My youngest is almost 21 months and talks a LOT less than my oldest did so I've been feeling concerned. I'm not sure if it is just because I am comparing or because it is actually concerning... He has probably 35 words but about 1/2 of them are pretty difficult to understand without knowing him well. Like he says "da" for hot "shash" for trash and "sow-sigh" for outside. He doesn't say a lot of words that you'd think he would say like "up" or "eat". And he doesn't put any words together. He seems to understand a lot though. Does he still seem like he is within the normal range? Also, any suggestions for helping him acquire more words/speak more clearly?
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I highly doubt that he has any sort of delay. My daughter had much less words than that at his age, then hit 2 years and started using new words daily. She's 2 1/2 now and has a gigantic vocabulary.
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I think he probably just hasn't hit the language explosion yet. 21 months was about when my oldest hit it, but I think my youngest hit it later. By 2.5, he was talking up a storm, but definitely didn't seem as vocal as early as my older one. Give it a few more months, I think!
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At my DD's 2-year well visit, the question the doc asked was "does she have at least 20 words yet." So I would think your son is totally fine. (My DD had hundreds of words by that point but she was totally silent during the exam!)
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@travellingbee: I'd give it a few more months before worrying, but I had speech concerns for my son and by 2 he qualified for speech services. If you feel like he's still behind after a few months it doesn't hurt to follow through and get an eval through ECI or private therapy.
I noticed a huge difference in his speech compared to peers his age and still continue to notice a difference. Much of his speech is difficult for others to interpret even now at 2.5 years old whereas most other kids his age are speaking clear sentences.
My biggest advice is trust your gut! Our pedi wasn't concerned at our 2 year well visit but wrote the referral for the eval anyway. The therapist said that based on scores alone his receptive language is too high to qualify him but professionally she felt like he has oral motor issues that are affecting his speech and so our goals are to improve his oral motor skills, articulation and expressive language.
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A good rule of thumb that my doctor used was that at age 2, a stranger should understand about half of what a child is saying. At age 3, a stranger should understand about 3/4, and at age 4, 100%.
The biggest marker is using other kids as a guide. My son sounds within range until you hear other kids his age speaking, then you notice he has oral motor issues.
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@CatchAFallingStar: well it's not the number of words I'm concerned about but rather how hard it is to understand them. But that's good to know.
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@Adira: Hopefully so. I will wait until his 2 year appt and see what the dr thinks at that time...
@PawPrints: Yeah I think the number of words he can say is fine, I guess I'm worried about how unclear they are and that he can't put any together. That's good to know, though that they were asking for only 20.
@Boopers: Very interesting. I'll talk to his teachers today too about what they think compared to his peers. My only comparison has been my eldest who was/is very verbal. -
@travellingbee: I think when DS was that age DH and I were the only ones who could understand him. He had maybe 30ish words and only occasionally would string 2 together. Then his language explosion hit at 22 months and all of a sudden he was talking in sentences. Over time he's also become intelligible to other people. But every so often I have to interpret for my parents or other people. And he is well within the scale of normal.
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@ShootingStar: great! That's comforting
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@travellingbee: My son was similar at that age in terms of vocab and pronunciation and we never got that 18 month speech explosion everyone talked about. He had a bunch of ear infections and when they had him assessed by the audiologist prior to tube surgery, they said he had significant hearing impairment caused by the fluid trapped in his ear. He had the surgery done at 21 months and at 22 months, his hearing was declared to be in normal range. However, his speech was still fairly limited by age 2. Our pediatrician suggested we go ahead and get an assessment done by early intervention, since it didn't hurt to at least get feedback from specialists.
They came to our house and the speech pathologist worked with him for about an hour and while we ultimately did not get accepted (he needed to be 30%, or at that age, 8 months behind, but he was more like 6 months delayed), it was really helpful to know I wasn't being insane and that he actually WAS behind somewhat. They assured me that usually things even out by age 3, but that's why DH and I went ahead and put him in a full day 2's preschool program - so that he would be verbally stimulated by being around a lot of kids. The speech pathologist also gave us pointers and tips on how to speak to our son and engage him, told us what we were doing right, what we could use improvement on, etc. EI agreed that if there was a delay, it was better to get it handled now rather than get looped into the school system. So we made a plan, informed his preschool teachers, who were familiar with nonverbal/delayed kids, and we all worked collaboratively to amp up DS1's speech.
DS is now 3 and he's definitely within the normal range of speech for that age, although when I see him with his friends in class, he does seem to be slightly behind in expressive speech and isn't as good at stringing full sentences together as his much more verbal friends. But I'm super glad we were proactive and I am confident he will just fine by the time he's in kinder.
TLDR version: Have you checked his ears and either way, it doesn't hurt/cost anything to have EI come assess him.
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I would have him evaluated if it was me. I had similar concerns about my oldest and it turned out she was significantly delayed and we did 2 years of speech therapy.
Our Early Intervention program's motto is "don't worry but don't wait" and they recommend anyone with doubts can self-nominate their kiddo to be evaluated for services. They will evaluate all areas of development, not just your area of concern FYI.
