When does "delayed speech" in a child become worrisome? *UPdate in original message*

[EKS]

Back when my older son seemed slow to talk his (very laid back) doctor explained to me that he wasn't going to start worrying about it until my son was 3.  If that doctor said 3, then it probably means that 3 is actually pretty late to start thinking about an evaluation.

[BusyMom5]

At 2, I wouldn't worry too much about it.  By 3 I'd get an evaluation.  I've had one with APD and one that just needed speech therapy.   Both were behind at age 2, and by 3 is was pretty clear they needed targeted help. 

Things to watch- peer interaction with other kids the same age- are they able to play, or does their speech create a barrier?  Do they try to engage in communication? Pointing,  acting things out, going to get a sippy cup when thirsty?  Are they trying to talk?  Our evaluator told me after the 2 year old evaluation that I needed to encourage speech- don't give her a drink until she uses her mouth and sounds to attempt to say it.  It doesn't have to be clear, but you need to see her trying.  Do they make the same sounds for the same thing?  How are they at listening?  Can the point to a cow?  A pig?  A drink?  An apple? 

It can be hard to bring it up, I did at Christmas,  in a very kind way, explaining my own kids' flags and treatment.  It's hard to see huge red flags and not say anything.  This little one is very behind in lots of areas, not just speech.   Her play style is of a 1 year old, but she's 3.  No words.  Motor control issues that I noticed at 3 months.  I have encouraged evaluation over and over!  Mom is afraid,  I think.   

[lmrich]

Your friend might also want to get a new pediatrician as well as seeking an evaluation.  

[ktgrok]

At 3 an evaluation is warranted. My understanding is that a large percentage of speech delayed kids are just that, delayed, and no intervention is needed...BUT a certain percentage DO need intervention, and the sooner the better. Waiting makes it much harder, and effects other areas of development. So an evaluation is exactly the right thing to do, so they can look for the red flags that indicate this is the kind of kid that NEEDS therapy and won't learn properly without it, vs the normally delayed kid. You need an expert to figure that out, and they err on the side of intervention, because it is so important to not miss the kids that need that intervention. 

[Ellie]

11 hours ago, Catwoman said:

Ellie, my biggest concern is how the child’s receptive language is. Does she understand everything that is going on? Is she able to communicate effectively and without words? Does she seem otherwise intelligent?

If her receptive language is very strong, I would suggest that the parents read about Einstein Syndrome, and see if the description fits their child, and if it does, I don’t know what state your friend lives in, but Dr Stephen Camarata at Vanderbilt would be an excellent person to contact for an evaluation. https://medschool.vanderbilt.edu/hearing-speech/person/steve-camarata/

I don't know the answers to these questions, but I will gently ask questions.

We are in Texas, FTR. I will sleuth around and see if I can find out what her school district does for evaluations and whatnot.

[SKL]

I recall that people were commenting on my kids' reluctance to speak as young as 1.5 years old.  (My kids did talk, but mostly only to me.)  At their 1yo checkup, the pediatrician asked if they said "mama" and "dada" and wrote a note about my answer.

[Ellie]

1 hour ago, Ellie said:

We are in Texas, FTR. I will sleuth around and see if I can find out what her school district does for evaluations and whatnot.

Yes, her ISD has services, although it sounds as if the children are evaluated/diagnosed some where else first. But at least I have something I can suggest, if that conversation actually happens.

[katilac]

15 hours ago, wendyroo said:

 I was always thrilled when my kids qualified for speech therapy. Speech therapy for little kids should be fun - stories, games, toys, etc. My kids always enjoyed therapy

One of my kids had speech therapy at 4, and she loved it. 

15 hours ago, MEmama said:

Gently, Please don’t.

BTDT as the parent. They know perfectly well that their kid is hard to understand, they spend their whole time translating after all. Being the 70 bazillionth person to suggest speech therapy isn’t going to help, it gets really, really old tbh. The *only* time I would interfere as a friend would be if they honestly didn’t know therapy was available, or if their kid is 100% cut off from the rest of the world (which they aren’t, because the kid talks to you).

DS starting speaking early but was hard for other people to understand until he was 5. He was profoundly precocious in other aspects though and my mama gut felt strongly that his brain was working on other skills other than speech—since we could understand him, it was less of a priority (yes, he had friends and went to preschool and did sports and took a zillion classes at our parks and rec—there was *lots* of exposure to other kids and adults). I had a strong sense that it would sort itself in kindergarten, which is exactly what happened.

Now, I’m not saying that kids never need intervention (and NO speech is vastly different than unclear), but even well meaning people don’t usually know the entire picture. I was very quiet about the things my kid talked about and knew because I didn’t know anyone who could relate; had they known they might have better understood why I wasn’t too concerned. 
 

None of that relates to the OP though.

editing: because of pressure we did send him to a speech therapist at age 3, who diagnosed him with speech apraxia. She didn’t listen to anything I had to say about his other developments and DS hated how condescending she was so he only went a couple times. Despite her *promises* that he would be forever ruined if we took him out of the program, his speech cleared up exactly when I thought it would.  

