No words at 18 months

takmjs

I'm also posting this on the January 2012 and March 2012 boards, since those are my daughter's actual and adjusted birthdates. I apologize this will probably be long...

My daughter was born at 30 weeks. She passed her infant hearing test with no problems. She has not said a single word, and she's now 18+ months (16 months adjusted, but our speech therapist said they don't adjust age for speech beyond a year)....so that makes her 18 months in the speech world. Anyway, we had her in the county's birth to 3 intervention program last summer just to see if she was on track. She was, and they released her at about 9 months actual age.

Since she hadn't said a word, I asked them to come back and do another eval on her, which they did a few weeks ago. She's also not walking yet (she's starting to stand on her own in the middle of the room for a second or two, so I think she's close), and she qualified for speech every 2 weeks and physical therapy every month. She tested at a 20 month range for comprehension, but an 11 month age for expressive language. They'll be doing our first speech visit next week.

We had our 18 month check-up with the pediatrician, and she suggested we get a hearing test done. I agreed, even though to me, if she has comprehension at a 20-month level, she must be able to hear us, right?! We just got back from the hearing test today, and they said she could hear the medium range, but didn't seem to hear the low or high range sounds. She was antsy and not wanting to sit after a while and was distracted by the moving animals they wanted her to hear/look at, so the tester said it could be that, or there could be an issue. She wants us back for a retest in a month.

When I'm talking to someone new and mention I have a daughter, their first question: "how old is she?" Almost everyone's first comment when they hear how old she is, is "oh, that's a fun age. She must be walking and talking all over the place, huh?" I'm starting to feel like I've failed her, and I feel embarrassed to have to say "no" all the time, but I don't know what else to do.

I'm wondering if anyone else has had children with any hearing issues or speech issues similar to ours (NO words at 18 months), and what you did about it, and what worked well. Should I push for her to be seen again sooner than a month? Or am I just being a paranoid mom?

epapcun

Try not to be too discouraged. Speech and language development takes time, and your daughter has the advantage of having comprehension skills within the typical range. I'm a speech pathologist and work with plenty of preemies and kids with global developmental delays. Now the adage (in the speech world) doesn't always hold true, but very often we expect "late walker = late talker." This is largely because the brain often focusing on major developments one or two at a time, starting with easier, gross motor developments. Speech is complex, fine motor movement, and is often attained after some of the big ross motor developments. Again, usually, not always. If your daughter has some other anatomical or physiological reason why walking or talking is more difficult for her, then this expectation for order of development obviously is null. Hopefully she just has a little catching up to do in both areas. Does she make any sounds or babble? Or seem to "talk in her own language" without any discernible words? Is she interested in imitating speech and nonspeech (environmental/play sounds)? Does she watch your mouth when you're practicing sounds with her?

In regard to the hearing assessment: Did the audiologist provide you a copy of her audiogram results? If so, did they outline the "speech banana?" Generally speaking, if she's missing out on hearing the very high frequencies, like 8000 (which they do test), she is not really missing out on speech sounds. High frequency sounds, like /s/, /f/, and "th" are really more in the 4000-5000 Hz range. She will miss out on more speech sounds if she truly does have a hearing loss between 250-500 Hz, but not so much below 250 Hz. Don't fret too much; the re-assessment may yield different, more accurate results. 

Rest assured that you have not failed your daughter in any way. Just provide her plenty of love and stimulation, and she will gain these skills in time. Hopefully you'll start to see more progress as she continues therapy. Once she achieves some of the basic skills for the more challenging tasks of walking and talking, the more fine tuned skills will build upon and follow. Good luck!

Mrs. Alice

My twins were 28 weekers and started ST at 20 months because they had little to no words or comprehension.  That's great that she scored so high for comprehension!  We never did do a hearing test though since they seem to not have a difficulty hearing us or things.

We went through Early Intervention and it was mostly them checking progress and demonstrating and teaching us things to do with them to help develop their speech.  Since they started at such a low level we really just focused on them mimicking sounds.  Once they started doing that, the words began coming. 

They know several words but still struggle with communicating their needs and they still are not comprehending very much.  But they've made a lot of progress over the past few months.  I definitely know how hard and frustrating it is for your child to be delayed in development.  I have times where it really gets to me but for the most part I just have to accept that's our situation now and they have proved to us that they just do things on their own time frame sometimes.

takmjs

epapcun:

Does she make any sounds or babble? Or seem to "talk in her own language" without any discernible words? Is she interested in imitating speech and nonspeech (environmental/play sounds)? Does she watch your mouth when you're practicing sounds with her?

In regard to the hearing assessment: Did the audiologist provide you a copy of her audiogram results? If so, did they outline the "speech banana?" Generally speaking, if she's missing out on hearing the very high frequencies, like 8000 (which they do test), she is not really missing out on speech sounds. High frequency sounds, like /s/, /f/, and "th" are really more in the 4000-5000 Hz range. She will miss out on more speech sounds if she truly does have a hearing loss between 250-500 Hz, but not so much below 250 Hz. Don't fret too much; the re-assessment may yield different, more accurate results. 

