Is my 20-month-old linguistically delayed or am I paranoid?
July 28, 2010 10:46 AM   Subscribe

Internet people that are not doctors, am I being overly anxious about my toddler's lack of speech?

My (only child) 20-month-old has always been on track (for what it's worth) developmentally. Language-wise, he's not quite there.

What he does say:
He regularly says: no, Mommy, Daddy, "ba" for book, bottle, "wa wa" for water, "all done", "nig-nig" for being tired, "bye-bye," "bubble," "nose," "noc" for knock, and "pe" for please.

and SOMETIMES says "doggy" (although this stopped for the past 3 months) "ditty" for kitty (irregularly), "ba" for balloon, "bow wow," "ba" for belly button, "ba" for bird, "ba" for ball, "do" for door and a few signal words "oodoom" for vacuum (recently stopped), a-ta for fan or anything hanging from ceiling.

He doesn't know any animal names, but can point to them in books and has for a few months. He doesn't know any body parts except for nose, but can point it them and has been able to fo ra few months. He doesn't do any animal sounds. He can't say hi. He can't say yes.

The only 2 word phrase is "bye bye daddy" when he wants to go to bed with me alone.

When I ask him to say something "can you say bird?" he doesn't reply.

Other factors:
- He can recognize, for example my shoes versus his dad's shoes, and will say "Daddy" or "Mommy" when appropriate for the object.
- He does follow directions and understands things "shut the door to the fridge" "get your shoes" "get daddy's shoes" "do you want to draw."
- When he wants something he points and grunts and I say "use your words" and he doesn't use the words.
- Daycare uses lots of signs and he signs for "please' "more" and "all done."
- He started singing in the last month, but just babble.
- We read ALL THE TIME.

When we hang out with other kids (or see Facebook updates) it seems that all the other 20-month-olds are leaps and bounds ahead of him language-wise.

So, MeFi, is he normal? I don't have any frame of reference beyond our friend circle and what I've read online (which varies greatly.)

I called the doctor already. I've asked daycare and they say that he is behind but they're not freaking out.
posted by k8t to Education (41 answers total) 1 user marked this as a favorite
Anecdata: a good friend of mine didn't talk until he was almost 4; doctors were so concerned that they had his parents hold him back from starting school, so he's a year older than everyone he graduated with. But other than that he's perfectly fine, and is about to finish college.

I understand why you would be worried about this, but 20 months is still very young. It sounds like you're doing everything you can; it's just a matter of time until you find yourself wishing he would just SHUT UP for even one minute :)
posted by hermitosis at 10:50 AM on July 28, 2010

Personally I see no significant abnormality in your child's development. People do not all develop at exactly the same rate. I have known other children who have developed more slowly than your child but who still turned out, in due course, to develop fully into normal children. And that is exactly what I expect in the case of your own child.
posted by grizzled at 10:52 AM on July 28, 2010

I think he is fine. I have observed my daughter, who is now 26 months, and her friend, who is male and 24 months... and he's always been slightly behind in language. I think it's just how little boys roll.
posted by FergieBelle at 10:55 AM on July 28, 2010

I'm not sure I've really been around a lot of toddlers that are speaking a lot of coherent words at 20 months.

My nephew is 3.5 and is behind on his speech. But all of the sudden in the last month he started improving greatly. It was strange to my sister - all the sudden he is saying more words and pronouncing them clearly.
She was also worried about his speech because two of her friends have children the same age as her son and they're already speaking like they're 6 years old.

My sister (mother of the above reference nephew) had speech issues until she was 5 or 6. I remember she had a hard time pronouncing everything. no one could understand her.
In 1st grade, she attended speech lessons at school and then everything turned out fine.
Actually, she went on to win some public speaking competitions in high school and college.

Every child is different.
My cousin didn't walk until he was 2.5, I refused to use a toilet until I was 4 - it's all different - especially when they're toddlers.
posted by KogeLiz at 10:56 AM on July 28, 2010

My mother is a Speech Therapist and a big part of her job is evaluating kids in the Birth-3 age range even though she works for the Special Education department of a school district. Your doctor should be a good resource, but if you are still concerned after talking to them, I'd check into your local school district to see if they would be willing to give your child an evaluation. I'd guess that they have some requirements that the child has to meet before they will spend the time/money to evaluate, so running through those with someone could be enough to put your mind at ease.
posted by soelo at 10:58 AM on July 28, 2010

You can get his hearing tested but in general the answer to the question "am I overreacting?" by a parent is "yes". he could be deaf. He could have enlarged adenoids leading to hearing problems. Or he could just be sitting out on the edge of the bell curve. Get his hearing checked and then stop fretting.