Your ds started speaking early but was hard to understand. That is a vast chasm of difference from a kid who has zero words at three years old. 

The mom brought up that she mentioned it to the doctor, who told her not to worry. This tells me that two things are likely; one, she is indeed concerned about his speech and unsure of what to do, and two, it is unlikely that 70 bazillion people have mentioned it to her, or she would have said that. 

My dd was 4 when her preschool teacher suggested a speech evaluation. A grand total of zero people had suggested it before, so I would definitely not assume that the mom has been told numerous times (again, if she brought it up and talked about what the doctor said, it's likely she would mention it if people were constantly telling her to get it done). 

Many, many people are unaware that they can get a free evaluation done, and then free services. It's a kindness imo to mention it, particularly if you can add that they don't need to go through their ped (that's how it is in my area). 

11 hours ago, HS Mom in NC said:

Niece was only babbling at age 3.  She was evaluated and they said she was fine and would starting speaking eventually.  By 4 she she had caught up with her peers without intervention.

Good point that evaluations can, and do, go both ways. Most programs are quite busy enough without luring in kids who don't need intervention, lol. 

10 hours ago, kbutton said:

I have a friend who is an audiologist. I don't think a speech therapist could replicate what she does. A screening? Yes. A non-talking 3 y.o. is past screening and needs a heavy duty hearing test.  

 I live in a very poor school district, and they have audiologists on staff. Even if this district doesn't, a speech evaluation that screens hearing is a good first step. I just don't see most parents going from zero to hella expensive audiologist appointment all at once. (our experience with audiologists have been 'hella expensive even with insurance' but ymmv). 

[LMD]

At 3, the youngest with much older siblings, I wouldn't exactly worry but I would be taking notice. I'd want to see other things, is the child showing understanding? Do they talk at all - words, sentences- or just baby babble? Do they talk more when alone with parent? Do they do other things with words (enjoy being read to for example)

A 3 year old struggling with comprehension and not able to form basic words at all would be immediately worrying. I have seen more than a few youngest children be very with it but not say much until a lot later than average.

So, I'd be watching carefully but need more info before panicking. 

Edited April 28, 2022 by LMD

[kbutton]

10 hours ago, katilac said:

 I live in a very poor school district, and they have audiologists on staff. Even if this district doesn't, a speech evaluation that screens hearing is a good first step. I just don't see most parents going from zero to hella expensive audiologist appointment all at once. (our experience with audiologists have been 'hella expensive even with insurance' but ymmv). 

You didn't say that you were talking about school district evaluations where an audiologist was going to also be evaluating. I have yet to experience an SLP practice that includes a hearing screening (though one had a mostly useless APD screening that checked auditory working memory***), and we have had testing at three different SLP practices. 

I'm not recommending 'hella expensive,' I'm saying that the beeps and blips of a screening will not give a meaningful rule-out for hearing issues in a child with no words. It just won't. It is a meaningful confirmation of a hearing issue if they don't pass an initial screening. 

It is a place to start, but I don't want anyone reading along to think that an SLP is going to do an adequate hearing screening or that it is typical for it to happen at an SLP evaluation. Your phrasing suggested that the screening would be part and parcel of an SLP evaluation without providing additional context. I've never seen that happen.

***For those listening in, APD is far more than just auditory working memory. The test may have some utility for the purposes of speech, but it also does not diagnose or rule-in/rule-out APD. 

Edited April 28, 2022 by kbutton

[KSera]

8 hours ago, LMD said:

At 3, the youngest with much older siblings, I wouldn't exactly worry but I would be taking notice. I'd want to see other things, is the child showing understanding? Do they talk at all - words, sentences- or just baby babble? Do they talk more when alone with parent? Do they do other things with words (enjoy being read to for example)

A 3 year old struggling with compression and not able to form basic words at all would be immediately worrying. I have seen more than a few youngest children be very with it but not say much until a lot later than average.

So, I'd be watching carefully but need more info before panicking. 

As someone said above, getting an evaluation isn’t panicking and at 3 with no words, an evaluation is definitely called for. He could end up catching up either way, but he also might not. I disagree with the idea that it’s okay as long as he has comprehension and otherwise seems with it. My youngest child with excellent language skills did not meet speech milestones starting in late infancy and it was an issue that definitely required therapy and has nothing to do with older siblings taking for him. He mostly caught up by four with help and hard work (started speech at 20 months), but still isn’t as intelligible as peers (though language skills are very advanced). 

[Zinnia2]

My 3yo was only saying 10 words at age 3, and by a month later, he had thousands.  Super odd development pattern.  My pediatrician had told me not to worry, and though I did worry, I didn't have him evaluated after that conversation.  I kind of wish I had, though.  He was so frustrated by not being able to clearly say what he wanted to communicate.  

