A 30-month-old child is brought for evaluation of speech delay. The child can say approximately 20 single words but does not combine two words. She follows two-step commands and can identify body parts. She makes eye contact and engages in parallel play. The EXPECTED developmental milestone for expressive language at 24 months is:
- A Vocabulary of 20 words with no word combinations expected
- B 3-word sentences and use of pronouns (I, me, you)
- C Complete sentences of 4 words with storytelling ability
- D Vocabulary of 50+ words and combination of 2 words into phrases ✓
Explanation
By 24 months, the expected expressive language milestones include: vocabulary of at least 50 words and ability to combine two words into meaningful phrases (e.g., 'more milk', 'daddy go'). Failure to meet these by 24 months constitutes expressive language delay and warrants evaluation. This child at 30 months has only 20 single words — far below the 24-month milestone — and no 2-word combinations. This is a significant speech-language delay requiring formal audiological assessment and speech-language therapy referral. Three-word sentences and pronouns are expected by 30–36 months. Four-word sentences with stories emerge at 3–4 years.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.