Parents of late-talkers - let's talk!

[mamandedeux]

I keep seeing threads pop up about toddlers not talking, so I was hoping we could ''consolidate'' some info in this thread here. It was actually a thread here that made me question my own child's speech, and we recently got an evaluation. He was tested at 20 months, and scored at the 12-month level in expressive, and 30-month level in receptive. The SLP didn't feel there was anything ''wrong'' with him, but he still hasn't gained any new words in the last two months. I thought maybe we could share what others are doing to help speech along, and what the results have been.

Here's what the SLP suggested doing:

-repeat every word many times over, and focus only on one word at a time (e.g.: You want to go DOWN? Down? Down. Down. Go down. Let's go DOWN.) until he repeats it, then offer praise.

-encourage gestures and signs, but don't allow child to communicate solely with them. For eg., if DS signs more, I'm supposed to get him to attempt to say it before I accept it.

-withold some things until DS makes an attempt at vocalizing. So even though he signs truck, makes a driving gesture, pushes me to the shelf, I'm not supposed to let him have it until he attempts to vocalize. 

None of the above is really working. Because he understands so much, he looks at me like I'm dumb when I repeat myself and he just says yes (Me: Down? DS: Yes. Me: Down, Down, we go down. DS: yes, Yeeeeessssss!!!!!!).   

He has about 20 signs, and will NOT attempt to say words at all when signing. He gets mad if I try to push him, like he knows I understand, so I should comply.

I am very uncomfortable withholding things, so I haven't pursued that very much. The SLP said to not do it with food or cuddles (thank goodness!), but still...

Anyway, any thoughts would be welcome.

DS is 22 months today and has about 15 words. He's also very social and babbles constantly, just not coherently. He also has some inner ear fluid (failed tympanogram - type B), but passed the hearing test. He has no other issues that could suggest apraxia or autism, although I don't want to rule those out solely based on one SLP's assessment.

TIA!

[fizgig]

Our son is a late talker though he also has a receptive delay which makes therapy very different.  We've been trying to understand what is going on with him forever now (he is 30 months and at about 14 months receptive and expressive).  Like you son, we are pretty certain our DS isn't on the spectrum which has actually made it a challenge to get good info since so much of the therapy out there is geared towards kids on the spectrum.

I will say that I've done about a million tons of research and the kind of "withholding" therapy that calls for ignoring other forms of communication from your child can hurt more than help in some cases.  My own gut reaction to the Speech Therapist that suggested withholding was like yours.  I was suspicious and so I looked further into it.  According to my research, what you are talking about can work for kids who don't have the "will" to communicate (very withdrawn or those on the spectrum who don't make the effort).  However (!!!) it can actually hurt kids who are already trying to communicate - especially if you can clearly understand what he is signing, etc. 

The theory being that what you are teaching him is that his attempts to communicate are not being heeded which might actually just cause him to communicate less in general.  The opposite of what you want!  I highly recommend a book called Play To Talk by Jim McDonald - it has opened up a whole new level of communication with our son.  It is all about recasting, talking at their level, fostering a sense of back and forth interaction.  We found a new therapist who works with me and doesn't believe in withholding (she is actually training me in what is called the Hanen method which helps ME become the main therapist for our DS.)

There aren't very many resources for late talkers who are not on the spectrum but there is a group (Natural Late Talkers) that has been really helpful for us as we try to work help our DS talk more.  Hope that helps!  I would love to hear more from other late-talker parents :)

[APToddlerMama]

Originally Posted by mamandedeux 

DS is 22 months today and has about 15 words. He's also very social and babbles constantly, just not coherently. He also has some inner ear fluid (failed tympanogram - type B), but passed the hearing test. He has no other issues that could suggest apraxia or autism, although I don't want to rule those out solely based on one SLP's assessment.

My son has a speech delay as well and I used to work in EI too. There is no way in a million years I would do what your SLP is suggesting in terms of withholding things.  I think that sounds super old school and cruel.  I would listen to your gut and do what you feel comfortable with.  If you feel like you can encourage him to vocalize without ignoring him or putting too much pressure on him and frustrating him, I might try that a bit, but not refusing him things if he won't vocalize. 

Have you seen an ENT?  Fluid in the inner ear is a really common cause of speech delays.  Several kids I had on my caseload had tubes placed in their ears and their speech really took off.  The fluid can make things sound like the kids are listening to speech under water which will obviously impact what they learn to say.  If you haven't yet seen an ENT, I would do that for sure.  It can be such an easy solution.  Good luck mama! 

[mommy212]

Subbing- 22 months DS has 10-15 words, but is very good at understanding . He has never been evaluated or anything. He mimics words a lot lately but doesn't remember them or use them later.