[ktgrok]

Yup, there should be a way to get a totally free evaluation. Often involves the school district, depends on the age and the area. Here they do one program before 3, and a different program after 3, but it is all free. There is an initial screening that is pretty quick and not a big deal - not stressful to the kids at all. If they don't pass that, they qualify for a more indepth evaluation. Depending on the results of the evaluation they then may qualify for therapy. As others said, it should be fun, not stressful. 

We did have one bad therapist, who was NOT suited to work with young kids. She would put my child in a chair that was like a highchair, with a desk that locked in place, locking them into the chair and then try to force her to say words. It was VERY stressful and we quit very quickly. That one was actually a private therapist, come to think of it. We went there because my dd didn't quite qualify for free therapy with the district, but we were told if our insurance covered it she would do well with some therapy. After that disaster we stopped, waited, and had her reevaluated by the district, at which point she was behind enough to qualify. We did her therapy at the local school, in the library, and that therapist was AWESOME. My dd loved it, and she sent home stuff to work on at home, etc. I think most are like that. 

[Jean in Newcastle]

My feeling (based on being a special ed teacher but this is about a child I have never met and it’s a specialized field ….) babbling at that age seems somehow “worse” than having few words or even none. Babbling , to me, hints at wanting to communicate  but not being able to put the sounds into word form. So is the babbling based on not being able to hear other’s speech clearly so it all sounds like babbling to him?  Or is it being extremely delayed in the developmental production of words?  

[TravelingChris]

I still really regret that I didn't go to a pediatrician out of the mulitary system w my first born.  He was developing ear infection after ear infection.  They even tested his conductive hearing when he was about 15 months and saw that he did have very clogged up ears but he wasn't delayed in their book.  Both dh and I knew he was because we could see his frustration w communication.  That was in July.  In late December (Christmas in a tiny TLF)  and he had his ear tubes in by early February (21.5 months old) znd also was immediately goven  a therapist to come to his home day care and give sign language and speech therapy.  By July, he was no longer needing zny therapy because his vocabulary was at the level of a five year old.

If you read that far, you msy think that is a story w a successful ending.  It isn't.  He has permanent hearing loss which is considered monor 15db anc he also tends to read lips and wants captions on shows he is watching.

Now the really sad part of your friend trusting that doctor.  They have figured out why Head Start and other programs that start at 3 don't help underprivileged children catch up to children of well educated parents -  it is because the first 3 years are the most important for learning.  

That child needs to evaluated immediately and I am not sure how the early spécial ed works, but I know there is a national system to identify and help children who will fall behind because of a disability ang get them help.  It was around even in the very early nineties when my son used it and still around in the tens when I was researching spécial éd programs.  Your frienx needs that information too.

 

[Jann in TX]

Living this scenario with my 2yo grandson right now!  My DD is medically disabled so DH and I are raising GS (DD helps a few minutes each day as she is able).

GS was 2 in December-- so almost 2.5 years old.  He says 'Mama' (his mom or me), 'Mommy' (his step mom) 'Dada' (my DH) 'Daddy' (his bio dad), 'No' and RARELY anything else-- he currently really likes the number 4 so he says that if we are counting with him.  Less than 10 words.

At 18 months his vocabulary was larger (closer to 20 words)!  He had Covid in January and his long-Covid symptoms are just starting to go away--speech progression stopped around the same time so there may be a link...

Last month we had a speech evaluation done in our house-- they found him to be 6 months behind-- but not far enough to be eligible for services at this time. 

GS will be starting daycare this summer-- hopefully being around other children will help with his working speech.

GS's pediatrician was able to provide the referral for the speech evaluation (they actually helped set it up for us!).  There was no cost involved and GS is on Medicaid.

Pediatrician also sent GS for a hearing check (PERFECT!).

GS is very bright for his age-- numbers, letters, patterns, creativity, he can follow multiple directions... he just will not talk!  He can and does use some sign language. 

My DH and GS's bio-dad were both 'speech delayed'-- not speaking in sentences until 3.5 yrs old but when they DID start talking they were speaking in PERFECT sentences.  We are in standby mode-- but we spend time every day actively encouraging GS to talk--- life would be SO MUCH EASIER if he would communicate his needs with us!!

 

 

[kbutton]

48 minutes ago, Jann in TX said:

Last month we had a speech evaluation done in our house-- they found him to be 6 months behind-- but not far enough to be eligible for services at this time. 

Can I just note that I am livid that a delay equal to of one fifth of his entire lifespan is deemed not enough? Yikes!

[kbutton]

Oh, and some governmental agency recently changed all the language milestones--dumbed them down. People ought to be aware of this going into an evaluation. I don't know if all the tests have caught up yet or not, or if the testing was showing a population wide dumbing down, so that the guidelines were changed. 

[Jean in Newcastle]

Another question:  is the child babbling?  (ie. experimenting with making sounds)  Or is he making words that just aren't clear?  (For example my toddler would say "bargish" instead of "garbage" but he was definitely making the word while just not having all the speech sounds yet.) 

[Tanaqui]

That's a good question, Jean - but if even his close family doesn't know what he intends to say, he still needs help.

