Language Delays in Children - due to brain injury?
April 1, 2019 11:56 AM Subscribe
My 17 month old has only three words (mama, uh-oh, no-no) and doesn't even use those very often. Should I be worried?
The good things:
* Receptive language - she understands almost everything that I say, she follows directions.
* Non-verbal communication - I almost always understand what she needs, why she's upset, etc. So we are communicating, but she is not speaking. She shakes her head (mostly no, sometimes yes). She points to what she wants. She can sign a few things - all done, more, help - and mostly uses them appropriately.
Neutral:
* She spends the day with an English-speaking nanny who interacts with her well. My older kid was in daycare, so I feel like he had more interaction - other kids, several caregivers, etc.
The challenges:
* I try to enunciate and ask her to speak (like "M-m-m-ilk" when it's obvious she wants milk), but she won't say it.
* Sign-language: sometimes I feel like she's just signing what I've said (like I'll say "Are you all done?" and she'll sign all-done, but then take another bite or be upset that I'm taking her plate away).
* She's a second kid to a very verbal 4.5 year-old - as in, he never stops talking.
* We tend to read more books at my older kid's age level, but after realizing this is not great, have been making an effort to read stories directly to the younger one - simple books like Colors! Animals! etc.
And my biggest fear - she has had two injuries in her life that I fear contribute -
* Her skull had minor fracturing at birth. The doctor described it as egg-shell feel under the scalp. It was fully healed by her first pediatrician appointment at about 6 days old. I was induced and my labor consisted of full dilation, and then pushing, but she never descended, resulting in C-section after a couple hours.
* At four months, she choked on a grape-sized wood pellet in a play area. She fully choked for what felt like forever (likely a minute or two?) while we did back blows and throat sweeping. She never lost consciousness and I took her to the pediatrician immediately where they did an oxygen test and she was fine (though due to extenuating circumstances at the doctor, this test was 30 min to an hour after the incident and I'm not sure it told us anything).
So my questions - 1) is this even considered a delay? and 2) could either of the brain injuries have contributed? Is this a thing? and 3) is any of this a rational fear?
You are not my doctor - and I plan to ask the pediatrician about this at her 18 month appointment. Our pediatrician is very low-key and non-intervention which I normally like, but this lack of language is worrying me. I am going to ask for a referral for early intervention testing (I'm in NY - these services are easy to obtain, there's a well-defined process).
The good things:
* Receptive language - she understands almost everything that I say, she follows directions.
* Non-verbal communication - I almost always understand what she needs, why she's upset, etc. So we are communicating, but she is not speaking. She shakes her head (mostly no, sometimes yes). She points to what she wants. She can sign a few things - all done, more, help - and mostly uses them appropriately.
Neutral:
* She spends the day with an English-speaking nanny who interacts with her well. My older kid was in daycare, so I feel like he had more interaction - other kids, several caregivers, etc.
The challenges:
* I try to enunciate and ask her to speak (like "M-m-m-ilk" when it's obvious she wants milk), but she won't say it.
* Sign-language: sometimes I feel like she's just signing what I've said (like I'll say "Are you all done?" and she'll sign all-done, but then take another bite or be upset that I'm taking her plate away).
* She's a second kid to a very verbal 4.5 year-old - as in, he never stops talking.
* We tend to read more books at my older kid's age level, but after realizing this is not great, have been making an effort to read stories directly to the younger one - simple books like Colors! Animals! etc.
And my biggest fear - she has had two injuries in her life that I fear contribute -
* Her skull had minor fracturing at birth. The doctor described it as egg-shell feel under the scalp. It was fully healed by her first pediatrician appointment at about 6 days old. I was induced and my labor consisted of full dilation, and then pushing, but she never descended, resulting in C-section after a couple hours.
* At four months, she choked on a grape-sized wood pellet in a play area. She fully choked for what felt like forever (likely a minute or two?) while we did back blows and throat sweeping. She never lost consciousness and I took her to the pediatrician immediately where they did an oxygen test and she was fine (though due to extenuating circumstances at the doctor, this test was 30 min to an hour after the incident and I'm not sure it told us anything).
So my questions - 1) is this even considered a delay? and 2) could either of the brain injuries have contributed? Is this a thing? and 3) is any of this a rational fear?
