15 month old with very limited repertoire of sounds/syllables

June 12, 2018 12:13 PM

My 15 month old says no words, is very limited in the types of sounds she's able to make (both vowels and consonants), and doesn't really try to mimic or imitate new sounds. When googling, I see apraxia come up a lot and don't know whether this is a legitimate concern at this point. Can anyone help me understand what's normal and what isn't at this stage?

I have a 15 month old baby/toddler who is definitely behind the curve in terms of speech and vocalization, but because I have almost no experience with children of this age, I’m struggling to know what is just normal variation in development, and what could be legitimate cause for concern/further evaluation.

My daughter doesn’t have any words, and in fact really uses the same syllable(s) for just about everything – she will point and say “ba” or “da” at just about any object she is curious about. She also doesn’t have much variety in the sounds she makes when babbling, maybe ba, da, ma, na and some nonsense baby gibberish. Almost all her sounds end in the vowel sound "ah" or "uh". She doesn’t ever really to imitate words people make (once in awhile she will if it's within her repertoire of sounds), but she will imitate things like blowing raspberries, blowing kisses or shushing.

Having said that, she clearly has strong receptive language as she clearly understands a wide range of objects and commands. She also knows a couple of signs (pretty much just food related ones). There are no concerns at this point about autism really, as she makes a ton of eye contact, points, claps, waves, plays peekaboo, and generally loves attention and interactive games with people. She was also pretty early with motor skills, taking her first steps before 9 months and generally being ahead of the curve with that stuff.

I understand that some babies don’t say their first word until 18-24 months (or later!) and that there’s a wide range of normal with this stuff. I guess the reason I’m slightly concerned is that I imagine those children that speak later are still making a wider variety of different sounds while babbling, imitating syllables, things like that. Is it normal for a baby of 15 months to be so limited in the sounds she's able to make? In googling this, I have seen a lot of results that mention Childhood Apraxia of Speech, but I have no idea if that's something to be legitimately concerned about at this point, as she's still quite young. Her pediatrician doesn't seem concerned yet, but I was curious what other parents might have experienced, since – as mentioned – I have no experience around other babies to draw on. Thanks for any input you might have!

posted by noboru_wataya to Human Relations (21 answers total)

Are you doing a 16 month well check? I just had mine with my 15 month old (you basically can do it in an 8 week window and ours was a bit early). Our kiddo sounds very similar to yours, down to details of being very good at motor stuff and good receptive language, but not so much making words. Ours even mimics nonverbal sounds like sneezes and such too!

Anyway after our kid much like yours, our doc said kiddo is still completely normal and I strongly suspect yours will too. Just keep going to well checks and she’ll most likely catch up real quick.
posted by SaltySalticid at 12:21 PM on June 12, 2018 [6 favorites]

Hi! If you are in the US, you should contact your local Early Intervention Program. They can come in and do an assessment and determine if your child would benefit from services through them. It's a free-to-you program exactly for this purpose, and if your child should need services, through this program she would be eligible until the age of 3.

Whenever parents or caregivers have doubts of this sort, I always recommend going through the motions of evaluations because that will give you the best and most useful information about your child for you. My child's medical care provider wasn't concerned at his 24 month appointment when he wasn't talking still because he was making sounds, but we ended up seeking out Early Intervention relatively late because he still didn't progress, so he only received a few months prior to us seeking private speech therapy.

My cred includes being a parent to a child who did have a severe speech delay and a board member of my school district's special education advisory board. If you are in Massachusetts, please PM me and I can certainly point you to more specific resources.
posted by zizzle at 12:22 PM on June 12, 2018 [13 favorites]

I'm also here to plug your local Early Intervention program.

There is zero downside to having a comprehensive assessment done for your child. Zero. Its free to you. Generally the contact is through your local school district, but just plugging "Early Intervention [your state]" should get you the connection you need.

Really, I can't cheerlead for them enough.
posted by anastasiav at 12:27 PM on June 12, 2018 [4 favorites]

This is a question for your pediatrician, who is not only an expert but also has been seeing your daughter regularly. (Of if you're in group practice, at least has access to records and can consult with colleagues.) If you have the 15/16 month checkup coming up, ask then. If you just had a checkup, the pediatrician should have screened for language development. If she didn't, call and make another appointment.

Chances are it's within the normal range, but verifying that - and getting appropriate diagnosis and referrals (to early intervention or similar) if it isn't - is exactly why you have a pediatrician.

We had a similar issue. Our wonderful doctor listened, smiled that "I'm here to reassure you, you loving, (over)concerned parent" smile, and told us everything would be fine.
posted by Mr.Know-it-some at 12:29 PM on June 12, 2018

My off-the-cuff sense is that it is perfectly ordinary for productive language milestones to be wildly different from one kid to another, but that's gossip and my kids' peers, rather than science. (I think if you have a sense there's something off about your kid's receptive language -- they're not understanding you -- you worry much faster, but not for slow speech.) But assessments can't do any harm, I'd just expect that they'll tell you your kid is fine.
posted by LizardBreath at 12:29 PM on June 12, 2018

Our son's pediatrician said he was not worried about our son not saying ONE STINKIN' WORD at his 24 month check up. The doctor said he only seeks intervention for otherwise normal appearing children after 27 months and zero words.