[Jann in TX]

1 hour ago, kbutton said:

Can I just note that I am livid that a delay equal to of one fifth of his entire lifespan is deemed not enough? Yikes!

Yes!  Our thoughts exactly.

I must add that DD and I are both teachers-- before she became ill she was a dyslexic specialist.  She has lots of knowledge about how language is learned/formed...  still, neither of us know the best ways to remediate/encourage GS to speak!

I guess he will just be a 'strong silent type' for now....

 

 

[Jann in TX]

1 hour ago, Jean in Newcastle said:

Another question:  is the child babbling?  (ie. experimenting with making sounds)  Or is he making words that just aren't clear?  (For example my toddler would say "bargish" instead of "garbage" but he was definitely making the word while just not having all the speech sounds yet.) 

Not babbling either we are counting his KISSY as one of his 10 words (kitty).... he DOES cry/tantrum... but mostly he is just happily quiet!

[Catwoman]

Just now, Jann in TX said:

Yes!  Our thoughts exactly.

I must add that DD and I are both teachers-- before she became ill she was a dyslexic specialist.  She has lots of knowledge about how language is learned/formed...  still, neither of us know the best ways to remediate/encourage GS to speak!

I guess he will just be a 'strong silent type' for now....

 

 

Because it sounds like this runs in the family, and given the rest of the details you posted, I would not be too concerned about your gs at this point. He will probably start talking when he feels like it, and if you pressure him too much, you may actually end up delaying him from starting. It’s hard to know where encouragement ends and pressure begins, though! 🙂 

[AnneGG]

Interesting replies. 
 

I would recommend your favorite pedi to your friend and see what happens. current pedi should have been concerned about a three year old with no speech. Pediatricians should be using some form of self/parent reporting screeners to ensure milestones are being met. Huge red flag. I would not make any recommendations for therapy or evaluations unless you know of a specific, outstanding therapist. 

I am also of the mindset that people can be treating/getting help for XYZ and choose not to share that information. My DS received therapies for years and I never told anyone when they mentioned he was delayed. None of their business. When I get together with my friends I don’t want to talk about how stressful having a high needs, delayed child is and I don’t want pity. I just want to drink our coffees and escape. It was the one time I didn’t have to think about it. *Not trying to be snarky.* 

[Brittany1116]

1 hour ago, kbutton said:

Oh, and some governmental agency recently changed all the language milestones--dumbed them down. People ought to be aware of this going into an evaluation. I don't know if all the tests have caught up yet or not, or if the testing was showing a population wide dumbing down, so that the guidelines were changed. 

Yes, I heard this not long ago. Something to do with masking and isolation effects.

[KSera]

57 minutes ago, Brittany1116 said:

Yes, I heard this not long ago. Something to do with masking and isolation effects.

It’s the CDC guidelines that were changed, and the changes were in the works long before the pandemic began. The last update was 2004 so they were already working on new updates. The changes are highly controversial though. Their goal was to reduce the “wait and see“ approach of pediatricians by changing the guidelines to being ones that 75% of kids would meet by that age rather than the old standard of 50%. But of course this means it may (probably will) just make it worse because a lot of pediatricians will take those same later guidelines and still use the wait-and-see approach. 

[cjzimmer1]

3 hours ago, Jann in TX said:

Living this scenario with my 2yo grandson right now!  My DD is medically disabled so DH and I are raising GS (DD helps a few minutes each day as she is able).

GS was 2 in December-- so almost 2.5 years old.  He says 'Mama' (his mom or me), 'Mommy' (his step mom) 'Dada' (my DH) 'Daddy' (his bio dad), 'No' and RARELY anything else-- he currently really likes the number 4 so he says that if we are counting with him.  Less than 10 words.

At 18 months his vocabulary was larger (closer to 20 words)!  He had Covid in January and his long-Covid symptoms are just starting to go away--speech progression stopped around the same time so there may be a link...

Last month we had a speech evaluation done in our house-- they found him to be 6 months behind-- but not far enough to be eligible for services at this time. 

GS will be starting daycare this summer-- hopefully being around other children will help with his working speech.

GS's pediatrician was able to provide the referral for the speech evaluation (they actually helped set it up for us!).  There was no cost involved and GS is on Medicaid.

Pediatrician also sent GS for a hearing check (PERFECT!).

GS is very bright for his age-- numbers, letters, patterns, creativity, he can follow multiple directions... he just will not talk!  He can and does use some sign language. 

My DH and GS's bio-dad were both 'speech delayed'-- not speaking in sentences until 3.5 yrs old but when they DID start talking they were speaking in PERFECT sentences.  We are in standby mode-- but we spend time every day actively encouraging GS to talk--- life would be SO MUCH EASIER if he would communicate his needs with us!!

