What early intervention can I do to develop babies speech?
July 31, 2018 4:04 AM   Subscribe

I'm concerned about my toddler's speech development. I have put her on the wait list for intervention by the state but it can be up to six months before the evaluation. I would like to to do things in the meantime to help. Please point me to resources.

My baby is 17 months old and does not say any words yet. She does not follow simple instructions. She does babble and sometimes she will imitate sounds. She points very rarely and only at certain things. For example, she will point to a ball whenever she sees a ball and especially if I say "where's the ball?" but even though I know she understands the word "shoe" she would not point at a shoe if I asked where the shoe was. It's like pointing is just for balls. She does not call me mama or anything else. There has been no regression. Neither I nor any doctor or professional she has seen has any concern about autism.

I have spoken to her pediatrician about her language development multiple times. He takes a sort of laissez-faire view and thinks she will talk when she talks and there's nothing to worry about. I am 80-90% confident that this is absolutely right. I know that some kids develop some things earlier than others and there's no particular benefit to being early or harm in being late.

But since I'm still 10-20% worried that there's a language development issue, I'd like to do something as soon as possible. It's not like extra enrichment can hurt, right?

I realize that speech and language therapy is a whole professional field and that I can't learn to be a language therapist by reading blogs or watching youtube videos, but I'm sure I can do better than I'm doing already. If/when she gets some intervention some of that will surely be the language therapist teaching *me* things, right? So can I learn some of that now? What should I be doing to help my baby learn to talk? Please suggest the following:

1. Actual things I could/should do.
2. Resources for reading or viewing that will teach me actual things I could/should do.

What I'm already doing:
- talking to her (but who knows if I'm saying the right things)
- Reading and singing
- Naming objects that have her attention and repeating the words and asking her to try saying them.
- I have read nurtureshock and its chapter on language development already
posted by anonymous to Grab Bag (24 answers total) 5 users marked this as a favorite
One site with activities and milestones is Pathways.
posted by typecloud at 4:12 AM on July 31, 2018

Baby signing time was enormously helpful for my kid (preemie with concerns, has ended up moderately dyslexic so far but very verbal in a leap). The youtube videos will give you an idea of what the show is like and the series was easy to follow for parent and child.
posted by dorothyisunderwood at 4:26 AM on July 31, 2018 [1 favorite]

Get the Hanen Method books, and an assessment by a private speech therapist if you can afford it. There may be a clinic that does it at sliding scale rates.
posted by yarly at 4:43 AM on July 31, 2018 [6 favorites]

Another test to consider with a pediatrician is a hearing test, especially if your child has had several ear infections. Fluid in the ear can reduce hearing effectiveness, and impact learning. One of our children had this and the solution was the microscopic tube in her ears. They then picked up talking faster and had less ear infections.
posted by nickggully at 4:56 AM on July 31, 2018 [16 favorites]

Seconding the hearing test; I know a few families with speech delayed kids (including myself) where there turned out to be some hearing loss.
posted by tchemgrrl at 5:18 AM on July 31, 2018

How physically active is she? A mom I was talking to said that she had been concerned about her daughter's language development and was told by a speech therapist that it's relatively common for more physically active kids to pick up language a little later. Something about a relationship between motor development and speech development (I guess an inverse one?)
posted by brilliantine at 5:18 AM on July 31, 2018 [1 favorite]

It's hard without an assessment because speech is a very complicated issue. There two main parts to communication: receptive and expressive .

Some kids with language delays have receptive problems . This could be hearing issues. It could be audio processing issues (she hears, but it doesn't compute), or a wide variety of things.
It could also be expressive so she understands, but has a problem where her brain and mouth don't work together. Sometimes it's as simple as doing excersizes to increase coordination. Sometimes it's harder.

You can throw excersizes at her but until you have an idea what is going on, it's hard to target exactly what you should do. Sign language is great because it bypasses both some receptive and expressive issues, but if it's something where she needs intensive practice, it can slow down progression if she's too reliant on it. But that's a problem for another day.
posted by AlexiaSky at 6:25 AM on July 31, 2018

Thirding the hearing test, or even just confirming that she doesn't have recurrent ear infections. Our friends' daughter did not start babbling or pointing until she had her ear tubes put in and the fluid was no longer impacting her hearing.
posted by lydhre at 6:27 AM on July 31, 2018 [1 favorite]

There’s a book called It Takes Two to Talk, which was recommended to me by a speech pathologist friend, that I found useful with different sorts of language games when my kids were in this situation.

