- Does not babble or attempt to talk by one year of age
- No words produced consistently by 16 months
- Delayed development of vocabulary, concepts and grammar
- Does not talk and uses more gestures than words by 2 years of age
- Speech and language is different from children of the same age
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- Limited speech sound repertoire
- Inconsistent sound errors
- Increased frustration during communication attempts
- Speech is difficult for strangers to understand
- Increased need for repetition for response to commands, questions
- Decreased/lack of appropriate playing skills
- Inconsistently says a word accurately, then doesn't use it again
- Hoarse voice quality
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- Decreased eye contact
- Decreased interest in social situations by age 18 months
- Delayed response time
- Decreased need to communicate wants and needs to others
- Lack of imitation skills
- Loss of previously mastered skills
- Dysfluent speech
- Consistently 'nasal' speech
- Difficulty understanding others with the hearing device
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