Also, don't buy into the bullshit other parents lay on you about how far ahead their kids are. Every parent makes their kids seem like the greatest prodigy of all time but most will grow up to be janitors and accountants and other such mundane things. It's a goddamn kiddie arms-race out there. Don't buy into it.
posted by GuyZero at 10:59 AM on July 28, 2010 [3 favorites]

I apparently didn't talk until I was 3. You can check my posting history if you want to see if I am well adjusted or not.
posted by mmascolino at 11:02 AM on July 28, 2010 [2 favorites]

Yeah, there's really a lot of variability in language development, and boys typically lag a little behind girls. My son was just about where your son is at that age -- he's 5 now, and his language is fine if a little hard to understand at times.

Like you, I was pretty freaked out at the time so I subjected the poor guy to a fancy hearing test and a bunch of other assessments which determined that he was fine although his language was a little behind the curve. You might get his hearing checked just to rule out an easily remedied problem, but other than that I wouldn't worry too much.
posted by nixxon at 11:04 AM on July 28, 2010

I didn't speak until I was three. I haven't stopped talking since.
posted by fantasticninety at 11:09 AM on July 28, 2010

Some kids are smooth developers and some are big on the punctuated equilibrium. The latter, which is one of those things that make parents worry. Why isn't this kid talking? Or crawling? And then they start doing that thing and you forget how worried you were.

How did he do when it came to walking?
posted by adipocere at 11:09 AM on July 28, 2010

You're worrying too much. I've got a 27 month old. He only recently started putting together two words, but he's been signing at us since 8 months. He once signed "all done, up please" at another little boy when he wanted a turn at a toy car at 12 months. Polite, but his tone and manner were clearly "leave. now."

We've got a little girl in our playgroup who's been speaking in full on sentences including adjectives and adverbs since she was around 18-20 months. The rest of the kids were barely verbal at that point. I remember her mom trying to minimize our amazement by pointing out she wasn't correctly using prepositions, yet. We asked her how she was doing with the ablative tense.

Kids are crazy observant and understand orders magnitude more than they can verbalize back to you. The fact that yours can clearly understand and follow instructions from you is good. The Mrs. and I constantly ratchet up the complexity of what we're asking of ours to see if 1) he understands and 2) he'll actually do what we ask. We don't always get what we want, but we're also not at all worried about his future ability to communicate, despite the hyper-verbal little girl in our playgroup.
posted by NoRelationToLea at 11:10 AM on July 28, 2010

Best answer: Here is some developmental information from the CDC about milestones for a 2 year old child and signs to be worried about. He should have more words by this point, but from your post it souds like he most likely has a speech delay and not a more significant condition. 24 months is a little older than your child, but it will give you an idea of where he should be. To also give you an idea by 2 a child should have up to 50-100 words.

Call your Regional Center stat and get in to have him evaluated, in California it is usually the Regional Center and not the school districts who evaluate kids 0-3. Once the child is 24 months old (here in CA) he has to have a much more significant delay to get services. You want Tri Counties Regional Center and you can call them at (800) 322-6994 or at (805) 962-7881. You can self refer and they will give you a speech evaluation by a licensed therapist for FREE. Really a good Speech Therapist needs to evaluate your child for a delay and the possible causes. Most pediatricians just are not well trained in this field.

I work in this field here in CA so feel free to drop me a message if you want some additional info.

Good luck with everything!
posted by Palmcorder Yajna at 11:12 AM on July 28, 2010

Response by poster: Walked at ~13 months.
posted by k8t at 11:14 AM on July 28, 2010

Response by poster: Thanks Palmcorder Yajna, I'll give Tri Counties a call. I appreciate the info.
posted by k8t at 11:14 AM on July 28, 2010

My cousin seemed to be behind on her speech. My aunt tried to wait it out, figuring she'd catch up on her own eventually. Finally she took my cousin to the doctor and he tested her hearing. It turned out that her ears were so clogged with earwax that she couldn't hear properly. They removed the wax and that was it, she speaks just fine now. So I agree with GuyZero, get your son checked out and in all likelihood it's nothing and you don't have to worry anymore.
posted by keep it under cover at 11:23 AM on July 28, 2010

whoa, Palmcorder! At my son's 2 year appointment, the pediatrician asked me, "Does he have at least 10 words?" I was able to say yes, he has 10 words exactly. She was unconcerned.