 

 

One think that I did with my late talker that confirmed for me at least that it was a case of not wanting to talk versus being not able to talk.  I regularly played "can you say " games. Mostly I'd stick to the 5-10 words he used and he would always repeat after me.  (Including if I said blanket, he'd repeat his made up word for that which was didi).  Occasionally I'd throw in a new word, often something close to what he already would say.  Crickets chirping, wouldn't even try, just stared at me. Immediately follow with a word he would speak and immediately he'd be back to playing the game.  Kid had no interest in making new sounds or words, he was happy with his tiny little vocabulary until he wasn't and then it exploded exponentially.  

Also I played this game while doing diaper changes or some equally monotonous task so it was a bit easier to engage him.

Edited April 28, 2022 by cjzimmer1

[kbutton]

2 minutes ago, KSera said:

It’s the CDC guidelines that were changed, and the changes were in the works long before the pandemic began. The last update was 2004 so they were already working on new updates. The changes are highly controversial though. Their goal was to reduce the “wait and see“ approach of pediatricians by changing the guidelines to being ones that 75% of kids would meet by that age rather than the old standard of 50%. But of course this means it may (probably will) just make it worse because a lot of pediatricians will take those same later guidelines and still use the wait-and-see approach. 

They are far more vague as well.

An SLP I follow on FB at one point posted the before and after guidelines, and the new ones were just...lame?...not as descriptive, etc. 

[LMD]

8 hours ago, KSera said:

As someone said above, getting an evaluation isn’t panicking and at 3 with no words, an evaluation is definitely called for. He could end up catching up either way, but he also might not. I disagree with the idea that it’s okay as long as he has comprehension and otherwise seems with it. My youngest child with excellent language skills did not meet speech milestones starting in late infancy and it was an issue that definitely required therapy and has nothing to do with older siblings taking for him. He mostly caught up by four with help and hard work (started speech at 20 months), but still isn’t as intelligible as peers (though language skills are very advanced). 

I never said don't get an evaluation or that it's okay?

I was literally just answering the question - when does delay turn worrisome - from my own experience. Not judging anyone else's.

I also have anecdotes, where speech therapy was worse than useless and the kids who barely spoke until 4 are absolutely fine (no language delays, no problem learning to read or write on time etc)

Edited April 28, 2022 by LMD

[katilac]

11 hours ago, kbutton said:

You didn't say that you were talking about school district evaluations where an audiologist was going to also be evaluating. I have yet to experience an SLP practice that includes a hearing screening (though one had a mostly useless APD screening that checked auditory working memory***), and we have had testing at three different SLP practices. 

I'm not recommending 'hella expensive,' I'm saying that the beeps and blips of a screening will not give a meaningful rule-out for hearing issues in a child with no words. It just won't. It is a meaningful confirmation of a hearing issue if they don't pass an initial screening. 

It is a place to start, but I don't want anyone reading along to think that an SLP is going to do an adequate hearing screening or that it is typical for it to happen at an SLP evaluation. Your phrasing suggested that the screening would be part and parcel of an SLP evaluation without providing additional context. I've never seen that happen.

***For those listening in, APD is far more than just auditory working memory. The test may have some utility for the purposes of speech, but it also does not diagnose or rule-in/rule-out APD. 

I think you may have taken my post as arguing with yours; it wasn't. I was just sharing my personal experience that going through the school district doesn't automatically mean there is no audiologist involved.

When my dd went, every child who walked through the doors got hearing and vision screening (not with an audiologist, or at least I don't think so), no matter what their evaluation was for. More currently, I'm only sure about it for speech evals (but don't think they've changed), and same for private evaluations. We've had the exact opposite experience: I've never not seen it happen. School districts vary widely in the US, everything is so local. 

And - ?? I didn't say you recommended hella expensive, I said that, in our experience, the audiologist was hella expensive, and explicitly stated that others might not have the same experience. I don't necessarily disagree with starting there, I just said I think it's unlikely that they would go from zero to sixty. And that, yes, it is a place to start, and the easiest/lowest barrier place to start for most people. 

 

Edited April 29, 2022 by katilac

[kbutton]

9 minutes ago, katilac said:

I think you may have taken my post as arguing with yours; it wasn't. I was just sharing my personal experience that going through the school district doesn't automatically mean there is no audiologist involved.

I didn't take it as arguing.

I am still trying to figure out where, up to the point in the conversation that I used to quote you the first time, that you referenced school district evals. I went back and looked for it. 

I am also sharing my experience as a mom of a child with speech issues and APD. 

13 minutes ago, katilac said:

I don't necessarily disagree with starting there, I just said I think it's unlikely that they would go from zero to sixty. And that, yes, it is a place to start, and the easiest/lowest barrier place to start for most people. 

I don't disagree, but I don't think that a basic screening that comes back fine is anything other than filtering out the worst possibility--it won't filter down finely to the many other possible hearing-related issues. It's like having the ER say you're not dying right now, but not diagnosing your slow-growing cancer that they can't see while trying to figure out the acute symptoms.

[katilac]

1 minute ago, kbutton said:

I don't disagree, but I don't think that a basic screening that comes back fine is anything other than filtering out the worst possibility--it won't filter down finely to the many other possible hearing-related issues. It's like having the ER say you're not dying right now, but not diagnosing your slow-growing cancer that they can't see while trying to figure out the acute symptoms.

