When do you worry about speech development?

[LittleIzumi]

I'm promising myself to not worry until he's 2. But. The Love is over 21 months, and has maybe 5 words, including the babyish words like "nana" for banana... and for his sisters... and for some other things that don't sound like nana, lol (and a couple of sounds like "Ah" for "Hot"), and perhaps 10 signs. I model and all that, and he slowly gets more, but it's at like one word a month, if that. He picks up signs faster but doesn't use a lot of them regularly. I know "technically" he's behind but is it anything to worry about yet?

 

ETA: For example, this morning he was in my bed babbling to wake me up, then out in the kitchen with his daddy, then back in my bed, then out in the kitchen, being rather noisy the entire time with different types of babbling and yelling. There was only one solitary intelligible word in all of that--"mama." And I only saw one single sign that entire time, "cereal" (which is what dh fed him). The entire rest of the morning so far since I've woken up, I've only seen one other sign, his version of "eggs" and heard only one other possible wordish thing, "A!" which is his spoken version of "eggs."

Edited July 20, 2012 by LittleIzumi

[LittleIzumi]

Added an example from this morning.

[PeterPan]

Well you're not too early to be watching it, that's for sure. The reception you'd get would totally depend on the SLP. I made the initial appointment for my ds at that age and he had his intake eval just as he was turning 2, maybe a month before. He is diagnosed with moderate verbal apraxia and some other fancy words (dysphagia?) on the paper. This same dc, when I took him to another SLP was totally BLOWN OFF. Makes me SPIT to think about it. That therapist that blew him off said they'd work on "communication" blah blah. I thought no he needs to TALK. Communication we've got. Went to an apraxia specialist and she had him TALKING the very first therapy session.

 

So I'm all in the camp of early diagnosis, good help, good intervention, blah blah. But it totally depends on who you have doing the evals and what you think is going on. When I read your story, I'm looking for number of sounds, loss of sounds, motor control and low tone, and whether it's *developmental* or *motor control*.

 

To inventory the sounds, you actually need to sit down with an alphabet toy or something else and do a thorough inventory. Also inventory animals sounds. ANYTHING he has needs to get inventoried and written down. Then see where you're at. Make a list of words or sounds he had (said once or twice) that he lost. See if he's low tone (your ped can tell you that or of course a good SLP). He may have indication of low tone in other places besides his mouth. W-sitting is still normal at that age apparently, but a LOT of it on top of low core strength and hyper-extension in the joints and whatnot is pretty indicative.

 

The bare minimum standard for age 2 is 50. That's words. Words can be animal sounds. Yes he should be acquiring at a fast pace. Yes I would be concerned and start picking a good SLP to get him eval. But I would figure out if you think it's motor control or a developmental delay. If it's motor control (apraxia), please get someone who actually does a lot of apraxia and knows it when they see it. Don't buy into the line that the dc has to be able to talk to see the apraxia. A specialist can isolate the motor control and actually show you it happening. If there's communicative intent (the dc wants to speak), and the motor control is the problem, the specialist will be able to isolate it and show you. It's not some crap shoot in the dark where you guess or just work on communication and hope to realize it in retrospect.

 

If it's any consolation, there are degrees of everything, and your blessed dc has more speech than mine did at that age. Mine is diagnosed as moderate verbal apraxia, and he had one word (mama, said rarely) and two sounds (/m/, /a/). He was basically silent otherwise and we lost him frequently. It was extremely scary, because there was basically NO sound from the child, no ability to reply or call out an answer to us. He had passive understanding of signs when we began them but did not *initiate* them. Any word he ever said was said once or twice and never again.

 

That's moderate apraxia. I have no clue what's up with your dc. Any time you're not hitting standards on speech, I think it's good to get the evals. Hopefully it's something mild. The interventions have gotten SO good and can bring such QUICK results in milder cases, I'm all for the interventions. PROMPT is what we've been doing for speech, and if you think it's motor control, PROMPT is the ultimate. Also you can start him on flax or fish oil. My ds gets fussy with fish, so we give him flax. Definitely boosts his speech.

[LolaT]

My DD, now 29 mo., had only two or three words at 2. His ped was not concerned at all. They are more concerned about other issues that could point to developmental delays and autism. As long as he doesn't have any other signs they just tell you that they are most likely to start catching up by three. I still had DD2 evaluated by Kids On The Move, here in UT. He showed no other signs of concern. We did a few months of therapy, but it wasn't very helpful. He seems to progress best on his own and he gains new words in spurts. As of a couple of weeks ago, he is now saying many more new words and starting to put two and three words together.