[petriescz]

Great idea for a thread! My son is 33 months currently. He is receiving speech and OT once a week from early intervention and speech twice a week from a private speech therapist. His diagnosis is motor speech disorder, dysarthria(weakness) and possibly apraxia. His receptive language is above average, his exspresive. Is right about average but his intelligibility is the 3 rd percentile. He talks in sentences and has a good vocab but is extremely difficult to understand.

At 15 months he had 3 words. He nevere babbled. At 18 months he had about 10 words and a few 2 word phrases like, "i did it". At 24 months he had about 30 words and some 2 word phrases. He started speech at 27 months against the advice of our pediatrician. I decided why should we wait when i knew something was wrong. He is now talkling up a storm and therapy has been very good.

On the other hand my 4.5 year old son had the exact same development until 22 months. No babbling, little words etc... Bt then started talking in clear sentences and never stopped.

It's so hard to know if they are just late tallkers or if something else is going on. It can't hurt at all to get an evaluation from early intervention or a private slp.

[Peony]

So glad to see some others. DS1 is 2y4m, has been in weekly speech therapy through EI since 19 months. At this point he still only has 25 words or so, 3 signs, he does try to mimic others at times. He has some other things that make me wonder about him, he tends to live in his own world, we don't always know how much he understands but yet when he wants to, he will fully engage strangers and be this friendly little boy. Other days, he will wander around the house not making a sound for 5 hours.  EI doesn't say much other then he is making great progress. 

We just today got into a private SLP for her to do an eval. Perfect timing because our EI therapist was injured this week and is unable to work for a while, they have no back up therapist and have no idea when his services will be able to resume. 

[mamandedeux]

Thanks for sharing, mamas. It is good to hear that progress does come. Although I don't feel his lack of speech is holding my DS back at all, my biggest fear is that he'll realize at some point that he's not being understood by others. So far, he doesn't seem frustrated by his lack of words, and seems to communicate very well through signs, grunts, head shakes, pointing... etc. Have any of you dealt with frustration? How did you handle it?

I'm glad that I followed my gut on the withholding approach. I suspect it wouldn't work, anyway.

Another question: do you tell strangers that your child has a speech delay, or do you just act as thought nothing's wrong? I ask because sometimes people will ask him things like ''what's your name?'' or other silly questions (that honestly, I don't think too many 22-month-olds could verbally answer). I usually just answer for him without saying anything else.

Thanks!

[fizgig]

Our DS is just starting to experience real frustration so I'm not sure how we will best handle it.  He is verbalizing a lot and we sometimes just can't figure out what he is saying and he looks at us like we are kind of slow :) 

I generally don't mention his delay unless there is a reason (they are asking him questions and getting insistent, etc).  I've realized that most of the time no one even notices and I'm making a real effort to not make it a big deal for anyone (especially him!).  There have been a few times at the park where I've explained to get someone to leave him alone since people sometimes take it personally when kids don't respond to them.  Right now we are actually starting to have to deal with other kids talking to him and they don't seem to understand.  I'd be curious to hear if anyone else is dealing with that issue.

[Peony]

DS1 rarely exhibits frustration, maybe it just hasn't appeared yet. I never know with him. When people ask him questions, I just respond for him and sometimes say he is quiet boy or can be difficult to understand or say nothing at all about him not responding. 

[chel]

My dd is 20m and just put two words together, "no mama".. Not my ideal phrase, but she only has a handful of words so not much to work with. So far we're in a wait and see.

[voca]

At 22 months I am pretty sure my daughter had less than 15 spoken words, though she probably had upward of 30 ASL signs at that point. Now at 25 months I have lost count of both words and signs, and we get lots of two-three word phrases. She can do more than three words but it seems to take a lot of effort, signed sentences are more common. She had no words at all at 16 months, though she started signing a little around 14-15 months. Neither my sister or I talked beyond Mama and Dada until about 2.5, similarly for my cousins, so my family actually consider her an early talker!

Getting a proper evaluation wouldn't hurt at all and appropriate therapy might be a good idea. I just wanted to reassure you that plenty of kids start "late" without there being anything wrong per se.

I certainly wouldn't deny him when he signs. Communication is communication. Speech is just a handy medium. If he signs already, why not try to teach him more ASL signs, build on the language development he has? Keep in mind that ASL is just another language, so from the point of view of brain development it is stimulating the same capacities.

[mamandedeux]

Originally Posted by APToddlerMama 

Have you seen an ENT?  Fluid in the inner ear is a really common cause of speech delays.  Several kids I had on my caseload had tubes placed in their ears and their speech really took off.  The fluid can make things sound like the kids are listening to speech under water which will obviously impact what they learn to say.  If you haven't yet seen an ENT, I would do that for sure.  It can be such an easy solution.  Good luck mama! 

Quick update: we are finally seeing an ENT next month, and will look at getting tubes put in. He still has fluid that doesn't seem to be draining.