Right, but if the person won't go to the doctor for whatever reason, I'd still want them to go the ER. 

[kbutton]

1 minute ago, katilac said:

Right, but if the person won't go to the doctor for whatever reason, I'd still want them to go the ER. 

Not disagreeing.

If the ER = SLP evaluation, I would never promise they'd get a hearing evaluation at that ER. But then we're back to where we started. 🙃 I do think a school district will do hearing. I think in some places, it's actually required at certain ages--at various times, we've been required to go in for a hearing eval for my kids' 3 year eval for their IEPs, but other times, we haven't been. 

[Xahm]

On 4/28/2022 at 11:57 AM, Jann in TX said:

Living this scenario with my 2yo grandson right now!  My DD is medically disabled so DH and I are raising GS (DD helps a few minutes each day as she is able).

 

We had a somewhat similar child. He clearly understood everything and could follow multi step directions at 2 but had maybe 5 words. I wasn't worried because I had some other slightly late talkers and my husband was a late talker, but I wanted to get the ball rolling in case there was a problem. He was evaluated as havering a kindergartner's receptive vocabulary, which got me to thinking. This but had frequently heard us say since variation of "he doesn't really talk" over and over again. I switched the script to "he's a great communicator and really working to add spoken language to the mix," which still communicated needed information to those interacting with him but also encouraged him to talk more. Almost immediately, he began speaking much more and we ended up dropping speech therapy because by the time we got off the wait list, he had zoomed past all the milestones. I'm sure it was partly a matter of timing, but I am firmly convinced that he had been listening to us and it affected him considerably. I have no idea if that story can be of use to you, but I encourage you to think about what he's overhearing and if you can make changes to that to encourage him to speak.

[ktgrok]

Our school district did provide a free audiologist appt

[KungFuPanda]

On 4/27/2022 at 12:09 AM, Ellie said:

A friend's dd was 3yo in February, and is not talking. My friend, "N", says she has "mentioned" it to her doctor, who told her not to worry, but that in itself doesn't necessarily mean much. My friend's dd, "E", has two teen-aged siblings, and it's possible that they do the talking for her, but still...

If I suggest that N has E evaluated, N will probably do it, because she respects me. ❤️ But I don't want to say anything unless I'm reasonably sure that there's a problem. I don't see the family [long story], and I have only met E once, so I don't know if E is doing any of the NT things like pointing, or the  autistic things like stemming, and I don't know how to ask N if E does (or doesn't) do them. E does do some sort of babbling, but no discernible words.

What does the Hive think?

 

On 4/27/2022 at 2:05 AM, Ellie said:

I think my friend might need to be more proactive, as she has "mentioned" it to the pediatrician, who at that time was not worried. I will encourage her to push more.

I would say that YOU don’t need to be sure, your friend doesn’t need to be sure, and the pediatrician is irrelevant. They just have to make a phone call and get an appointment. After an evaluation they’ll have more information and can proceed from there. It’s free and not terribly time consuming but they need to get the child evaluated sooner rather than later. 
 

It’s not remotely helpful to the child to do nothing and assume they’ll outgrow the problem. All the stories from parents who “just knew” their kid would outgrow it are tales of luck where the parent’s original psychic feelings were validated. I “just knew” my first child would be a boy. She was not so my personal sense of otherworldly “knowing” was not validated.
 

The books about late talkers only help some parents feel good about not seeking help for their child. There are parents who read these books and delay important interventions because it’s emotionally easier than facing the possibility that your child has a problem.  You don’t know if you are right or not until years later and you could be missing a valuable intervention window. I’d advise your friend to get the evaluation before school is out for the summer. The child could have a problem and be eligible for a summer program. The child could also be determined not to have a problem and that will put your friend’s mind at ease. It’s win-win. 

This is one of those situations where your feelings and your friend’s feelings take a back seat to what is best for the child. 
 

 

[J-rap]

At age 3 and no words, but some babbling, I'd be concerned.  With babbling, it sounds like she's attempting to speak, but can't.  I have a nephew who barely said a word or two by age three, but the words he said were articulate, and between 3 and 4, he began speaking a lot.  He's very shy and very smart, and age 7, his speech is fine.   

A simple evaluation can't hurt anything, and could help a lot.  I don't see any negatives with her going through some evaluations.

My dd was speaking at 3 so this is different, but her words were often unclear.  Turns out she had a hearing loss.  We wouldn't have known that if we didn't have her evaluated.  She did seem to hear us fine, but it turns out she wasn't hearing a lot of the specific sounds.

Her evaluations were free through the public school, and even when she was homeschooled she was able to see the school speech therapist (whose name, ironically, was Mrs. Speaker!).   She eventually got hearing aides.

Edited April 30, 2022 by J-rap

[Catwoman]

2 hours ago, KungFuPanda said:

 

I would say that YOU don’t need to be sure, your friend doesn’t need to be sure, and the pediatrician is irrelevant. They just have to make a phone call and get an appointment. After an evaluation they’ll have more information and can proceed from there. It’s free and not terribly time consuming but they need to get the child evaluated sooner rather than later. 
 

