Estimating communication competence of infants and toddlers.

Identifying young children who need referral to a speech/language pathologist is difficult because of possible communication problems. The limited time available to a pediatric nurse or nurse practitioner further complicates referral decisions. Early identification is advisable, yet unnecessary referrals can be costly, both in time and money. Recent research has indicated that some aspects of behavior may be particularly useful in making referrals. This article presents developmental milestones for infants' and toddlers' language comprehension, oral expression, gesture, and social interaction, which may be considered when estimating a child's need for further assessment. Questions frequently asked by parents concerning communication and resources for additional information are also presented.