Which of the following is a red flag for speech-language delay in a 3-year-old?

• A. Not using 2–3 word phrases by age 3
• B. Using full sentences with complex grammar
• C. Clear intelligible speech to unfamiliar listeners
• D. Normal receptive language development

Answer: (A)

At about 3 years old, expressive language should show growth from simple words to phrases and more complex sentence structures. A key milestone is combining words into two- to three-word phrases and starting to form more complete, understandable speech. Not using two to three word phrases by age three signals an expressive language delay, which is a red flag that warrants a formal evaluation by a speech-language pathologist and possible early intervention. It can also prompt a hearing check and monitoring for other concerns that affect language development, such as autism spectrum features.

The other statements describe typical or expected abilities: using full sentences with complex grammar is advanced for a 3-year-old and would be a positive sign; clear intelligible speech to unfamiliar listeners indicates good articulation and functional communication; normal receptive language means understanding is on track. These do not raise concern for a delay.