Early intervention for 18 month old's speech — The Bump
Special Needs

Early intervention for 18 month old's speech

I had a bit of an upsetting visit with DS's pedi earlier in the week.  He doesn't say a lot of words, but he babbles constantly and does consistently say bye-bye, ma, dada, baba (bottle), baby, and something that sounds like hello.  I think he has also said thank you, and touchdown, but the pedi said that it doesn't count if it was only a one or two time thing? 

He was a very early walker (about 8.5-9 months) and his motor skills are still above average, and his comprehension is great. If I ask him to get me a cupcake from his toy kitchen for example, he will get it, or if I ask him if he wants to feed the cat he will go get a can of food and put the can in the cat's dish.  He does lots of other things like that too, those are just two examples.  I mentioned all this to the pedi and she said she wants to see him back in a month regardless to to re-evaluate and if she doesn't see an improvement she wants him to go to EI.

I personally feel she is overreacting.  I was a late talker, and so was my dad, and DS clearly hears fine, has never had an ear infection, etc.  I requested a different dr at the practice for when he does go back, but what is your opinion?

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Re: Early intervention for 18 month old's speech

  • I also wanted to add that she gave him the standard autism screening test and afterwards she said she had "zero" concerns about autism.  He is very tuned in and makes good eye contact and interacts well with others.
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  • When a child understands what someone else is saying, it is said that child has good Receptive language.  When a child's speech is developmentally on target, it is said that child has good Expressive language.  It is possible for a child to excell in receptive language, but be delayed in expressive language. 

    It is also possible for a child to have an expressive language delay and not have autism.

    News like this can be difficult to take in, but if your child does have an expressive language delay, finding a doctor to tell you what you want to hear will not help your son.

    There is absolutely no harm in getting your son evaluated for EI. The worst that could happen is that your son recieves therapy until he is on par with his peers. If he truly is a delayed talker, as you and your father were, then it shouldn't take long for him to catch up. If, however, he does have a more significant delay, you will be giving him a headstart.

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  • image-auntie-:

    I think you're very fortunate to have a pedi who is so proactive about your child's development. A lot of parents here are up against docs who would dismiss a concern like this.

    I get that hearing something you weren't expecting is upsetting, but I think it's foolish to go defensive. When a child isn't hitting milestones in  one area and there's free help available to address it before it impacts him behaviorally or socially, it's worth exploring. 

    Sorry if I came off as defensive, that wasn't my intention.  I was just surprised that she had ANY concern about his speech, bc from what I have read and from other parents I know thru DS's activities he participates in, he is average with where he is at speech wise.  I was trying to find out from other parents on this board if they thought it was surprising that she even brought it up.

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  • And the reason I asked for another dr is bc the dr who said this to me is a new dr, she has only been practicing less than 2 yrs.  The other dr I will be seeing is the owner of the practice and Head of Pediatrics at the hospital, I felt it would be beneficial to hear her opinion, for my son.
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  • When my DD was 18 months she had fewer than 10 words and we had her evaluated for Early Intervention; she qualified for speech therapy based on her expressive language deficit.

    Pediatricians do their best but they aren't experts in all areas of child development; their training is in the detection and treatment of disease. Early Invervention has speech/language pathologists who are experts in speech and are best able to evaluate your child. 

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  • Like Auntie said, I wish our pedi had been that proactive and my son had a lot less words then your DS at 18 months. He also failed the autism screening and they still didn't want to refer us to EI for three more months.

    If your doctor thinks there could be a delay there is no harm in having an evaluation. It's free and it can be very beneficial even if your DS doesn't qualify. Even if he is just a late talker, a lot of late talkers benefit from speech therapy and catch up to their peers faster!



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  • image-auntie-:

    imageCocoBrynne:
    Sorry if I came off as defensive, that wasn't my intention.  I was just surprised that she had ANY concern about his speech, bc from what I have read and from other parents I know thru DS's activities he participates in, he is average with where he is at speech wise.  I was trying to find out from other parents on this board if they thought it was surprising that she even brought it up.

    I don't think it's surprising she brought it up at all. Given that he's doing so well with receptive langauge, cognition and motor skills it seems even more worthy of a closer look. Your pedi must feel his delay is significant because recent changes to Birth to 3 in PA have made qualifying for services around expressive language more difficult.

     

    Ihttp://www.psha.org/pdfs/OCDEL-letter-9-12.pdf

     

    ME, all the kids I know well- nieces, nephew, friends' kids and son- had at least 2 word phrases by this age. My sister's kids, my godchild and son all had sentenses by this age. DS scalded himself at 18 months and when his pedi asked what happened to him he was able to tell her "I spilled hot tea on myself".

     

     

    That is interesting to me, bc I have read that if a child is more advanced or focused on one or more particular area(s) that it's not abnormal for them to lag behind in another.

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  • image-auntie-:

    imageCocoBrynne:
    Sorry if I came off as defensive, that wasn't my intention.  I was just surprised that she had ANY concern about his speech, bc from what I have read and from other parents I know thru DS's activities he participates in, he is average with where he is at speech wise.  I was trying to find out from other parents on this board if they thought it was surprising that she even brought it up.

    I don't think it's surprising she brought it up at all. Given that he's doing so well with receptive langauge, cognition and motor skills it seems even more worthy of a closer look. Your pedi must feel his delay is significant because recent changes to Birth to 3 in PA have made qualifying for services around expressive language more difficult.

     

    Ihttp://www.psha.org/pdfs/OCDEL-letter-9-12.pdf

     

    ME, all the kids I know well- nieces, nephew, friends' kids and son- had at least 2 word phrases by this age. My sister's kids, my godchild and son all had sentenses by this age. DS scalded himself at 18 months and when his pedi asked what happened to him he was able to tell her "I spilled hot tea on myself".