 

Hope that helps. The Kids On The Move people are VERY nice if you just want to cover all the bases and it may be free depending on your income. Otherwise, I wouldn't worry too much unless you notice other areas of comcern.

[LittleIzumi]

Well you're not too early to be watching it, that's for sure. The reception you'd get would totally depend on the SLP. I made the initial appointment for my ds at that age and he had his intake eval just as he was turning 2, maybe a month before. He is diagnosed with moderate verbal apraxia and some other fancy words (dysphagia?) on the paper. This same dc, when I took him to another SLP was totally BLOWN OFF. Makes me SPIT to think about it. That therapist that blew him off said they'd work on "communication" blah blah. I thought no he needs to TALK. Communication we've got. Went to an apraxia specialist and she had him TALKING the very first therapy session.

 

So I'm all in the camp of early diagnosis, good help, good intervention, blah blah. But it totally depends on who you have doing the evals and what you think is going on. When I read your story, I'm looking for number of sounds, loss of sounds, motor control and low tone, and whether it's *developmental* or *motor control*.

 

To inventory the sounds, you actually need to sit down with an alphabet toy or something else and do a thorough inventory. Also inventory animals sounds. ANYTHING he has needs to get inventoried and written down. Then see where you're at. Make a list of words or sounds he had (said once or twice) that he lost. See if he's low tone (your ped can tell you that or of course a good SLP). He may have indication of low tone in other places besides his mouth. W-sitting is still normal at that age apparently, but a LOT of it on top of low core strength and hyper-extension in the joints and whatnot is pretty indicative.

 

The bare minimum standard for age 2 is 50. That's words. Words can be animal sounds. Yes he should be acquiring at a fast pace. Yes I would be concerned and start picking a good SLP to get him eval. But I would figure out if you think it's motor control or a developmental delay. If it's motor control (apraxia), please get someone who actually does a lot of apraxia and knows it when they see it. Don't buy into the line that the dc has to be able to talk to see the apraxia. A specialist can isolate the motor control and actually show you it happening. If there's communicative intent (the dc wants to speak), and the motor control is the problem, the specialist will be able to isolate it and show you. It's not some crap shoot in the dark where you guess or just work on communication and hope to realize it in retrospect.

 

If it's any consolation, there are degrees of everything, and your blessed dc has more speech than mine did at that age. Mine is diagnosed as moderate verbal apraxia, and he had one word (mama, said rarely) and two sounds (/m/, /a/). He was basically silent otherwise and we lost him frequently. It was extremely scary, because there was basically NO sound from the child, no ability to reply or call out an answer to us. He had passive understanding of signs when we began them but did not *initiate* them. Any word he ever said was said once or twice and never again.

 

That's moderate apraxia. I have no clue what's up with your dc. Any time you're not hitting standards on speech, I think it's good to get the evals. Hopefully it's something mild. The interventions have gotten SO good and can bring such QUICK results in milder cases, I'm all for the interventions. PROMPT is what we've been doing for speech, and if you think it's motor control, PROMPT is the ultimate. Also you can start him on flax or fish oil. My ds gets fussy with fish, so we give him flax. Definitely boosts his speech.

 

Thanks!! He has lost some sounds (and some signs), and he has ZERO interest in repeating sounds, words, or signs unless he's actually confronted with that thing. You can't ask him to "display" any communication, ever. But if he sees an actual baby, he'll call out, "bay-buh" and sign it. So evaluating all of his sounds is a bit hard, since I have to just remember when he's used it previously or try to bring out actual things. No alphabet recognition or interest (not a big deal). He does have three animal sounds though, and I didn't know that counted. Almost doubles his "words."

 

He seems quite quick at receptive language, just not at expressive. He's always trying to make noises and communicate--it's just a complete mishmash of sounds all the time. Right now he's running around hollering, in different tones and different places, "Wah-ah, bachhhhh, wee-ya, wee-ya, mmmmmmmm (high pitched keen), ah!" He does that sort of babble or single-tone shrieking most of the day. If he gets to a "word" he knows, he'll stand in front of me & do it over & over until I figure out what it is or fake it :lol: (like the "ah!" was apparently "hat" for the headband he was holding). It seems like he wants to talk, but can't get things working yet.

 

With our financial situation, any evaluation would be through EI. They are pretty great here. The Drama went through EI for sensory and communication issues (almost no receptive or expressive--that was fun).

[Crimson Wife]

Receptive language delay is more of a red flag than expressive language delay. There is a lot of language development between 18 mos and 2 1/2, and some kids are just naturally on the later end of that.