It’s not remotely helpful to the child to do nothing and assume they’ll outgrow the problem. All the stories from parents who “just knew” their kid would outgrow it are tales of luck where the parent’s original psychic feelings were validated. I “just knew” my first child would be a boy. She was not so my personal sense of otherworldly “knowing” was not validated.
 

The books about late talkers only help some parents feel good about not seeking help for their child. There are parents who read these books and delay important interventions because it’s emotionally easier than facing the possibility that your child has a problem.  You don’t know if you are right or not until years later and you could be missing a valuable intervention window. I’d advise your friend to get the evaluation before school is out for the summer. The child could have a problem and be eligible for a summer program. The child could also be determined not to have a problem and that will put your friend’s mind at ease. It’s win-win. 

This is one of those situations where your feelings and your friend’s feelings take a back seat to what is best for the child. 
 

 

One important consideration for parents who believe their child is an "Einstein syndrome" type of kid, is that they need to be sure to get their child evaluated by someone who is an expert in that area; some evaluators don't seem to believe that it even exists, and I have personally known parents whose child was misdiagnosed as autistic because an inexperienced evaluator didn't know how to properly deal with that type of child.

Even Dr. Stephen Camarata, a well-known authority in the field, had one of his own late-talking children misdiagnosed as autistic. He and his wife had believed that their child took after him (a late talker) and was a very bright child who was simply choosing not to talk yet, but they were concerned that their own personal biases might be causing them to lose their objectivity, so they went to an outside evaluator, who basically asked questions and used a checklist to determine that the child was autistic. (Spoiler alert -- the kid was just a late talker, and began speaking in full sentences shortly afterward.)

Intervention and evaluation can be important, but if parents truly believe that their child is just a late-talker, they really need to find a qualified evaluator who has experience with late talking kids who have no other issues other than not talking by a certain age. It's not that common a scenario, and many well-meaning evaluators can really mess up the diagnosis.

 

[KSera]

37 minutes ago, Catwoman said:

One important consideration for parents who believe their child is an "Einstein syndrome" type of kid, is that they need to be sure to get their child evaluated by someone who is an expert in that area; some evaluators don't seem to believe that it even exists, and I have personally known parents whose child was misdiagnosed as autistic because an inexperienced evaluator didn't know how to properly deal with that type of child.

Even Dr. Stephen Camarata, a well-known authority in the field, had one of his own late-talking children misdiagnosed as autistic. He and his wife had believed that their child took after him (a late talker) and was a very bright child who was simply choosing not to talk yet, but they were concerned that their own personal biases might be causing them to lose their objectivity, so they went to an outside evaluator, who basically asked questions and used a checklist to determine that the child was autistic. (Spoiler alert -- the kid was just a late talker, and began speaking in full sentences shortly afterward.)

Intervention and evaluation can be important, but if parents truly believe that their child is just a late-talker, they really need to find a qualified evaluator who has experience with late talking kids who have no other issues other than not talking by a certain age. It's not that common a scenario, and many well-meaning evaluators can really mess up the diagnosis.

 

I think the “Einstein syndrome” idea is somewhat muddled. A lot of the descriptions of it seem to misunderstand autism and think that if a late talking child later proves to be very intelligent that proves they aren’t autistic, which is clearly not the case. It’s pretty widely speculated that Einstein was on the spectrum himself. 

[Catwoman]

5 minutes ago, KSera said:

I think the “Einstein syndrome” idea is somewhat muddled. A lot of the descriptions of it seem to misunderstand autism and think that if a late talking child later proves to be very intelligent that proves they aren’t autistic, which is clearly not the case. It’s pretty widely speculated that Einstein was on the spectrum himself. 

Have you read the books on the topic? 

There are many children who are extremely intelligent late talkers who are not on the spectrum.

Personally, I have never liked the “Einstein syndrome” term, and suspected that was just made up because it made a provocative book title. 😉 But it seems to be the most recognized way of describing late talkers who are basically only choosing not to talk, but once they decide to start, they often use complete sentences and have an advanced vocabulary right away.

[KSera]

19 minutes ago, Catwoman said:

Have you read the books on the topic? 

There are many children who are extremely intelligent late talkers who are not on the spectrum.

Personally, I have never liked the “Einstein syndrome” term, and suspected that was just made up because it made a provocative book title. 😉 But it seems to be the most recognized way of describing late talkers who are basically only choosing not to talk, but once they decide to start, they often use complete sentences and have an advanced vocabulary right away.

I haven’t read any books on it, only articles. But I’ve had enough in those to see a lot of things that raise an eyebrow. Like the above mentioned statements that “some of these late talking children later turn out to be gifted, analytical thinkers” (which is completely compatible with being on the spectrum). And from Stephen Camerata, who has written extensively on Einstein syndrome:

Dr. Camarata adds “although all autistic children are late talkers, not all late-talking children are autistic”.