2 months and 29 days later, Little Murrey made it in under the wire when he uttered "Apple" (looking at the lid of my laptop). He is almost 9 now, smart as a whip, and super chatty.
posted by murrey at 12:31 PM on June 12, 2018 [12 favorites]

The typical guideline is "walk by one, talk by two." At 15 months, your child is starting to engage in the beginnings of language, and it sounds to me like she's doing OK. If you want to take her in for a free evaluation, it can't hurt, but I really wouldn't worry about it at this point in time.
posted by ubiquity at 12:31 PM on June 12, 2018 [1 favorite]

Nothing wrong with getting involved and checking things out around early intervention, etc.

But...

I know I am a sample size of one but I was basically non-verbal until age 4-5, to the point of school officials suggesting I be held back a grade. Turns out I was just a bit of a slow starter, eventually I caught right up and as an adult I certainly seem to have suffered none, just ask friends who can't shut me up.
posted by Cosine at 12:33 PM on June 12, 2018 [2 favorites]

Response by poster: I'm in Canada so I will have to research what our equivalent of early intervention is and how to access it. Sounds like her development isn't wildly concerning but I agree with the folks who say it can't help to have an evaluation done, if one is readily available.
posted by noboru_wataya at 12:39 PM on June 12, 2018

Seconding contacting the local school and inquiring there.

We had a similar issue and the staff at our elementary school told us who to contact and where to go, even though we had no children enrolled yet.
posted by JoeZydeco at 12:59 PM on June 12, 2018

Yes, Early Intervention is wonderful!

At 15 months, our daughter wasn't really speaking, either. It's hard to remember exactly, but I don't think she was saying much more than "da" and "ga" at that point. We took a vacation right around the time she hit 16 months, and she really blossomed after that. Now, at 18 months, she won't stop talking. She learns new words every day (yesterday was "knee"). She can address people by name now (just me and her grandfather, but still...), and if you ask her certain questions, she responds. At 15 months, my wife and I were pretty concerned about whether she'd learn to speak. At 18, we're now more concerned that she doesn't stop!

The reason I endorse Early Intervention, though, is because our daughter had some physical problems, too. She wasn't even army-crawling by a year, and our nurse practitioner actually thought she might have cerebral palsy. Our daycare suggested the Early Intervention program, and it's been night and day. It's been a lot of work, but physically, our daughter is mostly caught up (she hasn't taken steps on her own yet, but she can stand without support and walks with a walker 23.5 hours a day), and her speech is back to normal. It's made a notable difference.

Another thing we did, which I know is wooooo but I'm still throwing it out there, is cranial-sacral therapy. It still sounds like BS to me, but the temporal correlation between cranial-sacral sessions and developmental milestones is hard to miss. I don't think I could suggest doing that on its own, but combined with Early Intervention PT, it has worked very well for us.

One final thing: is your kid in daycare? Being around other kids further along seems to make a difference, too. Our daycare has a policy that kids can't be promoted out of the infant room until they can crawl, so our daughter was still in the infant room at 15 months. Our physical therapist talked to the daycare to persuade them into moving her up, and the peer pressure from the bigger kids seems to have accelerated her development. Physically, she started feeding herself and holding her bottle almost instantly despite never having any inclination to do so before, and she started to crawl soon thereafter. She also became a lot more vocal. I'm convinced that being around kids who were already walking and talking is part of the reason why she started doing it all of a sudden.

But yeah, I definitely think it's too early to really worry about it.
posted by kevinbelt at 12:59 PM on June 12, 2018

I'm also in Canada, and my son (now 5 yo and very chatty) was mildly delayed in his speech. I brought it up with our family doctor at all check-ups starting around a year and kept getting push back (boys talk later! he'll figure it out! just keep reading to him and talking to him!) but kept asking for a referral. Eventually, I was given contact information for a local early-intervention type of organization (Kidsability) and we went for an informal evaluation. My son didn't end up qualifying for any additional services and started talking around 26-27 months on his own, but I felt better having done SOMETHING.

If you are in Ontario, the Early Years Centres may be a source for connecting with an early intervention program, and you may not need a referral from a doctor.
posted by Vicmo at 1:01 PM on June 12, 2018

My mother's job was doing developmental testing of toddlers, and I will tell you a secret she told me: kids before age 3 develop language skills at all sorts of different rates for all sorts of different reasons, and early interventions at this stage are done primarily to make parents feel better, not because most delays actually mean anything.

You should still pursue early intervention! It might help and it almost certainly won't hurt, and making you feel better about what you're doing is an important benefit! But you also don't need to worry right now.
posted by waffleriot at 1:35 PM on June 12, 2018 [3 favorites]

Best answer: I'm a Speech Language Pathologist in Early Intervention, and suggest the recommendations to call a local Early Intervention Agency. Where in Canada are you? I have a friend whose son was born in Canada and has told me that EI program there left much to be desired, at least compared to the US. If you are in BC, my friend could pass some information on to me.

As for Childhood Apraxia of Speech, I get this question a lot. It's a pretty rare disorder (I've been working at my current job for 5 years, and have seen two kids who went on to get a CAS diagnosis), and it is rarely diagnosed before the age of 3 (due to the evaluations for usually requiring a lot of purposeful imitation)
posted by Ideal Impulse at 2:52 PM on June 12, 2018 [3 favorites]

If you’re in BC, the infant development program through the DDA does this. Call the 811 nurse line to get info, or google it. We did this, and my son did a stint of speech therapy (and other therapies as he had other delays) when he was 2. (After an assessment at 18 months). It really helped, and at 8 he barely has a lisp so it worked. But do call.
posted by Valancy Rachel at 4:14 PM on June 12, 2018

I imagine those children that speak later are still making a wider variety of different sounds while babbling, imitating syllables, things like that. Is it normal for a baby of 15 months to be so limited in the sounds she's able to make?

So, just another piece of anecdata, but I did not speak AT ALL until I was almost 2. I probably babbled a bit, like your daughter is doing, but no meaningful words, not even purposeful "Ma" or "Ba" to indicate my parents. My mom loves telling the story of how she took me to see her best friend from college when I was ~18 months old, and her friend's daughter who was a couple months older sang a whole song about the moon hiding behind a lemon tree; meanwhile I just stared around and couldn't even say the "E-I-E-I-O" of Old McDonald. Then at around 20-22 months, I suddenly found ALL THE WORDS and basically haven't shut up since.
posted by basalganglia at 4:36 PM on June 12, 2018

Back in the dim dark ages we used to say walk early, talk late and vice versa. Walking at 9 months, like your daughter, is very early. My daughter said her first words at 8 months and as we say fondly, hasn’t shut up since. She’s 30something. But she didn’t walk a step until she was almost 16 months. My son, on the other hand, started walking and climbing at 9 months - and he didn’t talk until hmmm I think it was about 15 or 16 months (when he had an epiphany at the zoo and shouted A DOG! at the friendly goat he was petting.) in conclusion, I would not worry too much yet. Many many many children don’t start talking by 15 months. So go ahead and ask the pediatrician, but if they say don’t worry, take that advice to heart.
posted by mygothlaundry at 5:09 PM on June 12, 2018

Best answer: Please do not listen to anecdata and stories that are meant to comfort you. Obviously, the ones who reply "Look at me, I didn't speak until I was two and I turned out fine and I'm so smart!" are a self-selected bunch. Those who did not turn out fine are not likely to be posting here on Ask Metafilter; they are the ones who drop out of school early and not perusing a wordy section of the Internet.

There are a couple of articles about variability in toddler's speech along with percentiles, and I just did a quick Google search and found this one: A statistical estimate of infant and toddler vocabulary size from CDI analysis

At age 16 months, girls at the 10th percentile have a productive vocabulary of 16.9 words (i.e. they can say 16.9 words).
Girls at the 50th percentile: 57.2 words.
Girls at the 90th percentile: 142.7 words

Based on what you are saying, I am guessing your daughter will fall below the 10th percentile when she gets to 16 months. I think speech therapists will be concerned only if they fall below 5th percentile, hence the advice from speech therapists to not worry about it (but what works in a general population may not work for you as a parent!).

As for receptive vocabulary (words they understand) at age 15 months:
Girls at 10th percentile: 43.5 words
Girls at 50th percentile: 245.1 words
Girls at 90th percentile: 735.3 words.

Hopefully this gives you an idea about where your child's development falls.
posted by moiraine at 8:01 AM on June 13, 2018 [6 favorites]

And here is a graph from of receptive and productive vocabularies by age and percentile.
posted by moiraine at 8:55 AM on June 13, 2018 [1 favorite]

A hearing test may be a good thing. A friend of mine finally had her son tested and it turned out he needed tubes in his ears. Your doctor could recommend someone nearby. I live in Ontario, and there is lots of help available, but if your doctor is stubborn, you may have to insist on seeing a specialist. Also call the health line for references to hearing and speech specialists in your area.
posted by Enid Lareg at 8:15 PM on June 13, 2018

Best answer: My daughter had apraxia. I thought everything was fine, when friends and relatives were asking from 15 months, "Shouldn't she be talking more?" I finally had her tested at 18 months, and was told she was severely speech delayed. She was also eventually diagnosed with a motor planning disorder, which didn't help matters any.

She's 13 now, and I sometimes still have trouble understanding what she's saying. I often wonder if those three months would have made a difference. Get your girl tested, even if only for Future You's peace of mind.
posted by The Almighty Mommy Goddess at 1:05 AM on June 14, 2018 [1 favorite]