My kids were both very late talkers, as was I. I’m just at the tail end of this with my son now and it has been an extremely frustrating few years. I can see now why my mother was still talking about how late a talker I was at my college graduation. My intense, years-long, freaked-out study of this has shown that the reason the experts really won’t do anything is because there’s effectively nothing that can be done to rush the process along, which takes its own time and operates under its own logic in every kid; the whole idea of “milestones” is very misleading. My advice would be to keep a log of what your child can do at each age and revisit it every few months to see the progress, and talk with your doctor regularly about where things stand before you can get into Birth to 3 (or whatever that sort of intervention is called where you live). That helped us a lot to feel like we were getting somewhere, especially with my daughter (for whom we had a ton of worry for many years). With my son it’s easier because I can see him on more or less the same trajectory she was on, but with her it was very frustrating and scary that she could do so little of what her peers could do, and had many odd behaviors as a result. It all went away once the talking started.

So hang in there and don’t get too frustrated by the professionals. They’re not trying to gaslight you or shut you down, even if it can feel that way a bit; they’ve just seen how much variety there actually is in human development that the baby books don’t talk about.

Feel free to MeMail me if you’d like to talk more.
posted by gerryblog at 6:28 AM on July 31, 2018 [3 favorites]

In addition to a hearing evaluation and a speech evaluation, I second the sign language. It was so helpful for communications from my children before they could talk. It also is believed to help with verbal language development. Some of the signs they were really into using: more, all done, milk/drink, eat, toilet/diaper, book to communicate their wishes; and plane, helicopter, dog, cat, car, to communicate that they saw a thing before they could say the word. It helps if the thing is something they are really into.
Just a thought, but there are a few types of books that my children loved and that I think help with language development that you might look into including in your reading time if you are looking for additional reading options:
1. books that go through the alphabet with many items for each letter on a page, some of them are very arty and beautifully designed, saying the same letter start sound showing your mouth shape is something the speech therapist would do with my daughter (closer to 3 years old though) so she could mimic the mouth shape
2. books like "Katie Cat Learns First Words" that show common items, point at an item and say the word (and sign it if it is a sign word your're learning), she can see more pointing and that pointing results in action of saying the word
posted by RoadScholar at 6:35 AM on July 31, 2018

- talking to her (but who knows if I'm saying the right things)

Don't worry about this one tiny bit. It doesn't matter what you're saying, just talk. Your toddler's brain is a crazy pattern-matching machine picking the structure and syntax of language from you, way before they're ready to use it verbally.
posted by desuetude at 7:00 AM on July 31, 2018 [9 favorites]

Also suggesting a hearing test. My daughter went through a point and grunt phase. We thought she would never talk. Baby sign language was very helpful with my grands. Now they talk *all* the time. Can't remember who said it but, you can't wait until your kid starts to talk, then when they do, you can't wait for them to shut up, lol.
posted by PJMoore at 7:07 AM on July 31, 2018 [1 favorite]

(1) You've done the right thing by getting on the list for an evaluation
(2) 17 months is late enough to be "late" but not outside the norm by any stretch of the imagination. Speech for us began in earnest around 19-20 months and was well established by 2 years. So, concerned but not panicked is a good place to be.

There are a number of good suggestions here already, but a valuable thing that hasn't yet been brought up is teaching your child that speech is a 2 way, interactive thing. So, when your child babbles, look at her face and smile and repeat her babble back to her. Try to have "conversations" with her, complete with intonation and facial expressions, using her babble sounds.

When you name an object, try to find a way to say its name several times, and over emphasize the name. "Hey, where's your SHOE? Oh yeah, here's your SHOE! This is a BLUE SHOE. Let's put your SHOE on and go for a walk!"

You also say that "pointing is for balls". Great. Build on that. "Where's the BALL? (baby points) Yes! The BALL is over there! And look, there's a truck! (you point at the truck) Let's get this TRUCK (you point at it again) and drive it over your toes! (you vroom, hopefully baby laughs).

Animal sounds are good early words, so if you have any puppets or farm toys or whatever, you can ham it up with the mooing and baaing and whatnot. Especially in these early stages, react VERY ENTHUSIASTICALLY to any verbal response to "can you say...", even if it's the completely wrong sound. "Can you say 'cat'?" "mmrf." "YEAHHHH! This is a CAT!"

