Language development provides the foundation for later literacy success. Pediatricians can help families understand typical developmental milestones, identify potential concerns early, and connect caregivers with appropriate resources and support when needed.

The resources below provide developmental milestones, literacy indicators, and age-specific recommendations to support conversations with families about language and literacy development. When concerns about speech or language development arise, referral to a speech-language pathologist may be warranted.

In addition to broad developmental milestones, pediatricians can benefit from understanding key language and literacy indicators, questions to ask caregivers, and resources that support children at each stage of development.

Birth to 1 Year

Literacy Indicators

  • Responds to your voice during shared book reading
  • Looks at or shows interest in books and pictures
  • Enjoys read-aloud and singing experiences
  • Makes sounds or facial expressions during book time

1–2 Years

Literacy Indicators

 Ask caregivers if their child:

  • Points to pictures in a book when named
  • Attempts to say familiar words from favorite books
  • Brings books to be read
  • Tries to turn pages in a board book

2-3 Years

Literacy Development

Ask parents or caregivers if their child does the following:

  • Name pictures or objects in books without prompting
  • Finish familiar phrases in books that have been read multiple times
  • Pretend to read or tell a story
  • Recognize familiar signs or logos (e.g., stop sign, store logo, restaurant logo)

Preschool (3-4)

Literacy Development

Ask parents or caregivers if their child does the following:

  • Sit and listen to a short story from a picture book
  • Show interest in letters, especially those in their name
  • Recognize words that rhyme (e.g., cat, hat, bat)
  • Know how to open a book and turn pages one at a time, and know where on the page to start reading
  • Remember some letter names and their sounds once they have been taught

Preschool (4-5)

Literacy Development

Ask parents or caregivers if their child does the following:

  • Understand that written words have meaning and that we read from left to right
  • Recognize and name several letters of the alphabet and the sounds they represent
  • Tell you the beginning and ending sounds of words when prompted
  • Attempt to write their name or other familiar words
  • Answers simple questions about a story read aloud (e.g., “What happened at the end?”)

Early Elementary (Grades K-2)

Note: The CDC and ASHA guidance for language ends at age 5

Literacy Development

Ask parents or caregivers if their child does the following:

  • Break down words into individual sounds, or phonemes (example: breaks “sat” into the sounds s-a-t), and blend sounds together to make words (example: blends s-a-t to make the word “sat”)
  • Consistently apply the correct sounds to letters when prompted
  • Sound out unfamiliar words when reading instead of using context and picture cues to guess at words  
  • Spell and read words accurately after instruction and practice 
  • Read aloud and participate in reading activities without reluctance
  • Retell a story in order (beginning, middle, and end)

Later Elementary (Grades 3-5)

Literacy Development

Ask parents or caregivers if their child does the following:

  • Read with accuracy and with expression
  • Spell most words correctly
  • Write well-structured sentences and organized paragraphs
  • Summarize a story and explain what characters feel or why events happened
  • Reads longer and more complex words fluently 
  • Avoid reading or have low self-confidence in literacy tasks

Middle School and Beyond

Literacy Development

Ask parents or caregivers if their child does the following:

  • Exhibit the ability to read unfamiliar or complex words accurately and automatically
  • Spell accurately most of the time, particularly when spelling common words
  • Write a paragraph and/or essay with well-organized writing and accurate sentence structure 
  • Understand complex information, draw inferences, and analyze texts
  • Know and correctly use a variety of vocabulary words

Sharing these milestones with parents helps build awareness of the knowledge students need to become skilled readers. The following resources will provide additional information for families with readers who need extra support: