Language Understanding starts with recognising and differentiating sounds to developing the ability to reason and criticise. Like every other aspect in development, understanding can be assessed clinically and through history. Have in hand a number of common objects for example, a book, a pen, a doll, a spoon, a bowl, and a cup. Assess understanding by looking at;

- object recognition
- picture recognition
- ability to carry out instructions
- use of grammar

Introduce yourself to Lucy and her parent and gain consent for the examination.

 A) Object recognition
- By pointing.
Ask Lucy to point to a named object for example, show me the pen. You may also ask her to point to her head or nose or a body part on a doll, for example show me  the doll's nose.
- By naming
present an object to Lucy and ask her to name it (what is this?).
- By Use
This can be done in two ways depending on the developmental age of the child
- display a set of objects and ask Lucy questions relating to use, for example; which one do we use for eating, writing or combing. Lucy should respond by pointing to the appropriate object.
- you could also present an object to Lucy and ask her  to tell you its use. For example, while presenting a pencil or crayon to a child you ask them: what do we do with this?  She should respond by answering your question or using the object appropriately.

 B) Picture Recognition
 Here, the object is replaced by a picture. Ask Lucy to recognise the picture by pointing, naming and by use. For example, while presenting a set of pictures ask- which one do we use for eating?

In general most children;
- Recognise their name by 8 months
- Can name parts of their body by 15 months
- Can name parts of a dolls body by 18 months
- Can name common  objects between 12 and 18 months
- Develop functional understanding between 21 and 33 months
 

C) Ability to carry out instructions
 Give instructions to Lucy having one or more information carrying words. The instructions should be carried out in the correct order. You may have to repeat the instruction more than once. Start at a level appropriate for her  chronological age and work you way either upwards or downwards depending on her response.

- Between 12 and 18 months children should understand one information carrying word and should be able to follow simple commands for example; get your shoes
- By two they should be able to follow commands carrying two information carrying words(ICW), e.g. put the cup on the table. Brush the doll's hair
- By three years a child should follow a command carrying three ICWs. Some may also be able to follow instruction with two commands (put the book on the floor and give the doll a drink) though this develops at about 31/2 years.
- By 4 -41/2 the child can follow instructions carrying 3-4 ICWs as well as instructions with 3 instructions. (Before you give mummy the pen, put the cup on the table and give me the book.)
- At 5 years children understand everyday language.

D) Grammar
- Understanding big and small. Hold two objects of different sizes in hand and ask Lucy to point to the big or small object.  Understanding big and small comes at a mean age of 2 years.
- Understanding of verbs. This can be tested using action pictures. Have a few action pictures to hand and ask Lucy  to identify which of them is sleeping, eating, writing. Understanding simple verbs come at around 24 to 30 months.
- Understanding prepositions. Place a book or whatever you have on a table. Place another object under the table, ask Lucy to show you which of the objects is under or on the table. You could also perform this test by asking the child to place a book under, on or behind a stated object. Understanding prepositions occurs around 30months to 3 years.
- Understanding adjectives. Have to hand three objects of different sizes, ask Lucy to identify which of them is smallest, bigger or biggest. Understanding simple adjectives develops between 3 and 31/2 years.
- Understanding negatives. Place two similar (type, use, colour) objects on the table and one other object, for example Two pens and a book; a spoon a plate and a book. Then ask Lucy to show you which of them is not a pen or which one is not used for eating. Understanding negatives occurs at a mean age of 3 years.
- Understanding time. By three most children understand the past tense, yesterday and this morning. At 4 they can appreciate the past present and future. A five year old appreciates the meaning of time with respect to daily activities
- Understanding complex questions. Ask the child a complex question e.g., what will you do if you fell and hurt your head? What will you do if your sister was hurt while you were playing?

Size of vocabulary
Parents can usually tell how many words they think their child has
In general children at;
- 12 months about  5 words
- 2 years  about 50 words
- 3 years  500-1000 words
- 4 years  1000-2000words
- 5 years  1500-2000words