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21 Month old speech delay?

post #1 of 19
Thread Starter 
background info:

I know my daughter is very intelligent.
She signs many words.
She walked at 19 months.

My daughter is 21 months old and doesn't say too many words yet. She can say "hike, east, happy, hi, bye, hay, uh-oh, mum, dad" She knows many animal noises. She has better than average small motor skills for her age. She doesn't use sentences but she will put sign language words together. For example, she'll tell me 'book' and then 'sleep' if she wants to start reading books and then go to bed. I have been taking her to storytime and doing my best to encourage her to speak. Is it time to call in a professional speech therapist?
post #2 of 19
Your DD sounds a lot like my DS at 21 months. He had some words (maybe 20ish) and lots of animal noises. He didn't really sign at all though. His speech didn't take off until after he turned 2, and now he talks all the time. I hear new words every day from him. I personally wasn't worried about DS's speech then- he understood most of what we told him and could follow simple directions. At that point I think he was concentrating more on his physical milestones.
post #3 of 19
My daughter is almost 23 months and it's only in the past month really that I've noticed her language starting to take off. Before that, she literally knew 10 words, and a few animal sounds, and no signs. But now she's starting to put 2 words together and is repeating everything we say. I really don't know many kids your daughter's age who have great language skills. I wouldn't worry about it at this point!
post #4 of 19
I'm a special education teacher and I wouldn't worry yet as she is using signs to communicate her needs.
post #5 of 19
It sounds like she's developing language, and you are doing a great job encouraging it.

However, if you are concerned, you could talk to your pediatrician, who could refer you to an early intervention program. I worked as an early interventionist for several years, and I had a lot of almost 2 year olds with language delays getting services. Some very minor delays, some bigger. Services were typically a home visit with either myself (in situations where the language development evaluation found only a minor delay), or with a speech therapist (for a bigger language delay) working with the child and the mom (usually the mom, sometimes the dad) to demonstrate some simple things to work on to encourage language development. The child's language development was evaluated with a screening test and we also always did a hearing test, since that can also affect language development. Many of my kids had chronic ear infections and/or had tubes. All services were free of charge, and it's all play-based. Very fun for the kids, actually! Frequency of visits depend on the need of the child - if a delay was very minor, I might check in once a month to see how they're coming along, if the delay was a little bigger, I might do weekly visits. A lot depends, too, on how concerned the parents are.

A bit of a long-winded response, but maybe it'll help to hear how the process can go (at least here in my state). Hope it helps.
post #6 of 19
Thread Starter 
Thanks for your responses. I've been considering early intervention, which I now have a better understanding of :-) but 1: I don't want to overwhelm her with a new person and a new activity or cause her to go to the dr. any more often than she does already because she's terrified of it and quite shy and timid and 2: while my husband realizes there is a delay, he feels it is nothing to worry about at this point. I think after reading these responses, I'll go with my first plan which is that if I'm not satisfied with her language skills at 2, I will consult our pediatrician and early intervention program. Thanks again.
post #7 of 19
My dd is in EI for delays, and is having her yearly IFSP meeting next week. Before the meeting, her therapists evaluate all areas of development, including speech. All of her signs were counted as words.
post #8 of 19
Yup, that's something to remember. Language development at this point, if you're counting "expressive vocabulary", includes words AND signs. And since she does have quite a few spoken words, it's probably unlikely that there are hearing issues at play.

I have a friend with a toddler who didn't have any words at 12mo, this was odd for her since her previous 4 were chatterboxes. She asked her doc, who said he doesn't even ASK parents about speech development until they are 2.

In other words, anything under 2 is still within normal range.

My DD started a few spoken words around 15-16mo. By 21 mo she had maybe a couple dozen. It was around that time, shortly before age 2, maybe 22-23mo, she went though a CRAZY spurt, literally adding 3 new words to her spoken vocabulary every day!

We had never been concerned about her "later" development, since she had well over 100 signs, was obviously developing normally otherwise, and had great receptive language skills too. Plus, my little brother was one of those who didn't say a word until he was 3. Our parents were starting to consider some kind of therapy, when he started off with full sentences, all at once. And he grew up "just fine".

So while I agree that IF you're worried, it can't hurt to get an evaluation, it sounds like you probably don't need to be worried. 21mo is still young, is still within the normal range, and she seems to have good indicators that things are "normal" in terms of hearing and language comprehension.
post #9 of 19
A friend went through this recently with her DS, she was told that they wouldn't be concerned as long as he was saying SOMETHING by the time he was two. And yes, signing counts. (He didn't sign). One day it all just came together for him and he's at or above where he should be now.
post #10 of 19
my 22 mo old says NOTHING but will follow detailed directions and use 2-3 signs
post #11 of 19
I wouldn't worry yet - especially if she is 'understanding' language. My daughter said 'mama' at that age, that's IT. Seriously... I was flipping out when I saw kids half her age saying more.