Overall, your list sounds like you're headed in the right direction. I think your best bet to up your game is to build shared interest with your kid (i.e. you don't redirect her to the ball if she's busy with the cow, you plop down with her and the cow and start mooing). And then reinforce the two way communication - verbal and non - while making it easy for her to pick out certain words as important. When you read a story, it's less important to read all the pages in order than to engage your kid's interest if they suddenly get interested in one of the pictures.

The way my child's therapist has always started a session (OT, not speech, but same idea) is to let him loose into the gym, see what he latches onto, and use that to devise a game. The game is sneakily designed to build a scaffold from what he can do now towards where she wants him to be. That's the underpinning of most of what I've suggested in this post.
posted by telepanda at 7:08 AM on July 31, 2018 [1 favorite]

You need to do a hearing test - she may be hard of hearing. Some children who are hard of hearing have trouble with specific sounds and the sound "sh" as in "shoe" is one of them. Get her checked out to make sure that is not what is going on.
posted by Toddles at 7:51 AM on July 31, 2018

My now-26-month-old only started talking about three months ago, and he still doesn’t really speak the way I think most 26-month-olds do. So I’ve been there!

- It was not a hearing problem.
- Sign language was mostly a waste of time. We had been working on sign language since he was six months old and nothing ever stuck, despite using signs frequently and consistently. With the help of an SLP, we eventually got him to sign “more” when he was about 18 months, but it’s still his only sign.
- Whoops! I wrote this paragraph before I saw that you were already on the list. Sorry. If you’re in the US, look into Early Childhood Intervention. At least in my area, you don’t need a referral from your pediatrician. Evaluations are free. (We actually had my son evaluated at about 12 months for failure to babble and play social games, but he didn’t qualify for services because he wasn’t behind enough. We had him re-evaluated by a different agency at 16 months — only a different agency because we moved — and he did qualify then.). Services are provided on a sliding fee scale. For us, it’s cheaper than private therapy and it’s more convenient because the therapist(s) come to our house.
- I really like this blog, although they really push their books and other stuff you have to pay for. I just read the blog. Here’s a good post to start with.

After months of play-based weekly therapy through ECI, we finally had some success with flash cards, of all things. One of our therapists tried it once (it’s not something they normally do), and my son really responded to them, so we started using them at home on our own. He now knows probably 75-100 words, mostly animals (he freaking loves the animal flash cards). He takes me by the hand and drags me to the shelf where we store them and asks for “cards” and “animals.” But he still doesn’t say “mama” or “dada” or ask for favorite foods or anything, so we still have a lot of work to do.

Good luck! I know how painful it is.
posted by liet at 8:18 AM on July 31, 2018

The famous "30 million word gap" study was discussed in Nurtureshock. In case this is factoring into your concerns in any way, I just want to highlight that the study/figure was recently debunked: Let's Stop Talking About The '30 Million Word Gap'
posted by melissasaurus at 8:58 AM on July 31, 2018

My son had few words for a long time. We read to him every night, talked to him all the time, took him places, he went to daycare. At 3+, we went to visit family, and he wanted to keep up with his cousins, so he started talking; he must have been ready and that was the trigger. So, yes, hearing test, screening. Read to her, use sign. Try to give her opportunities to communicate, like leaving the snack on her plate on the counter and let her indicate she wants it. And patience, which is really hard.
posted by theora55 at 9:07 AM on July 31, 2018

We've been here! My first chilld sounds like your kiddo -- she said literally nothing at 16 months. At 17 months, maybe she said Mommy and Daddy. But once she started, she would not stop. By 2 she was speaking in absolutely fluent speech, full and complete sentences, no delay at all. Years later, her language skills are absolutely fantastic.

My second is the same, but has not caught up yet at 28 months. Lots of single words, no sentences. We are doing speech therapy now, but I don't really see it helping to be honest. I love the Hanen books though (It takes two to talk) and wish I'd had them earlier. I'm hoping starting preschool soon will help. I am comforted by the fact that she seems to understand absolutely everything.