You are not my doctor - and I plan to ask the pediatrician about this at her 18 month appointment. Our pediatrician is very low-key and non-intervention which I normally like, but this lack of language is worrying me. I am going to ask for a referral for early intervention testing (I'm in NY - these services are easy to obtain, there's a well-defined process).
IANA Child Development expert, so this is based purely on what I remember reading when my kids were that small, but I don't think you worry much about a kid with productive language delays so long as receptive language is good. And 17 months is still very young. Ask your pediatrician, but I wouldn't worry.
There are a million jokes and anecdotes about kids who didn't talk at all and then started in complete sentences at three or four, and while they're exaggerated, I think people tell those stories because it's a pattern that shows up.
posted by LizardBreath at 12:16 PM on April 1, 2019 [1 favorite]
There are a million jokes and anecdotes about kids who didn't talk at all and then started in complete sentences at three or four, and while they're exaggerated, I think people tell those stories because it's a pattern that shows up.
posted by LizardBreath at 12:16 PM on April 1, 2019 [1 favorite]
(1) it's worth noting but not outside range of normal
(2) no one can say for sure but it seems really unlikely based on what you describe
(3) yes rational but also WELL WITHIN RANGE OF NORMAL
There is SUCH a broad range of language development, and your child is (maybe) on the slower end but definitely not outside normal. My older child had only 5 words at his 18 month appointment. He was not referred for immediate intervention, but a note was put on his chart to reassess at 2. He blew away the 2 year old milestones.
Which is absolutely NOT to say that you shouldn't pursue early intervention testing - this is what it's there for. If your child is on track, the early intervention folks will tell you that. If she needs a nudge to learn to speak, whatever the reason, they will nudge her along. This is all many kids need. A few kids will need more help - but as the parent of a child who has received multiple types of therapies in his life, that's not the end of the world either. It's impossible to say which group your child will fall in, but 3 words at 17 months is not even close to a doom-and-gloom scenario.
Also, having watched various parenting forums and cohort threads over the years, I can tell you the 2 questions I've seen over and over and over are:
(1) will my 14 month old EVER LEARN TO WALK?
(2) will my 18 month old EVER LEARN TO TALK?
and the vast majority of those kids are doing both very successfully by 2.
posted by telepanda at 12:18 PM on April 1, 2019 [6 favorites]
(2) no one can say for sure but it seems really unlikely based on what you describe
(3) yes rational but also WELL WITHIN RANGE OF NORMAL
There is SUCH a broad range of language development, and your child is (maybe) on the slower end but definitely not outside normal. My older child had only 5 words at his 18 month appointment. He was not referred for immediate intervention, but a note was put on his chart to reassess at 2. He blew away the 2 year old milestones.
Which is absolutely NOT to say that you shouldn't pursue early intervention testing - this is what it's there for. If your child is on track, the early intervention folks will tell you that. If she needs a nudge to learn to speak, whatever the reason, they will nudge her along. This is all many kids need. A few kids will need more help - but as the parent of a child who has received multiple types of therapies in his life, that's not the end of the world either. It's impossible to say which group your child will fall in, but 3 words at 17 months is not even close to a doom-and-gloom scenario.
Also, having watched various parenting forums and cohort threads over the years, I can tell you the 2 questions I've seen over and over and over are:
(1) will my 14 month old EVER LEARN TO WALK?
(2) will my 18 month old EVER LEARN TO TALK?
and the vast majority of those kids are doing both very successfully by 2.
posted by telepanda at 12:18 PM on April 1, 2019 [6 favorites]
Our first child barely said a word until he was about 22 months old. Like your daughter, he seemed to be able to understand a good deal of what we were saying, and every now and then he would say "mama", "no", or "more", "up" but not much else. He would occasionally mimic one or more words that he heard us say, but not in an intentional way. At the time, we figured it was because he relied on the basic sign language we had taught him--signs for "help", "more" and pointing got pretty much all his needs met. Then, just a bit before his second birthday he started consistently using word in a more complicated way and has since then developed pretty normally without any deficit. He now talks non-stop for 13 hours a day.
