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Could you have him evaluated by birth to 3 in your state? It's usually an easy process and they come to your home.

@brownie: I had concerns about my sons speech. I called ou birth to 3 hotline number and they asked me a series of questions. I could tell the woman on the other the other line thought I was nuts for calling, however they did have a therapist call me. She asked me a series of questions and said that she felt like he was on target, but they would come out anyway.

It was a very easy process and gave me peace of mind. When they come out for the evaluation they tell you at that point if they qualify for care. It can't hurt, and you can probably get the answers you're looking for.

Ellie was delayed, but caught up remarkably well. She was never referred on to EI; I sort of wish she had been (for my own peace of mind, not because she has any lasting effect from not getting services). I think if you feel worried, it might be reassuring (at least) and helpful to have someone from EI evaluate him and give an opinion. She was speaking very little at age two; mostly still two word "sentences" and seemed to have regressions earlier-- so had the word "up" in her vocabulary at 14 months, only to have it vanish altogether at 18 months. I know it can be really concerning as a parent.

My daughter was evaluated by EI at 2 yo and while they said she had a speech delay, they said it wasn't bad enough for state services. So I took her to a private speech therapist instead. She sounded a lot like your LO at that point. Receptive was strong yes, but not so much her expressive. I knew that even if her case wasn't very grave, that therapy would still benefit her, so why not?

When she was 3, I could still see she was behind a little. She would improve, but at a very slow rate. Never saw "word explosions" during that year, which many parents speak of.

So at 3, had her evaluated for state preschool services, and she qualified. A speech therapist went to her school twice a week. She made major improvements that year, but still was always a bit delayed.

At 4, we moved cross-country and state services continued after a few months of a break for our family to get settled in a new neighborhood. After about a year in Pre-K, her language caught up to her peers, but we were still working on articulation.

At 5.5 now, still working on articulation. Also, now that we are in Kindergarten, we are realizing how her speech delay affects literacy... It's an ongoing work in progress, but I keep seeing improvements and I know she'll catch up even more in the coming years. I expect to continue her therapy til at least 7 yo.

The first step is an evaluations, whether state or private... I don't think it would hurt to establish a baseline to see where your LO is at. Good luck!

@brownie: I see you're in California; as am I. In my area, we have SARC-San Andreas Regional Center. They handle services like behavior, speech, and occupational therapy, and have clinicians on staff for diagnostics, assessments, etc. I would think that you have a very similar umbrella system in Southern California, but I'll look into it when I'm back home and see if I can come up with better info.

I work in behaviorism/special education and am well versed in speech delays. I'd definitely start with your ped, and see if you could get a referral to a respected SLP in the area.

@brownie: I've worked in the private and public sector and even when the public sector won't qualify you for services, the private can usually get at least some sessions paid by insurance. If that is what happens (you only get approved for minimal services) don't be discouraged; there is a ton of stuff parents can do once they get the basic info from an expert. Ask for detailed explanations (handout, ideally) of what sounds/phonological processes they are targeting, where the articulators need to be to produce that sound, and what kind of cues can you give you child to support them in using their best speech.
Good luck!

My son is almost 3 and we're in the process of deciding what to do...birth to 3 is a joke where I live, the most they can do at this point is refer him to a preK program in the public school system, so we're going the private route.

The best speech therapists are all independent (meaning they do not accept insurance) and navigating that has not been fun.

Just two other points, bilingualism in itself does not cause speech delays (if you think about it, kids in that situation have more options for words, so they actually can choose from a larger pool) and the issue isn't just the words...it is often oral motor. This was eye opening for us, because it stems from the teeth and jaw strength. There are a ton of exercises that kids can be taught to strengthen the oral area, which will help them form more sounds/letters/words.