizes 100 sight
words
Creates rhyming words
Reads on grade level fluently (accuracy,
rate, and intonation)
Begins sentences with capitals and
attempts punctuation
Spells frequently used words correctly (56)
(60)
7-11 years: Reads and Writes simple sentences
Describes concrete and abstract 7:00-7:06 years:
thoughts (57) *Names 51 digits, 42 letters, and 41
objects in one minute
7:6-7:11 years:
Names 58 digits, 48 letters, and 45
objects in one minute (i.e., out of a
sample of 5 identical items) (60)*
8-10 years: Reads and writes simple compositions
Recognizes difference between 8:0-8:11 years old: *Names 71 digits, 57
behavior and intent letters, and 50 objects in one minute
Understands and uses time and (i.e., out of a sample of five identical
number concepts items) (60)
Follows complex directions
(57)
11 years: 9:0-9:11 years:
Forms one’s own thoughts from another Names 79 digits, 76 letters, and 53
person’s perspective objects in one minute Between 10:0-
Recognizes other people’s point of view 10:11 years old: Able to name 96 digits,
(57) 88 letters, and 55 objects in one minute
11:0-11:11 years: *Names 108 digits,
101 letters, and 62 objects in one
minute (i.e., out of a sample of five
identical items)
(60)
Thinks hypothetically, abstractly, and 12:0-12:11 years:
ccepted Articl
(Adolescents) logically
Takes on a problem and comes up with
multiple potential solutions (57)
*Names 120 digits, 111 letters, and 68
objects in one minute
13:0-13:11 years:
*Names 131 digits, 120 letters, and 73
objects in one minute
14:0-14:11 years:
Names 131 digits, 127 letters, and 80
objects in one minute (i.e., out of a sample
of five identical items)
Between 14:0-14:11 years old: *Names
131 digits, 127 letters, and 80 objects in
one minute
(60)

* These ranks for naming ability are based on the norms from the Comprehensive Test of Phonological Processing (CTOPP) (60) and the
child’s ability to perceive, process, and name objects/letters fast and accurately.

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