Then, with our daughter, who is now 17 months old as well, we've had pretty much the exact same development, except we never taught her sign language (poor kid). She understands, it seems to me, as much or more as her brother did at the same age, but is slightly less verbal (according to our imperfect recollection). For whatever reason, we just don't have very verbal babies.
posted by skewed at 12:22 PM on April 1, 2019 [1 favorite]
Then, with our daughter, who is now 17 months old as well, we've had pretty much the exact same development, except we never taught her sign language (poor kid). She understands, it seems to me, as much or more as her brother did at the same age, but is slightly less verbal (according to our imperfect recollection). For whatever reason, we just don't have very verbal babies.
posted by skewed at 12:22 PM on April 1, 2019 [1 favorite]
By eighteen months, children should have a vocabulary of between 5 and 20 words. Your child might be at the low end of this, but that's not alarming (and could definitely improve in the next month). At 18 months, the warning signals would be not using gestures, which apparently she does well, and not imitating sounds, which you don't mention. Personally, I would just give her as many opportunities to talk as you can: sing to her, read to her, talk to her, play word games, and so on. She'll soon start trying to join in. If another six months go by and she still seems behind, there will still be plenty of time to get help.
posted by ubiquity at 12:23 PM on April 1, 2019
posted by ubiquity at 12:23 PM on April 1, 2019
We worried about how long our kid took to talk, we even had her hearing tested. Eventually it turned out that there was nothing wrong with her, and the "normal timeline" for this is pretty wide. Now she won't stop talking.
I hope it's the same with your kid.
posted by w0mbat at 12:23 PM on April 1, 2019
I hope it's the same with your kid.
posted by w0mbat at 12:23 PM on April 1, 2019
Mine was roughly like yours at that age, and at just under 25 months many people are fairly impressed by the kid's language skills, both productive and receptive.
As everyone else is saying, the window of natural variation on these semi-arbitrary developmental milestones is huge.
posted by SaltySalticid at 12:25 PM on April 1, 2019
As everyone else is saying, the window of natural variation on these semi-arbitrary developmental milestones is huge.
posted by SaltySalticid at 12:25 PM on April 1, 2019
By the way, in case you aren't doing this already: one thing that's recommended for teaching babies the art of conversation is repeating their babbles back to them, with varied intonation, and letting them practice taking turns "speaking" with you. It's really fun for both of you, and you can get quite silly with it. Seeing you repeat their sounds helps them learn to repeat your sounds.
The other thing that it sounds like you are doing is really emphasizing the important word in a sentence, and then repeating it a couple of times in related contexts. So instead of "Would you like some milk?", "Would you like some ***MMILLK***? Here you go, here's your **MMILLK**"
And, lastly, animal noises 100% count as vocabulary words and are easy to say. So (again, if you haven't already) dig out your toy cows and get mooing. :)
(In all seriousness, it sounds like you're doing a lot of stuff right; you should definitely keep doing that stuff, but it sounds like you're on the right track and she likely just needs some more time.)
posted by telepanda at 12:32 PM on April 1, 2019 [3 favorites]
The other thing that it sounds like you are doing is really emphasizing the important word in a sentence, and then repeating it a couple of times in related contexts. So instead of "Would you like some milk?", "Would you like some ***MMILLK***? Here you go, here's your **MMILLK**"
And, lastly, animal noises 100% count as vocabulary words and are easy to say. So (again, if you haven't already) dig out your toy cows and get mooing. :)
(In all seriousness, it sounds like you're doing a lot of stuff right; you should definitely keep doing that stuff, but it sounds like you're on the right track and she likely just needs some more time.)
posted by telepanda at 12:32 PM on April 1, 2019 [3 favorites]
My son has a mild speech delay (he was speaking at a 30-33 month level at 36 months), and his development seems about similar as your child's at that age - very few words but receptive skills and signing are excellent. Still, as everyone here says, there's no cause for worry yet.
I'm sure you have your reasons for a nanny and not daycare, but I cannot recommend peer interaction enough. My son's vocabulary and speech and language skills absolutely blew up almost immediately upon starting daycare at 2.5 years old (prior to that he'd been with a Portuguese-speaking nanny since he was five months old.)
FWIW, I know first-hand what it's like to stress about a speech delay in your child. However, I'd wait until closer to 24 months to have your child evaluated by Early Intervention (you can always start the proceedings at 18 months if you want to put your mind at rest.) My own experiences with EI have been not entirely positive, as I do feel they label children unnecessarily, so I'd recommend an initial evaluation by a private speech therapist, especially if you have medical insurance that covers it. If you need services after that, Early Intervention is great.