 

However, at least here in CA it's easier to qualify for EI services prior to the age of 2 than it is from 2 to 3. I don't know what the rules are in UT, but I would call to request an evaluation sooner rather than later just in case.

[Lecka]

When I have kept a speech log, I tape up a paper on the refrigerator and just go and add to it. For repeats I might just add the date next to where it was said previously. (Otherwise I drew a line and wrote the date to start a new day.)

 

I considered leaving a dated index card different places, to be more convenient, and just grouping them by date. But, the refrigerator ended up working.

 

I also put what the word sounded like, and then the real word in parentheses.

 

I don't know what is appropriate to the different ages, but I have kept a speech log and I think they are very worthwhile.

Edited July 20, 2012 by Lecka

[PeterPan]

Losing is the big red flag for apraxia. Lack of expressive when receptive is fine is a red flag for apraxia. Apraxia is not a developmental delay but motor control and apraxia is fully treatable with PROMPT. It's not shocking that regular therapy would do no good if the dc has apraxia. There's typically no ability to imitate with apraxia, and a dc with apraxia may not respond well to traditional speech therapy. PROMPT actually puts their hands on the articulators and makes the connections for the motor control. My dc TALKED the very first day of therapy. 0 to 60 TALKING.

 

But that's because it was a motor control problem, no developmental delay. To find a PROMPT therapist you use the PROMPT provider locator. *Occasionally* someone who does EI service will be on that list. Check and see. I've even heard of schools being required to train the therapist to provide PROMPT. I think in that case the parent advocated and fought to get it.

 

It's interesting to know what they've lost, but when they inventory they're only going to consider current speech, not something he had one time that he lost months ago, kwim? They're going to sit down on that down, go through the sounds, try to get them to imitate, see what they get, and that's the inventory.

[Mandamom]

I had two of mine evaluated at 18 and 19 months due to similar issues. Both qualified for speech through Infants and Toddlers and my ds is still in speech with a apraxia (as he is learning to read he also has some dyslexic tendencies). My dd10 was in speech until 3 when she graduated from it. Ds will be in speech for a while longer.

 

anyway, my thought is to get an evaluation.

[Lecka]

I was keeping a log for the speech therapist to see. But I think to go in to a screening with a speech log lets them see just what is going on.

[Embassy]

I'd contact your local Early Intervention program for a screening or evaluation. It sounds like he has some good skills, but two things pop out to me that would make me want to get things checked out: the loss of sounds and signs and his multiple attempts to be understood (frustration). It sounds like he wants to talk more, but isn't able to yet. The babbling with an intelligible word here and there is a developmental stage.

 

Yes, animal sounds count and so do other sounds like car noises or the smacking of lips to indicate that he wants a drink.

 

- former EI SLP

Edited July 20, 2012 by Wehomeschool

[*Jen*]

My DS 22 months sounds the same. He babbles and talks in his own language but only has a handful of real words. This past two weeks he has suddenly added about 5 words. He has randomly said words like cracker or cookie one time well before he ever started calling me mama. This week he added magnet (as he is walking around the house smacking a magnet wand against the wall) yet he still doesn't call DH dada.

 

We are going to do a speech eval once he turns 2 and we are back home in our home state.

 

He is improving as he gets closer to two but I still feel that he needs some EI.

[SKL]

I had the same debate going on in my mind for years with my eldest. The thing was, she was very inconsistent. She didn't display any normal sort of learning curve. One day she'd be speaking in sentences and sounding "advanced," but the next day it was "enh. enh." She's still inconsistent at almost 6yo. I never ended up having her speech evaluated because when she was a tot, she was easily overwhelmed by new people/social challenges, and I felt any testing or therapy at that age would make things worse. And she was never technically behind the normal range in terms of what she "could say." But I'm still not sure whether I made the best decision.

 

For most kids, though, I don't think it can hurt to get an early speech eval. What you describe would probably concern me too, just a bit. It could just be individual timing, but if you feel something is off, it's worth a look.

 

I assume you've had his hearing checked already? Some of what you describe sounds like he might not be hearing everything.

[LittleIzumi]

I assume you've had his hearing checked already? Some of what you describe sounds like he might not be hearing everything.

 

He had his "newborn" hearing screen around 8 months :lol: and that was fine, but no tests since. He follow directions and seems to hear well....

[Crimson Wife]

He had his "newborn" hearing screen around 8 months :lol: and that was fine, but no tests since. He follow directions and seems to hear well....

 

I would get a thorough hearing evaluation, particularly if he has experienced any ear infections.