Which the first part is so patently false that it makes it difficult to trust anything else he says on the subject.

i’m not saying it can’t be a thing separate from autism and a phenomenon that is seen, but it’s also clear a lot of those talking about it and differentiating it from autism have a very poor understanding of autism.

Edited April 30, 2022 by KSera

[Catwoman]

23 minutes ago, KSera said:

I haven’t read any books on it, only articles. But I’ve had enough in those to see a lot of things that raise an eyebrow. Like the above mentioned statements that “some of these late talking children later turn out to be gifted, analytical thinkers” (which is completely compatible with being on the spectrum). And from Stephen Camerata, who has written extensively on Einstein syndrome:

Dr. Camarata adds “although all autistic children are late talkers, not all late-talking children are autistic”.

Which the first part is so patently false that it makes it difficult to trust anything else he says on the subject.

i’m not saying it can’t be a thing separate from autism and a phenomenon that is seen, but it’s also clear a lot of those talking about it and differentiating it from autism have a very poor understanding of autism.

The problem is that so many people make the assumption that late-talking automatically means that a child is autistic, and that is not the case.

Certainly, it is sometimes the case, but making the assumption that a child is autistic when the child is not, can cause serious problems for that child if he or she is incorrectly labeled and incorrectly treated. That’s why I am saying that if parents believe their late-talking child is not autistic, they need to be very careful when they choose an evaluator for that child, to be sure the evaluator is experienced, objective, and isn’t just checking off boxes without truly evaluating the child as an individual.

[KSera]

7 minutes ago, Catwoman said:

The problem is that so many people make the assumption that late-talking automatically means that a child is autistic, and that is not the case.

Certainly, it is sometimes the case, but making the assumption that a child is autistic when the child is not, can cause serious problems for that child if he or she is incorrectly labeled and incorrectly treated. That’s why I am saying that if parents believe their late-talking child is not autistic, they need to be very careful when they choose an evaluator for that child, to be sure the evaluator is experienced, objective, and isn’t just checking off boxes without truly evaluating the child as an individual.

I’m coming at it from the opposite of direction of someone who had the opposite happen. My child with near “genius” IQ was evaluated as a child and had all of their quirks chalked up to their giftedness and were told how amazing and bright their future would be. Fast forward to young adulthood where things were NOT going well, and they got an ASD diagnosis. When they were younger, I was only too happy to chalk things up to being because they were so gifted. In hindsight, I really think having had that ASD diagnosis young could’ve allowed us to get more targeted help earlier and could’ve led to a better place. I see that risk as being much, much greater than the risk of thinking a child might be on the spectrum and later deciding they’re not. So the kid might get some extra OT or emotional regulation support early on that they grow out of needing, though honestly, the kid with gifted intensities would likely benefit from the same.

[Terabith]

My autistic kid was speaking in complete sentences by 11 months.  She actually taught my oldest, not diagnosed with ASD, kid many language formations, especially how to ask questions.  

The literal answer to "when does delayed speech in a child become worrisome" is 18 months.  If a kid has fewer than about ten words by then, I would at the very least secure an evaluation.  

My oldest kid qualified for speech therapy at 15 months and for OT at 18 months.  They were seriously crunchy.  They said a whole bunch of random words once or twice (I specifically remember garage, light bulb, and elevator), but then never again.  Their issue turned out to be oral motor based.  But because therapy started so early, it was much easier to catch them up.  That said, I probably wouldn't have called for an evaluation at 14-15 months if they hadn't spoken at all; it was the pattern of saying words once and never again and not saying anything consistently that worried me.  By 18 months though, even the let's wait and see military pediatricians would have wanted an eval.  

[TravelingChris]

On 4/28/2022 at 11:48 AM, kbutton said:

Oh, and some governmental agency recently changed all the language milestones--dumbed them down. People ought to be aware of this going into an evaluation. I don't know if all the tests have caught up yet or not, or if the testing was showing a population wide dumbing down, so that the guidelines were changed. 

Yikes,!   How awful!  

 

[Clarita]

It seems really common in my area for kids to get speech therapy. A lot of them just get speech therapy for a short (< 1yr) period of time and then they are discharged. Most of them don't get an autism diagnosis just from needing speech therapy. 

[kiwik]

On 4/27/2022 at 4:46 PM, Scarlett said:

I have a friend whose child who will be 4 in June is impossible to understand.  Clearly very intelligent….and gorgeous, which is neither here nor there…..but literally I cannot understand a word he says.  His parents can……but I can’t. I have been mulling over whether to suggest an evaluation…….I am close friends with the grandmother so I might start there.  But yes, to answer your question….I think he needs an evaluation. 

It is common if not normal for a child not to be understood outside the family until 4 or 5.  

But for the 3 year old, I wouldn't jump to ASD simply because  most kids with ASD I know have average to above average language skills.  It can't hurt to get assessed unless it will cause financial hardship.  Whether it will help depends on whether you can access any help or support if there is a problem.

Edited May 2, 2022 by kiwik