You don't have to worry right now, as your child still seems within the range of normal and that range is very wide. Give it some time, and trust your instincts.
posted by Everydayville at 12:32 PM on April 1, 2019
I'm sure you have your reasons for a nanny and not daycare, but I cannot recommend peer interaction enough. My son's vocabulary and speech and language skills absolutely blew up almost immediately upon starting daycare at 2.5 years old (prior to that he'd been with a Portuguese-speaking nanny since he was five months old.)
FWIW, I know first-hand what it's like to stress about a speech delay in your child. However, I'd wait until closer to 24 months to have your child evaluated by Early Intervention (you can always start the proceedings at 18 months if you want to put your mind at rest.) My own experiences with EI have been not entirely positive, as I do feel they label children unnecessarily, so I'd recommend an initial evaluation by a private speech therapist, especially if you have medical insurance that covers it. If you need services after that, Early Intervention is great.
You don't have to worry right now, as your child still seems within the range of normal and that range is very wide. Give it some time, and trust your instincts.
posted by Everydayville at 12:32 PM on April 1, 2019
Neutral:
* She spends the day with an English-speaking nanny who interacts with her well. My older kid was in daycare, so I feel like he had more interaction - other kids, several caregivers, etc.
I'm bolding this part, because I wanted to ask, is your household bilingual? Studies have shown that children who grow up in households with more than one language, speak at a different rate than monolingual children (see here). My sons were raised in a bilingual household, and they did not speak until age 3. I was concerned, so I did an assessment with my state's early intervention program at age 2 (my first son was speaking maybe 20 words, and only 2 word sentences). If you are concerned, ask your pediatrician, or if you are in the USA, look into your state's early intervention programs and have your child assessed. Usually, early intervention up to age 3 is free.
posted by alathia at 12:36 PM on April 1, 2019 [4 favorites]
* She spends the day with an English-speaking nanny who interacts with her well. My older kid was in daycare, so I feel like he had more interaction - other kids, several caregivers, etc.
I'm bolding this part, because I wanted to ask, is your household bilingual? Studies have shown that children who grow up in households with more than one language, speak at a different rate than monolingual children (see here). My sons were raised in a bilingual household, and they did not speak until age 3. I was concerned, so I did an assessment with my state's early intervention program at age 2 (my first son was speaking maybe 20 words, and only 2 word sentences). If you are concerned, ask your pediatrician, or if you are in the USA, look into your state's early intervention programs and have your child assessed. Usually, early intervention up to age 3 is free.
posted by alathia at 12:36 PM on April 1, 2019 [4 favorites]
IANAPediatrician, but we have two young boys, and I can't rightfully say when they both started talking, but I remember that the range of "normal" development for tiny people is pretty frickin' broad, even if that didn't calm us as new parents.
A few additional thoughts:
- you probably see this in your older kid, kids aren't the most reliable of gauges of their own wants and desires, and often change their minds, particularly about food. There have been many times that our 4 year old says he's done with a meal, only to come back 5 minutes and say he's hungry, and even our 7 year old has done this, particularly when there's something more interesting than food.
- I've heard that kids are slower to speak if they're good at communicating through sign language. If you can understand them when they talk with their hands, why bother with the whole messy, complicated mouth, tongue and throat combination to say words?
- Early intervention evaluations are great, and put our minds at ease, in addition to getting our kids some early support where they were a bit behind the curve. Now they're verbose little people. So. Much. Talking.
posted by filthy light thief at 12:38 PM on April 1, 2019
A few additional thoughts:
- you probably see this in your older kid, kids aren't the most reliable of gauges of their own wants and desires, and often change their minds, particularly about food. There have been many times that our 4 year old says he's done with a meal, only to come back 5 minutes and say he's hungry, and even our 7 year old has done this, particularly when there's something more interesting than food.
- I've heard that kids are slower to speak if they're good at communicating through sign language. If you can understand them when they talk with their hands, why bother with the whole messy, complicated mouth, tongue and throat combination to say words?
- Early intervention evaluations are great, and put our minds at ease, in addition to getting our kids some early support where they were a bit behind the curve. Now they're verbose little people. So. Much. Talking.
posted by filthy light thief at 12:38 PM on April 1, 2019
Yes, I have an acquaintance whose kid had a speech delay due to some physical problems, and when he learned "no," there were some hilarious incidents of "WHY DID YOU TAKE THE FOOD AWAY JUST BECAUSE I SAID 'NO'!?!??"
posted by praemunire at 12:59 PM on April 1, 2019
posted by praemunire at 12:59 PM on April 1, 2019
This is my standard answers to questions like these:
In every US state, comprehensive early development assessments are available for children under age 3 upon request, completely free of charge (generally funded either by your local department of education or the state DOE).