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I'm also in the 'don't wait' camp. It does nothing but reassure you because you're doing something about it, and if they evaluate and say he doesn't need it, then awesome! But it's there if you do. It's true a lot (approx 70%) 'grow out of it' but for the 30% who don't, it can be a long road for help and services with wait lists. My son is in that 30% and has a suspected motor speech disorder. He was behind at 18 months and I am really glad I trusted my gut and not the million other people who told me to wait it out. He's almost 3 and improving weekly. As they say, you never regret calling but you might regret waiting (not to sound so dramatic!)
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My 2nd LO didn’t hit her language explosion until about 20 months. I think one of the big factors was that she was exposed to 3 languages on a daily basis. She also has a very talkative older brother and is very shy and reserved in nature. I probably wouldn’t be concerned until your LO is 2, at lot can change in a short time at that age. With my daughter, she went from maybe 30 words around 19 months to speaking full sentences in the space of a month.
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@muffinsmuffins: what did they consider behind at 18 months?
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@gingerbebe: yeah, he had significant hearing loss when we had his tubes put in at 11 months and I figured that's why he babbled late, but we had his ears rechecked a month ago and he's in the normal range for hearing now.
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@travellingbee: I'm in Canada so they use a tool called the Nipissing developmental screening for all well-baby checkups. Looks like the 18 month one requires 20 or more words that don't have to be fully understandable and at least 4 different consonant sounds. DS had maybe 3 words and mostly used the same sound (gah) for everything. He also rarely imitated us and preferred gesturing. The doctor said he wasn't concerned until 2.5 or 3 but the nurse practitioner made the referral to our public program anyway. We got assessed about 6 months later and have been in continuous therapy since (1.5 yrs) and will be for a long while as he has suspected apraxia of speech. Sounds like your LO is on track but I would still bring it up for peace of mind.
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Hard to say! If he seems to understand everything, that's a very good sign, but it's possible something is holding him back from talking that could be fixed with therapy. If you can get an Early Intervention eval, do it just in case! They're free and not too much hassle - but only for kids under three (at least, that's how it works here).
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According to my ped, your son would be just fine because mine is the same age and only has 10 "words" and the only two that other people can figure out. TBH though, I'm starting to get concerned about mine. He just started daycare, so I want to give him 2 months there to see if being around other kids and been in a more speech-rich environment will help.
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@mrs.shinerbock: I feel like they always minimize concerns like this.... but I did speak with his teacher yesterday and she thinks he's doing great compared to his peers and he's one of the younger ones so I'm going to chill for a couple of months and see what happens. If he still isn't making much progress by His birthday I'm going to get an evaluation.
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At our 2 year we'll visit our pediatrician expected my DD to have between 100 and 200 words. She didn't so we were referred for speech therapy. That was a HUGE help and within just a few months my daughter was right where she should be. She's now 32 months and I think she has between 500 and 700 words with new words added daily. If you're concerned bring it up to his doctor and she what they think.
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@travellingbee: Yeah, I would also recommend getting an EI assessment done before 3 years old because then you're having to go through the public school system. Its easier to do it before 3 and depending on your county, it takes several weeks or months to get the assessment set up. We live in a semi-rural county with a lower population and it still took us a little under a month to get the assessment done. Its free and it really doesn't hurt to try. Our son was borderline - he was 6 months delayed and needed to be 8 months delayed to qualify for service - and the EI folks told me that if his speech did not progress past where he was at the assessment in 2-3 months, they would quickly get someone out to assess him again to see if he would qualify for service at that point - meaning, they were willing and able to keep an eye on it so that he could get services as soon as possible. Everyone - his ped, his preschool teachers, the EI folks, the speech path from Easter Seals - all told me its SO much better and easier to get the supports in place before age 3 because its more efficient than the school system.
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I could have written this post 6 months ago.
DS1 was a super early talker. At 18m he could talk in 2-3 word sentences and by two he was clearly understood. We didn't realize he was unusual.
DS2 had maybe 5-10 words at that age, and only we understood him. We actually had him evaluated, and they said he was fine. Right at 2 he had a language explosion, and every day he said more and more, and easier to understand. He's now 26m and says a ton, and is starting to talk in longer sentences that are pretty easily understood.
Also, as the second child, I will say he hardly ever gets an opportunity to talk. His big brother NEVER stops talking lol
I'd just it a few months and then re-evaluate. I'm sure he's fine!
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@travellingbee: I'm also in the camp of, get him evaluated, why not.... It doesn't sounds like he's *too behind to me though, but if you're concerned I'd follow through on the eval.
My son is almost 2, we had him evaluated about 3 months ago for a speech delay and he ultimately qualified. The problem can be that they group expressive and receptive language together. My son's receptive language was excellent, but his expressive was poor. But the two combined put him at 'normal'. The people that do the evals say this happens a lot, and they are aware that their test is flawed when it was apparent that he was behind in speech. SO, they got him in through something else (can't remember) and we're moving ahead and doing well. Just go with your gut, it doesn't hurt to get evaluated. If services are needed, the earlier you start the better.
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I think it's within normal, esp if he can understand a lot.
As far as helping him with his vocabulary, narrate your day, read books, and do sensory activities. Sensory activities (spending time in nature, esp the beach) was the key to Olive's language explosion.
She was in early intervention because her receptive language was so poor and she didn't respond to her name. This is a post I wrote on it that might help:
http://www.hellobee.com/2014/05/07/the-best-things-we-did-for-dealing-with-olives-delays/
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