     

     

    That is interesting to me, bc I have read that if a child is more advanced or focused on one or more particular area(s) that it's not abnormal for them to lag behind in another.

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  • imageCocoBrynne:

    I personally feel she is overreacting.  I was a late talker, and so was my dad, and DS clearly hears fine, has never had an ear infection, etc.  I requested a different dr at the practice for when he does go back, but what is your opinion?

    Full disclosure: I haven't read the other responses here ... just popping in and noticed your question.

    There is no harm in having your child evaluated.  Your pedi recognizes that speech development is not her area of expertise & she wants to ensure that your child receives all of the benefits he is entitled to.  If EI sees a delay that can benefit from services, there is no harm in accepting the services.

    My daughter is 19 months old, is saying only a handful of words.  She understands some of what we say, but requires visual cues, like pointing, to really get the point across.  I had to ask for a referral to EI ... my pedi would not have given the referral on her own.  Be thankful that your pedi is being proactive. 

    If your son does not need services, the EI evaluation will confirm that.  If he does, definitely take them up on it.  What's the harm? 

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  • It sounds like the pedi doesn't have concerns about receptive language but is mildly worried about his expressive language. I'd respect her professional opinion and get an EI evaluation if she recommends it. It cannot hurt!
  • imageCocoBrynne:
    And the reason I asked for another dr is bc the dr who said this to me is a new dr, she has only been practicing less than 2 yrs.nbsp; The other dr I will be seeing is the owner of the practice and Head of Pediatrics at the hospital, I felt it would be beneficial to hear her opinion, for my son.


    I think there are plenty of good "new" docs. Typically they know the latest research/information out there.

    Also, being the head of a department does not translate into a better doc. If anything he/she may have more duties in other areas paperwork, meetings and less clinical visits.

    The original doc could be wrong, but I find it refreshing that he/she is keeping tabs on your little one.
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  • EI is awesome. It's a person who comes to your house and their sole purpose is to give your kid one on one attention. I don't see any negatives!
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  • Get the eval.  Either they'll tell your son is fine or they'll tell he needs help but you luckily caught it early.  Either way, you win.

    I have two kids who started services for speech at 17-18 months.  My older child walked at 9 months and was ahead of her age for all areas she was tested in except expressive speech.  But she was far enough behind at that age to receive services.  DD was also not pointing to things or asking for things.  The coordinator who tested her used the words "strategic" and "deliberate" to describe DD at that young age.  The coordinator said she suspected DD would be one of those kids who just started talking one day.  Sure enough, after 6 months of ZERO progress in EI, DD literally started talking one day.  I left her with my mom while I had an appointment, I came home and the kid who had said maybe 35 words at that point was stringing multi-syllable words together.  Within 6 weeks of first talking, she was regularly using 7-8 word complex sentences and holding long conversations.

    My younger child had almost identical development to my DD.  They hit all the milestones at similar ages, except he didn't walk until right at 12 months, but still not that late.  He had a similar number of words at 18 months , was not pointing, etc, but was very high in self help skills and probably was not asking for a lot of help because he didn't need it, he did a lot for himself.   when he was tested for, he qualified.  Closer to 2 years old, I kept waiting for it all to click like it did with DD.  That never happened.  When he finally did start trying to talk a little more, it was a struggle for him to get the words out.  We added private speech and OT to the mix and it has been a long journey.  But at nearly 4yo, my kid is a huge success.  We still have some work to do on articulation and will probably do another intensive speech camp this summer.

     So I guess the point I am making is that at 18 months, my kids presented exactly the same.  They were both considered delayed in speech although ahead in most other areas.  Both started EI speech.  One turned out not to have a problem and the other did.  Either way, I 'm grateful for a program like EI that was there to support me when I needed it.  I am SOOOO glad we sought help early in both cases, I don't know where my son would be today without it. 

     

    ETA:  BTW, after the experience we had with my DD being a late talker, I was reluctant to call EI for my son at 18 months.  I was sure he would talk just like DD did.  I would gladly have just waited it out.  It was my DH who insisted we look into help for DS and DH got the ball rolling with our Pedi.  I pretty much only took DS for the eval at 18 months to prove to DH that he was wrong.  I guess the joke was on me.  Now I am so glad DH and the Pedi pushed me to take DS that early. 

  • I haven't read all of the responses yet, but I figured I'd chime in real quick. I switched pedis for the opposite reason (kept putting us off about speech concerns) and had both of my kids evaluated. I don't know if it's the same everywhere, but they came to our house and my kids had a blast. It was really not a big deal. My older son is delayed, but not enough to qualify for any therapy. If they think it's a good idea, go for it. If he doesn't need it, then you'll know for sure. If he does, my younger son (he's about the same age as your DS) loves his therapy! It won't hurt anything and it can only help. It was hard for me to take that step, but I'm glad we did. 
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  • Your son sounds like my son. He had about that many words at 18 months and walked at 8.5 months. At three, he still requires speech therapy due to articulation. He has had it since 1.5.

    You're correct in thinking many kids who hit gross motor milestones early talk late and it's perfectly common. I had a similar experience in my family history--all my grandmother's children talked late. I didnt talk until three; nor did either of my cousins. The issue with me is I had an actual language disorder that caused my delays so I didnt just catch up naturally with time. I started kindie at a great disadvantage since I couldn't interact socially because my language was difficult to understand. It took until third grade until I talked properly. If I had early intervention available to me, I would have likely been at the level my peers were at.

    Take the help. Many language disorders present without a receptive language delay. No matter how qualified a pediatrician does not have the knowledge that a speech pathologist does in regards to language development.

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