The folks doing the assessments are specialists in early childhood development, and will look for all sorts of things, including language delay, cognitive differences, fine and gross motor skills and more. There is zero downside to having an assessment done. Probably, your child is developing typically. If not, EI folks can quickly and easily get you hooked up with resources to assist you and your child.
posted by anastasiav at 1:19 PM on April 1, 2019 [6 favorites]
In every US state, comprehensive early development assessments are available for children under age 3 upon request, completely free of charge (generally funded either by your local department of education or the state DOE).
The folks doing the assessments are specialists in early childhood development, and will look for all sorts of things, including language delay, cognitive differences, fine and gross motor skills and more. There is zero downside to having an assessment done. Probably, your child is developing typically. If not, EI folks can quickly and easily get you hooked up with resources to assist you and your child.
posted by anastasiav at 1:19 PM on April 1, 2019 [6 favorites]
This sounds a lot like my youngest, who was in fact speech delayed, but a totally normal speech delay probably a result of being the youngest of three children in a hyperverbal family where everyone is constantly talking AND where she is utterly doted upon and had two adoring older brothers tending to her every need at the slightest indication.
We had her assessed by Early Intervention shortly after 18 months (having discussed it with the pede at 18 months and deciding to go ahead). Her receptive language was off the charts -- I'd say to my boys (who were 6 and 8), "Have either of you seen my book?" and she would toddle off and come back with my kindle which she understood was the "book" I was looking for! Early Intervention diagnosed a speech production delay and okayed her for weekly speech therapy. We've been doing that for a year and a quarter, and she is toooooootally being graduated from speech therapy when she hits 3 (and speech therapy switches from Early Intervention to the school district) because while not all her consonants are very distinct, she talks a blue streak now. (While I was typing this she came in and said, "I get you diet coke, mama! Daddy open fridge for me!" Of course it was more like diet doke, and opin didge, but it was perfectly comprehensible, and now I have a Diet Coke.) And she adores her speech therapist and speech therapy is the highlight of her week.
Speech delays are by far the most common developmental delay and, happily, the most-successfully-resolved delay (I want to say 85% of them treated before kindergarten just go away and are never a problem again?). So even if it is a delay, it a very normal delay, and it's super-treatable. Talk to the pede, contact Early Intervention, and go from there -- it's so normal and so treatable!
(If you need help locating your local Early Intervention contact information/procedure, memail me or e-mail me and I am happy to help, it can be a little intimidating to figure out if you're new to it! For anyone who doesn't know, Early Intervention is a federally-funded program in the US providing developmental therapies to children with various delays between the ages of 0 and 3 years. It is free or low cost to families, and you have a right to it if your child has a delay, and every family has a right to an assessment. However working through the bureaucratic process can be a bit slow, so it's worthwhile to start the process of setting up an assessment now and you can always cancel it if you don't need it when it comes around! This offer is open to anyone reading later who would like some help or hand-holding with Early Intervention!)
posted by Eyebrows McGee at 1:19 PM on April 1, 2019 [5 favorites]
We had her assessed by Early Intervention shortly after 18 months (having discussed it with the pede at 18 months and deciding to go ahead). Her receptive language was off the charts -- I'd say to my boys (who were 6 and 8), "Have either of you seen my book?" and she would toddle off and come back with my kindle which she understood was the "book" I was looking for! Early Intervention diagnosed a speech production delay and okayed her for weekly speech therapy. We've been doing that for a year and a quarter, and she is toooooootally being graduated from speech therapy when she hits 3 (and speech therapy switches from Early Intervention to the school district) because while not all her consonants are very distinct, she talks a blue streak now. (While I was typing this she came in and said, "I get you diet coke, mama! Daddy open fridge for me!" Of course it was more like diet doke, and opin didge, but it was perfectly comprehensible, and now I have a Diet Coke.) And she adores her speech therapist and speech therapy is the highlight of her week.
Speech delays are by far the most common developmental delay and, happily, the most-successfully-resolved delay (I want to say 85% of them treated before kindergarten just go away and are never a problem again?). So even if it is a delay, it a very normal delay, and it's super-treatable. Talk to the pede, contact Early Intervention, and go from there -- it's so normal and so treatable!