At 20 months, he said "mama" for the first time. That's around the time he started saying "no" as well. I'd say he had 5 or 6 words then, and didn't really babble either. (But he did babble as an infant.) Also his receptive language was remarkable so we weren't worried about hearing or general intelligence.

Right around 27 months (just as I was ready to call the ped back) he added about 250 words and started speaking in short sentences (3 - 5 words). He never really did the two word thing.
posted by peep at 11:32 AM on July 28, 2010

My husband's neice was not talking at an appropriate developmental age although she seemed to understand everything. After many doctors and tests it was discovered she had a gradual hearing loss that eventually required cochlear implants. Because she was born with near normal hearing and it gradually deteriorated she understood a lot of speech and motions.

So nthing getting hearing testing. And the first 2 doctors did not pick it up. Possibly because she was losing it gradually but she is not deaf without her implants.
posted by shaarog at 11:33 AM on July 28, 2010

My son was just about three years old before he started talking very much. I didn't worry one bit as he'd been way ahead on his motor skill milestones, and he was my first kid.

He's a USAFA grad, so I think he did ok.

(If you would feel better of course have him evaluated. But a lot of boys in particular seem to be later talkers and much of the time there's nothing at all wrong.)
posted by St. Alia of the Bunnies at 11:41 AM on July 28, 2010

I have three sons, all adults now. The first one talked fairly well by two, the second one barely said anything until he was almost three, and the third one spoke in sentences at twelve months. All three are totally normal today, brainy, educated, etc. By all means, if you can get his hearing and speaking evaluated do so, but don't worry too much.
posted by mareli at 11:55 AM on July 28, 2010

Best answer: We just went to our first appointment with a speech pathologist yesterday afternoon, for our 17-month-old girl. She's bright and engaged, but less chatty than other kids her age. We were given some specific pointers to increase her motivation to speak, along with other tips. Here's what we compiled from memory after coming home from the visit.
  1. Give her choices between two things instead of immediately offering her the thing she wants.  Give her the opportunity to express her choice through looks, gestures, sounds, or words.  (But don't deny her the thing she wants until she gives you a particular word, etc -- this will frustrate her communication attempts.)
  2. When she wants something from you, get it and put it under your mouth (so she can see your mouth) and say the word for it.
  3. Encourage her to model our behavior by showing her to play with dolls, give her animals a ride, have a tea party, clean up with you, etc.  This teaches her to try to copy you, so maybe she will try to copy your speech, too.
  4. Move the majority of her toys so they are out of reach, and she will need to ask for your help in getting them.
  5. Replace her sippy cups with cups with straws to encourage tongue movement.
  6. Use gestures.
  7. Reduce her pacifier use (no objection to pacifier use for sleeping).
  8. Get her ears checked.
  9. Make sound effects to encourage her to make these noises too.  "Moo" and "vroom vroom"!
I can't tell you which points would apply for your child, but I figure you might like to at least see how the start of the process went for us.
posted by NortonDC at 11:59 AM on July 28, 2010 [2 favorites]

There's no such thing as worrying to much about your kid. (okay, maybe that isn't always true, but, hey, we worry because we love).

Agree with every kid is different and all that. But, I have a nephew who is your son's age and has the same things going on. Everyone in the family thinks he's fine except his mom. His mom took him to the county for evaluation and they provide free speech therapy for him. During the school year he goes to the school; during the summer they are coming to his house. The reassurance of the therapist has done wonders for everyone, and he has started saying more words (for whatever reason, he has trouble with what they call "nipple words" - I'm not even sure which ones those are). The therapist does think he's delayed, but it isn't serious, but worth working with him on. My nephew sees the whole thing as a big game and seems to love it. So if that's going to make you feel better, why not check it out?
posted by dpx.mfx at 12:04 PM on July 28, 2010