I think both you and your pediatrician are right. Most kids catch up, so you should be comforted. But also worth doing the early intervention stuff just in case. But I wouldn't expect a miracle through the speech therapy alone.
posted by heavenknows at 9:09 AM on July 31, 2018

Nthing go to the ear doctor (my father was one) 9 times out of 10 (like for real) that's what it is. I have seen (heard?) it for myself.
posted by sexyrobot at 9:10 AM on July 31, 2018

Everyone has already suggested everything I would, but how about thinking differently about it (ie: here is a joke)?

An English couple adopt a little German boy. After two years the child doesn’t speak and the parents are worried about him. After three years he has not spoken and by his fourth birthday he still has not uttered a word.
The English couple figure he is never going to speak but he is a lovely child and on his fourth birthday they throw him a party and make him a chocolate cake with orange icing.
The parents are in the kitchen when the little German boy comes in and says, “Mother, Father, I do not like the orange icing on the chocolate cake.”
My god,” his mother says, “you can speak?”
To which the German boy replies, “Of course.”
How come you have never spoken before? “his father asks.
“Well,” the boy says, “up till now everything has been satisfactory.”
posted by The_Vegetables at 11:48 AM on July 31, 2018 [3 favorites]

Nthing a hearing test just to check. I was born hard of hearing and wasn't diagnosed until I was 4 years old. For me, I can hear lower pitches better than higher pitches, so I absolutely would have been able to understand "ball" but (as mentioned above regarding the sh sound) "shoe" would sound like "ooo" and wouldn't mean anything to me. Once I got my hearing aids, my speech caught up very quickly and it was only a few years of speech therapy to work on my s sounds.
posted by acidnova at 12:05 PM on July 31, 2018

A blogger I used to read (but I forget who! Maybe Amalah?) got her son to say his first word as follows:

Sit together outside somewhere calm
Be silent
Blow soap bubbles- try to only blow one at a time
Do not speak at all
You and baby watch each bubble in silence
When the bubble pops, you excitedly say POP! just once.
Don't say any other words at all.
Repeat for as long as baby is interested.

Blogger and her advisor (pediatrician or whoever) figured the problem was that she was so anxious for baby to talk that she was saying too many words-

"let's blow bubbles, can you say bubble? look I dip it and blloooooow and there's a bubble, can you say bubble? look at the bubble, oooh it's going to pop, can you say bubble? where's the bubble! can you point at the bubble? there it is! oh look it popped! oh no it's gone! hahaha can you say pop?" ... it was all great stuff to say but there was too much of it, so her kid was a bit overwhelmed with ideas.

So maybe try keeping it simple?
posted by pseudostrabismus at 2:10 PM on July 31, 2018 [1 favorite]

Sorry coming back because the most helpful thing I learned from my kid's speech therapy and the Hanen books is the importance of silence. I was so worried about my daughters' lack of speech that I literally never shut up when I was around her. Silence was really powerful.
posted by heavenknows at 5:39 PM on July 31, 2018

From what you've described, I would actually be a little worried about autism. I think the lack of pointing is a big red flag. It's a communication issue and/or a motor planning issue. Our pediatrician back then told us repeatedly that our son would talk when he was ready, he's fine, kids do things at their own speed, he's smiling, engaged, makes eye contact. He didn't point, or imitate us waving bye-bye. He couldn't follow very simple directions or mimic things like ringing a bell. He struggled to play appropriately with toys. He was so happy and so fun and so connected with us. Always laughing and engaging with us. How could anyone think this kid had autism? Yet, no words, no pointing .. I knew in my gut that something was wrong. Even though many well-meaning pediatricians told me he was fine and that soon he'd be talking so much that I'd wish he'd be quiet. I have never once wished for that, by the way, now that he's talking. Every word is still a miracle. And yes, he does have autism. I could not even say the word for a very long time.

I would not wait 6 months for an assessment. I would find a developmental pediatrician or make inquiries at the nearest teaching hospital with a pediatric department that can provide a comprehensive evaluation. Or reach out to an organization like Autism Speaks for referrals to a place where she can be assessed. I think you're worried about your daughter and something doesn't feel right to you. 6 months is a very long time to wait to even begin the process, and you could be getting her some therapy or at least trying to figure out what's going on with her. None of the testing is invasive or unpleasant in any way and there is no downside to having a fresh pair of eyes take a look at her.

I wish you the best of luck and am happy to chat via Mefi mail if you'd like.
posted by Kangaroo at 8:49 PM on July 31, 2018

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