(If you need help locating your local Early Intervention contact information/procedure, memail me or e-mail me and I am happy to help, it can be a little intimidating to figure out if you're new to it! For anyone who doesn't know, Early Intervention is a federally-funded program in the US providing developmental therapies to children with various delays between the ages of 0 and 3 years. It is free or low cost to families, and you have a right to it if your child has a delay, and every family has a right to an assessment. However working through the bureaucratic process can be a bit slow, so it's worthwhile to start the process of setting up an assessment now and you can always cancel it if you don't need it when it comes around! This offer is open to anyone reading later who would like some help or hand-holding with Early Intervention!)
posted by Eyebrows McGee at 1:19 PM on April 1, 2019 [5 favorites]
I am not saying your child has a delay, but if you decide she might, all you're going to do is seek help. You're not going to label her or think of her as defective. You're going to work with a therapist to get some skills in coaching your kid to talk. You're already coaching her to talk. If you get an eval, you may end up with a professional giving you more tips so you can coach better. It takes awhile to get a ped appointment, testing, and then a therapist. There's really limited stigma around speech therapy, and all you're going to do is learn to play different games/activities with your kid. So if you have any concerns, just roll with it. I think you are within normal variation, but if you're in the same place at the next check up, in six weeks, other arbitrary point, ask for an eval. All it would do is help your kid.
posted by Kalmya at 1:45 PM on April 1, 2019 [2 favorites]
posted by Kalmya at 1:45 PM on April 1, 2019 [2 favorites]
Just wanted to say that I also live in ny and the EI intake process (at least in Westchester County) was incredibly easy. You make the phone call and things start happening.
The was it was explained to me: if your kid needs help it is better to start earlier rather than later. The entire process is free and my kid had speech therapy and his ability to communicate has improved hugely. Would it have done so without it? I have no idea but his speech therapist is great and I’m grateful for her time with the kid and her suggestions for me and the husband.
Before three years old it is fairly easy to set up, after three it is more complicated.
posted by sciencegeek at 1:52 PM on April 1, 2019 [2 favorites]
The was it was explained to me: if your kid needs help it is better to start earlier rather than later. The entire process is free and my kid had speech therapy and his ability to communicate has improved hugely. Would it have done so without it? I have no idea but his speech therapist is great and I’m grateful for her time with the kid and her suggestions for me and the husband.
Before three years old it is fairly easy to set up, after three it is more complicated.
posted by sciencegeek at 1:52 PM on April 1, 2019 [2 favorites]
We did EI in Chicago, for similar reasons, same situation with a very verbal older sibling. I highly recommend it. Super easy - a team of lovely people came over and spent a bunch of time with her. It actually turned out that she had a huge buildup of earwax in both ears, but nothing was seriously wrong. So maybe check on that at the pediatrician too? It can't hurt. We got that taken care of and soon after she started talking like she was getting paid by the word. And has not stopped since.
posted by true at 2:01 PM on April 1, 2019 [1 favorite]
posted by true at 2:01 PM on April 1, 2019 [1 favorite]
Ours said his first word at 19 months and added to his vocabulary very slowly. At 25 months one of his daycare educators was a little worried and asked us to write down all the words he knew. It totalled up to 60 words. A week later it was 150 words.
posted by the duck by the oboe at 2:12 PM on April 1, 2019 [3 favorites]
posted by the duck by the oboe at 2:12 PM on April 1, 2019 [3 favorites]
I didn't start talking until I was almost 5 because I couldn't hear. I had ear surgery, then could hear well enough to realize that all the noises people were saying to each other were WORDS. I quickly figured it out. One of my earliest memories is me realizing that my grandmother had been TALKING all these years.
I had to have a lot of special hearing training at Scottish Rite Hospital for several years, and my hearing comprehension has always been a bit of mess my whole life, but I've made a great life for myself and despite my hearing issues I'm a musician and I have great career and my life on the whole is awesome.
I don't mean to say that your child has a hearing issue, only to say that I am a person who didn't start talking until I was 4 years old cause reasons and that I turned out pretty awesome. In many ways I think my awesomeness is somehow due to my unique childhood. I didn't realize people were talking to each other so I had an incredibly rich inner imaginative world my first few years that shaped me in profound ways and has been a great gift in my "post being able to hear and talk" life.