They're in Michigan, but surely you've got something similar!
posted by dpx.mfx at 12:04 PM on July 28, 2010

Sounds like me when I was a kid. I didn't talk much until 5 or so. I grunted and pointed at things when I wanted them. I went to a special kindergarten because my parents were concerned about my apparent developmental delays. Much later I found out that I have a chromosomal abnormality (47xxy) which indicated possible language delays (among other things). This was discovered via blood test (karyotype).
posted by indigo4963 at 12:07 PM on July 28, 2010

I thought my son was a late talker at 20 months; he said just about the same number and types of words as your child. Around 23 or 24 months, though, he had a language explosion in which he seemingly went from a late talker to a gifted communicator overnight. He is now 27 months old and he speaks on the level of a three year old or perhaps even older, regularly communication in several sentence long paragraphs with prepositions and adjectives, etc. So, I'd say give it some time :) He may very well surprise you in a few weeks!
posted by mudlark at 12:14 PM on July 28, 2010 [1 favorite]

This is purely anecdotal but my nephew didn't say much of anything until he was four. Now, at 6, we can't shut him up. His sister, just 11 months behind him (my sister didn't get the memo) could damn near quote Shakespeare at 18 months. I think boys are just slower.
posted by notjustfoxybrown at 12:17 PM on July 28, 2010

Seconding the recommendation that you get your son's hearing checked, and I'd add a trip to an ear, nose & throat specialist. My daughter had significant, undiagnosed ear infections that eventually turned into otitis media, "glue-ear." This lead to speech- and developmental delay that we are still, four years later, having to work through.

Anecdata, confirmation bias, and all that, but I've met a lot of parents who share my story.
posted by lekvar at 12:18 PM on July 28, 2010

Of course, everyone either knows someone--or is that someone--who didn't talk until s/he was 3 (or 4! or 5!) and now holds an advanced degree from Harvard. But here's the thing: while most late talkers end up being just fine, some do not.

As a speech-language pathologist, I strongly encourage you to contact your state's version of 0-3 services. The free initial evaluation will make you feel a whole lot better regardless of its outcome. If the evaluating therapist is not concerned, swell! If, on the other hand, your little one ends up needing a little nudge, the state will be able to connect you to either free or significantly discounted services through its early intervention program and your dude can start growing his speech/language skills through play-based therapy.
posted by onepot at 1:07 PM on July 28, 2010 [1 favorite]

I'm not going to tell you what to do but merely supply another data point. My first son barely talked at 20 months, had about 25 words at age 24 months, and it accelerated from there, and sometime after that he did start talking for real. Now he's 11 years old and I can't shut him up. I was worried about him, but about the time I decided I maybe should do something, he was gaining more words and I never did get him checked or get any support for him. When my second son was only slightly faster at speech than my first son, the pediatrician was more worried than I was - since I knew what happened with the first. Second son talks just fine now too.

Checking into it is a good idea, though, I've had friends with children who DID have speech delays for specific reasons like those mentioned above. Appropriate therapy helped those children. I think 20 months is a little early to assume something must be wrong, however.
posted by molasses at 1:23 PM on July 28, 2010

Are you in a bilingual household, or are they exposed to a second language via a caregiver? If so, a delay in language is expected and normal. This was the case for my kids, and they were past their 2nd birthday before either started to use their words effectively -- and now, at almost five, they're both chatterboxes, with my son completely normal for his age and my daughter way ahead of the curve.

So, don't stress. However, don't be lazy, either -- get a hearing test, and check for ear infections once in a while (my son never complained about his, we only discovered them by accident via examinations.) Beyond that, your child is communicating pretty effectively without a lot of words, which is great, and we took a lot of comfort from our pediatrician saying "yeah, don't worry much at this stage" when they weren't talking yet.
posted by davejay at 3:14 PM on July 28, 2010

Has he been exposed to two languages?

I didn't speak until 18 months - my parents took me to a specialist because they were concerned - it turned out that because I had been taken from an English language kindergarten to a French language kindergarten and back to an English language kindergarten, my speech was delayed.

(If I had been left in the French kindergarten longer, I would have been bilingual.)

But the family joke is that once I started talking, I was making up for lost time, and never again stopped.