A little after age 2, she started talking and using 3-4 words at once - one day she just came up to me and said 'mama can I have a drink' for example, and she didn't look back. She NEVER really used one word for anything.

At almost 5 now she's a huge chatterbox And interestingly enough, I see some of her peers, who were talking MUCH more than she was at that age, having some language delays/development issues now and having trouble pronouncing letter sounds.

I'd wait until she is around 2 - I know it's hard, but if she is understanding you then it seems that there isn't a cognitive delay, she can hear fine, etc - a lot of language issues at that age are due to hearing problems as well, which it doesn't seem like she has.

I feel for you because I was there and I know how it feels - but try to wait just a few more months. If you are still worried, take her to a well-check at 2 and bring it up then, see what the ped. says.
post #12 of 19
I'm a pediatric SLP here, and normally I tend to encourage parents to get evals, just to be safe.

But I would agree with the PPs who have noted that, at her age, the # of words she has includes all spoken words, labeling sounds (such as knowing animal sounds) and signs. So I would guess that your DD isn't behind at all in terms of # of words. And if she is already combining 2 signs, then she is on target in terms of language development.

Also, both my kids signed in the beginning, and, while they weren't slow to pick up speech, I did notice that they were VERY late to start saying the words that they could sign. My son could sign "more" at 9 months, but didn't say it till around your daughter's age. He was using lots of other speech words, but didn't trade the spoken "more" for the signed "more" for the whole time. He did this with most of his signs. Though I didn't teach him a ton, so maybe he would have done it even more if he had been a more dedicated signer.

I think you are good to wait until 2, and then explore things then.
post #13 of 19
Thread Starter 
Interesting thing happened to me the other day-

I was at the library and my daughter handed this woman a book and signed for her to read it to her. When I explained to the woman what she was doing, she told me she was a SLP and allowed me to pick her brain about our situation. She did a couple "tests" to see if my daughter could hear her and understand her without looking at her and she said she didn't think I had anything at all to worry about. I feel much better now, and my daughter has picked up a couple words in the past few days- though she will only say them if you ask her to. :-) She's also picked up a few more signs. I feel comfortable now with where we're at. Thanks for all your help everyone!
post #14 of 19
I also work in early intervention in the northeast. From your description, I would not worry at all. She does seem to have a good vocabulary of words, and is using lots of signs. Her receptive language seems absolutely intact. All children develop these skills at their own pace, typically in a timespan from 12 months to 27 months for early language development. She is right on track. It sounds like you are very involved and give her lots of opportunities to express language/signs. She may have been very focused on getting the gross motor down (walking) and now is having a little more time to focus on language....usually babies/toddlers need to focus mainly on one and the other comes a little later.

As an OT, however, she did walk somewhat later (but still in a normal spectrum). Is she a small baby? I have found that strength sometimes leads to a little later walking in smaller girls.
post #15 of 19
I guess I have some similar concerns as the OP. My ds is 20 mo but only says mama and dada. He points a ton, waves in his own way (like rubbing his thumb/forefingers together) but doesn't say bye bye, understands and follows commands, loves books and can tell us what we wants quite well non-verbally, but isn't interested in speech. He is incredibly physical, and has been for some time (walked just before 1 year, climbs and runs like crazy). If he's been working on the physical stuff for so long, at what point do I worry that he hasn't started to concentrate on the verbal?
post #16 of 19
To be honest, I'd give him until at least 21 months. He does have words. I see many (particularly boys) that don't express language until around 2 years, so your son is a bit ahead of the game. Does he make any mono or multi-syllabic expressions/sounds?
post #17 of 19
cool, free eval!

Isn't the worry point if hearing seems fine that the child has no words at all at 24 months?
post #18 of 19
Originally Posted by sapphire_chan View Post
cool, free eval!

Isn't the worry point if hearing seems fine that the child has no words at all at 24 months?
The general rule is that a child should have a minimum of 50 single words and some 2 word combinations at 24 months. This does not include "Thank you" or anything else that was likely memorized as a chunk.

This does not automatically mean that a child below that point will qualify for EI services, or that they will never catch up, but that they are not hitting speech milestones with their peers. If nonverbal communication and receptive language seem fine, it is a better sign for a child with an expressive speech-language delay, but it doesn't mean there is no delay. I know that our school and EI tell every parent of a child with a speech delay to get an actual hearing test, since there can be subtle issues due to fluid that are difficult to notice in small children.

There is a huge language explosion between 18 months at 24 months. An 18-20 month old with a couple words and effective gestures is right on track, but by 24 months they really should be switching over to verbal communication.
post #19 of 19
Originally Posted by ehunter27 View Post
To be honest, I'd give him until at least 21 months. He does have words. I see many (particularly boys) that don't express language until around 2 years, so your son is a bit ahead of the game. Does he make any mono or multi-syllabic expressions/sounds?

My son says lots of syllables like da, ma, ba and lots of non-verbal sounds like mmmmmmmm! if he likes something or he grunts if he wants something. Does that help?
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