It's normal to worry and fret and be scared and wanting to make sure that your child is okay and in every possible way. I hope that my story helps round out those normal and valid parent fears (I'm a parent too!) with some perspectives from a kid who was seen as "having a problem" that really turned out to be quite an enriching gift.
No matter how this turns out, you're already doing all the right things a parent does to give their child a great life, just remember that no matter what, your child is on their own journey and as a parent you are doing everything you can for them and they are lucky to have you.
posted by nikaspark at 3:04 PM on April 1, 2019 [5 favorites]
I had to have a lot of special hearing training at Scottish Rite Hospital for several years, and my hearing comprehension has always been a bit of mess my whole life, but I've made a great life for myself and despite my hearing issues I'm a musician and I have great career and my life on the whole is awesome.
I don't mean to say that your child has a hearing issue, only to say that I am a person who didn't start talking until I was 4 years old cause reasons and that I turned out pretty awesome. In many ways I think my awesomeness is somehow due to my unique childhood. I didn't realize people were talking to each other so I had an incredibly rich inner imaginative world my first few years that shaped me in profound ways and has been a great gift in my "post being able to hear and talk" life.
It's normal to worry and fret and be scared and wanting to make sure that your child is okay and in every possible way. I hope that my story helps round out those normal and valid parent fears (I'm a parent too!) with some perspectives from a kid who was seen as "having a problem" that really turned out to be quite an enriching gift.
No matter how this turns out, you're already doing all the right things a parent does to give their child a great life, just remember that no matter what, your child is on their own journey and as a parent you are doing everything you can for them and they are lucky to have you.
posted by nikaspark at 3:04 PM on April 1, 2019 [5 favorites]
It sounds like she is definitely communicating, even if she doesn't have many words yet. I agree that more age-appropriate books and a little more one-on-one focused attention (ie, without brother) might be helpful (there's a 4 year gap in my kids, and kiddo 2 talked later than his chatty older brother did - we still have to tell helpful older brother not to finish sentences, not to do things for his brother, etc.
But what i didn't see mentioned in your post was anything about hearing or hearing testing. I know that hearing is tested at birth (in CA at least), but sometimes speech can be affected or delayed if there's an issue with hearing. For example, a friend of ours discovered that their child had a lot of water in the ear; eventually their child had tubes put in, but in the meantime it caused a speech delay. You might ask for a referral for testing at the 18mo appointment.
posted by vignettist at 4:56 PM on April 1, 2019
But what i didn't see mentioned in your post was anything about hearing or hearing testing. I know that hearing is tested at birth (in CA at least), but sometimes speech can be affected or delayed if there's an issue with hearing. For example, a friend of ours discovered that their child had a lot of water in the ear; eventually their child had tubes put in, but in the meantime it caused a speech delay. You might ask for a referral for testing at the 18mo appointment.
posted by vignettist at 4:56 PM on April 1, 2019
There are four developmental domains: social/emotional, motor, cognitive, and speech/language. I was taught by a pediatric neurologist whom I respect very much (as in, if I had children who needed a peds neuro, I'd want them to see her), that delay in one domain is often normal; delay in 2 or more warrants investigation. Here are the CDC milestone checklists broken down by age.
If you have easy access to EI type services, an assessment may help either ease your mind or start therapy early, but chances are good that this is well within the range of normal.
posted by basalganglia at 5:19 PM on April 1, 2019 [1 favorite]
If you have easy access to EI type services, an assessment may help either ease your mind or start therapy early, but chances are good that this is well within the range of normal.
posted by basalganglia at 5:19 PM on April 1, 2019 [1 favorite]
Nth getting her hearing tested - I know several younger children with talkative siblings who got ear tubes and turned into chatterboxes themselves.
posted by mogget at 6:02 PM on April 1, 2019
posted by mogget at 6:02 PM on April 1, 2019
Best answer: Not a direct answer, but I think it’s important to address your assertion in question 2.