I went on to get good grades in English Literature at highschool and university, and short listed for creative writing prizes, so I would say there doesn't appear to be any permanent disadvantage from being a little late to talk.
posted by Year of meteors at 5:01 PM on July 28, 2010

My first son was hyperlexic, and had about 15 words when he was 3. So he had speech delay, compounded by that he is male (who are a little slower) and in a bilingual situation (we live in Tokyo). We did speech therapy, but more to keep track of it.

He started daycare at 3, and that doubled his vocabulary in 2 months.

around 6 years old he has caught up quite well, in both languages. He is not as good as his peers, but he is bilingual instead.

I wrote a little bit about my experiences with hyperlexia if it would be interesting to read.
posted by lundman at 5:09 PM on July 28, 2010

Response by poster: No bilingualism at home or daycare.
posted by k8t at 5:12 PM on July 28, 2010

I really don't think you've got anything to worry about whatsoever.

We really liked this book regarding child speech development.
posted by wilful at 5:30 PM on July 28, 2010

The way my mother tells it, I was basically mute as a young toddler. Everyone commented on how I would just sit and watch everyone talk, but never utter a sound. One day, out of the blue, I said, "Mama, can I have a banana?", much to my mothers surprise. I haven't shut up since. I ended up reading well before a lot of other kids my age, I just waiting a really long time to start talking.
posted by tryniti at 5:33 PM on July 28, 2010

Theres a lot of questions to be asked (by a professional) to see if there's a real problem. But here's from my experience:

Does he have a pacifier? My kid started talking quite a bit after 25 months when he "lost" all his pacifiers. Apparently, they didnt even know he could talk at all in daycare.
posted by hal_c_on at 8:30 PM on July 28, 2010

You're fine, don't worry about it.
posted by Sebmojo at 8:32 PM on July 28, 2010

Coming late to the party... seconding Birth to 3 program. My 31 month old is a recent graduate. She went from barely saying anything at 26 months to full sentences now. The progress she has made since beginning to work with a speech therapist has been nothing short of astonishing. Not only did her therapist work with her, she worked with us to teach us how to teach her. I know there is a ton of anecdotal stuff about people who didn't talk for years and are fine now but that doesn't mean it is a good idea to let your child lag behind without doing anything about it if you are truly concerned. There are resources out there. Everyone told me not to worry and perhaps she would have caught up on her own, we'll never know, but I am glad I was proactive-just in case. I don't think it hurt her (or us) to have extra help. Good luck!
posted by supercapitalist at 9:07 PM on July 28, 2010

I posted a similar question here. You may find some of the responses useful.
posted by zaxour at 2:29 AM on July 29, 2010

This sounds very normal and I am surprised (alarmed, even) by all the calls for professional assistance. I'd stop worrying.

One thing that was useful here was Google image search; when my daughter was wee I sat her on my lap and brought up pictures of this and that that would be familiar. You may discover, with a recognisable repeating excited sound on some images, that he does have other 'words' you don't know about. I mean, it took me a bit to grok that 'dubbies' were 'strawberries' here, but GIS made that pretty clear.
posted by kmennie at 3:55 AM on July 29, 2010

Response by poster: No pacifier ever.
Rarely uses a sippy cup.
Off the bottle.
Is still breastfeeding at night.
posted by k8t at 6:10 AM on July 29, 2010

Nthing that while it could be a harmless delay, it could also be hearing loss. If your child is just a little bit behind the curve, it's no problem to wait it out and not stress out. But if it's hearing loss, there is a very short window of just a few years to catch it and get his hearing amplified so he can fully develop his ability to speak. Only an expert can tell you whether it's hearing loss, as loss can be progressive (he may have passed the mandatory hearing screenings that many hospitals and pediatricians now use but then developed loss over time) and you may not be able to detect a mild or moderate loss. Even very mild hearing loss can have a huge impact on a child's life if undetected.

In other words, it's probably nothing, but to be on the safe side, I wouldn't wait it out as many have suggested. His doctor can refer you to an audiologist for testing, or if there is an early intervention program in your county they may be of assistance to you, and their services are free.

I hope this helps. I don't mean to scare you, just sharing what I learned the hard way. Better to get it checked out and have it be nothing than to assume it's nothing and find out it's hearing loss or another kind of developmental delay that signals a larger problem.
posted by ravioli at 12:00 PM on July 29, 2010

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