Thank you for your reply. I feel better after reading everyone's responses.

She is making some sounds, but doesn't mimic me at all. Most of the time, it's just "uh, uh" grunting and pointing. She's done a couple animal sounds and car sounds, but it's mostly either "mmm" or "ugh." She does watch my mouth, but she doesn't imitate it at all any more. She used to try, but it always came out "bah, bah." She doesn't use "b" sounds any more. 

The audiologist did not give me a copy of the report. It was just a behavioral assessment with them watching her through the glass, so I can't imagine they have anything for me to see on a report/chart. Do you know if they would from that? They asked if she minded her ears being touched, but I'm not quite sure how I'm supposed to know that (am I supposed to pick at her ears all day?), so anyway, they barely touched the tip of the ear probe (like an earplug) on her ear, and she turned her head, and the woman said, "uh, nope, not today." I was disappointed that she barely tried. Between now and her next test, I'm supposed to touch her ears a lot so she's used to having her ears touched. 

takmjs

BostonKisses2:

Can you try to talk to your service coordinator and push for therapy once a week if you think it'll make a difference?

I'm not sure what to say about pushing to get her hearing checked sooner.  It almost sounds like they want to wait a bit in case there's fluid in there so they can give it time to drain.  Did your pedi check to make sure there isn't an abundance of fluid in there? 

I could ask for therapy once a week if I feel like biweekly isn't making enough of a difference. I really like our speech therapist, and I was surprised at how quickly my daughter warmed up to her. She taught us a couple signs, and my daughter's starting to do the 2 she taught us, so I looked up a few more before she comes next week.

My daughter's never had an ear infection, so I didn't think the fluid would build up, but I could definitely be wrong. The pedi did not check her ears, from what I remember. 

takmjs

M&MHaveMyHeart:

DS is 23 months & has NO words. He's been in the EI program for about 2 months with not much progress. He talks gibberish & is just vocal. 

We're going to see if he has the infamous 2 year word explosion but for now, I guess we just have to wait. Hang in there. 

I'm hoping for the 2 year explosion (or sooner) as well. I get a lot of stories about how "my niece/nephew/son/daughter/grandson/etc. just started talking magically one day." I keep waiting for that, but I'm doing what I can in the meantime just like you are.

Good luck for your DS, and I hope the EI program works for him to start saying a couple words. (I'm most anxious for "mama" and "dada.") It's nice to know I'm not the only one currently in this situation. People I talk to have already had kids overcome it, but I'm glad to have this group to have people going through it now.

damabo80

DD said her first word at 24m/22m. She is now 26m/24m. When she was tested at 19m/17m, she tested at 17m for understanding and 7m for expressive language. 

She was in speech therapy from 19m-22m actual, but imho it didn't do anything other than cause her have tantrums for 30 minutes every week. And I was OOP for it because insurance doesn't cover it. So, I cancelled it and am letting her progress at her own pace. If she's still behind at 3y, then I'll put her back into ST, but it seems like most kids who are "behind" in expressive language make leaps and bounds between ages 2y-3y. Just in the last month, she's acquired about 30 new words, so there was a definite explosion in language around the 2y adjusted mark. Now, her favorite game is pointing pictures out in a book and either saying what they are or having me say what they are.

takmjs

That's great to hear about your daughter. It sounds like she's talking up a storm. Good for her!

Thank you for replying!

DrRx

My daughter is almost 18 months old actual (14.5 months adjusted) and has no words.  She has a ton of gibberish, which sounds a lot like language in that she has different intonations and "words" that begin and end.  We get EI once a week and "words" is currently one of the focuses.  We are trying to work with her on signs, and on some stuff to make her repeat or say (ie, hold the ball up to our mouth and say "b-b-b- ball" and then give her the ball). 

A has started pointing at things and grunting/making noise when she wants something, and we are working really hard at trying to get her to say "more" or sign "more" or "please" when she does this rather than just giving it to her. 

SweetPeaKate

My DS was born at 30 weeks and is currently 20 months (18 adjusted). I think regardless you still need to adjust for speech mentally. He will say 2 words consistently...dada and ya-ya (our dog). I will occasionally get some form of momma, but it's not common. This just happened in the last month or two. We are following up with EI and I have a feeling he will qualify this time around for speech. He tested too high the first time around to receive services. I do have a friend with a full term 21 month old boy who didn't start talking until 18-19 months and now at 21 months he is using phrases. At some point I'm guessing we will have to check his hearing if nothing improves, but some kids are just late bloomers and being only 16 months adjusted, I would say she's got some time to grow especially since you've done what you can do (hearing test and EI). Just keep doing what your doing and have patience with her. (I'm a good one to talk, I'm secretly starting to worry about my son's speech, so I'm trying to remember this myself!)