Based on the information you have provided, unless your child’s healthcare provider has told you otherwise, your child does not have a brain injury. A minor scull fracture with no complications is not a brain injury. Choking with no loss of consciousness is not a brain injury. I fear you may be blaming yourself for injuries that don’t even exist and I think it’d definitely be worth speaking to your child’s provider about these specific concerns.
posted by pecanpies at 8:02 PM on April 1, 2019 [7 favorites]
Based on the information you have provided, unless your child’s healthcare provider has told you otherwise, your child does not have a brain injury. A minor scull fracture with no complications is not a brain injury. Choking with no loss of consciousness is not a brain injury. I fear you may be blaming yourself for injuries that don’t even exist and I think it’d definitely be worth speaking to your child’s provider about these specific concerns.
posted by pecanpies at 8:02 PM on April 1, 2019 [7 favorites]
My daughter did not speak until 22 months, and was officially diagnosed with a speech delay, due to extreme prematurity and medical complications. At six and a half, she now has an enviable vocabulary and is "ahead". (And she's also super tiny, so she looks like she's four but she talks like she's ten and blows people's minds.) We had lots of physical, occupational, speech, and feeding therapy through early intervention, but the thing that worked best was for me to back off. First child + traumatic birth caused me to be hyperfocused on her. I knew her so well I was able to anticipate her wants and get her water before she asked, for example - why would she bother to learn to speak understandable words? A few days of me pretending not to understand got her talking in almost full sentences.
I agree with pecanpies that the situations you describe above are not brain injuries. I encourage you to check with her doctor about exactly what long-term consequences he or she would ascribe to the two (very scary!) situations you've experienced. Early intervention is a wonderful, wonderful program, and my daughter would not have the skills she has today without it. If your pediatrician thinks a referral is warranted, definitely go. But I would not be concerned in your situation (and I wasn't, when my son also wasn't really speaking in words at 18 months - he came around in his own time).
posted by peanut_mcgillicuty at 8:36 PM on April 1, 2019
I agree with pecanpies that the situations you describe above are not brain injuries. I encourage you to check with her doctor about exactly what long-term consequences he or she would ascribe to the two (very scary!) situations you've experienced. Early intervention is a wonderful, wonderful program, and my daughter would not have the skills she has today without it. If your pediatrician thinks a referral is warranted, definitely go. But I would not be concerned in your situation (and I wasn't, when my son also wasn't really speaking in words at 18 months - he came around in his own time).
posted by peanut_mcgillicuty at 8:36 PM on April 1, 2019
To add to the anecdata pile: my mom claims I only said occasional single words until nearly 3, after which I suddenly spoke in complete sentences. My kid was slow enough on talking (very similar to your child; lots of pointing and not many words or attempts) that we had some extended questionnaires from the ped and were just a smidge shy of the mark for getting early intervention, and they asked extra questions about that for a few more appointments. He just had some testing at school (at 8) and scored ridiculously high in verbal expressivity. What you describe is very common, it is very likely to be a moot point within the next 6 months, it is very unlikely to be due to the injuries you describe, but it is a totally valid thing to keep an eye on and bring up at your next ped’s appointment.
posted by tchemgrrl at 5:56 AM on April 2, 2019
posted by tchemgrrl at 5:56 AM on April 2, 2019
Anecdotal, but my son was not saying ANYTHING at 17 months except non-word sounds (dodedodedo and the like). At 18 months he finally starting saying a few words and by 20-21 months he had so many words that I couldn't keep track of them anymore. He has been a super clear talker with an excellent vocabulary ever since. Some kids just take longer to start but end up surpassing kids who started earlier. If this were my kid I'd keep an eye on it but not worry until at least 24 months.
posted by rabbitrabbit at 6:36 AM on April 2, 2019
posted by rabbitrabbit at 6:36 AM on April 2, 2019
Response by poster: Thank you, these replies have been very helpful.
(And her babysitter says she said up, down, and help in the last few days!)
posted by valeries at 12:11 PM on April 3, 2019 [4 favorites]
(And her babysitter says she said up, down, and help in the last few days!)
posted by valeries at 12:11 PM on April 3, 2019 [4 favorites]
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Our pediatrician said something along the lines of, "most/all kids can talk by the time they're 2 and walk by the time they're 2. Beyond that general guideline, there's huge variation." I have a friend who's daughter didn't really talk at all until ~20 months, then just started talking in full sentences.
I think it's impossible for anyone to answer you questions about brain injury without extensive tests, which are probably not warranted at this point.
As a fellow parent I really, really (really) feel your anxiety and empathize with your worries about an accident possibly causing a delay. However, I think it's much, much more likely that this is normal developmental variation paired with, perhaps, not quite as much talking as your older kid because the younger one is with a nanny.
posted by Betelgeuse at 12:12 PM on April 1, 2019 [12 favorites]