Speech-wise, he's gained about 20 words in the last month, but still prefers to communicate in non-verbal ways. I'm super frustrated with speech therapy, but I don't want to vent right now, so I'll wait to cool off a bit.

I'm really worried about my little guy.
 

[Xavismom]

My DS is 23 months, and he pretty much just says Mom and Dad.

He has said many words, and even some phrases before, but its like he says something once or twice, and then never says it again. When he does say something it is easily understandable.

DH & I are sort of wait and see right now. DS is very advanced in other ways, and he does not seem frustrated about communication at all. He is pretty adept at letting us know exactly what he wants with gestures, and he clearly understands what we say to him. My DH is much, much more laid back about it than I am though. I will admit, there are some days it really really bothers/worries me. DH says its obvious he COULD talk, he just chooses not to at this point in time, and to let him do things at his own pace.

Also, I have no idea if this really means anything, but my DH is high-functioning. He cant remember when he really started talking, but he thinks it was pretty late. DS seems to be showing the same affinity for mathematics/mechanical interests as DH.

I am really excited for DS to start talking to me. I cant wait to hear what he has to say.

[APToddlerMama]

Originally Posted by mamandedeux 

Quick update: we are finally seeing an ENT next month, and will look at getting tubes put in. He still has fluid that doesn't seem to be draining.

Speech-wise, he's gained about 20 words in the last month, but still prefers to communicate in non-verbal ways. I'm super frustrated with speech therapy, but I don't want to vent right now, so I'll wait to cool off a bit.

I'm really worried about my little guy.

Sending you hugs OP.  It is hard not to worry about our kids. Twenty words in a month is fantastic though!  That is truly reason to celebrate.  Honestly the fact that he still has fluid in his ears means there is a very, very good chance that tubes will solve all his communication issues.  Trust me, I'd take that over years of speech therapy.  Good luck! 

[graciegal]

You know, I didnt talk until I was 24 months old and now I have three PhDs. Seriously, dont worry too much.

[tropicana]

i am a sucker for these threads b/c my daughter was a late talker. precious few words all the way till 2.5 yo. and then...

... language explosion that didn't quit. 

she is and always was highly social. 

just started talking at 2.5 in full sentences. 

is now 5.5 and *highly articulate* uses advanced vocabulary and never.shuts.up.for.anything.

if your son is advanced in receptive language and highly social, watch out -- he is probably going to follow my daughter's pattern.

by contrast, the neighbor girl talked up a storm super early. by the time she turned 5 she was so full of anxiety she had selective mutism by my observation. 

my daughter loves talking with anybody and everybody. you can send her up to the counter at stores to ask questions, she will make phone calls happily, etc., etc.

i just have to chime in on these threads since ours was such a come-from-behind success story.

realizing of course that not all late talkers are simply late talkers. for some, talking late is a sign of a more significant problem.

but i do believe that the parent "knows" if everything else is on track, and thus, it is simply talking late.

in reading the OP, that's what it sounded like to me.

[tropicana]

Originally Posted by mamandedeux 

Thanks for sharing, mamas. It is good to hear that progress does come. Although I don't feel his lack of speech is holding my DS back at all, my biggest fear is that he'll realize at some point that he's not being understood by others. So far, he doesn't seem frustrated by his lack of words, and seems to communicate very well through signs, grunts, head shakes, pointing... etc. Have any of you dealt with frustration? How did you handle it?

I'm glad that I followed my gut on the withholding approach. I suspect it wouldn't work, anyway.

Another question: do you tell strangers that your child has a speech delay, or do you just act as thought nothing's wrong? I ask because sometimes people will ask him things like ''what's your name?'' or other silly questions (that honestly, I don't think too many 22-month-olds could verbally answer). I usually just answer for him without saying anything else.

Thanks!

i wouldn't. plenty of kids who DO talk turn shy when questioned by strangers. my son, who is a lot more typical in developing his speech, talks up a storm in the privacy of our home, but as soon as someone talks to him in public, he hides between my legs. his chatterbox sister (the late talker) is more than happy to step in and answer any questions, and then start another conversation with the inquirer.

[APToddlerMama]

Originally Posted by tropicana 

but i do believe that the parent "knows" if everything else is on track, and thus, it is simply talking late.

I'm not trying to be a pain in the butt, but from my own experience as a parent as well as having worked in the Early Intervention program, I do not find this to be true at all for at least 50% of parents and probably way more like 80%.  My husband for one was in total denial about my son's needs for a very long time despite speech evaluations, etc. confirming my suspicions.  Working in EI, I had the opportunity to follow kids for a long period of time starting with the pediatrician's referral where the ped had concerns and the parents totally disagreed but were just going through the motions and "knew" their kids were fine, up to the point where it became very obvious that there was something very seriously atypical about the child's development that could not be argued with.  Lots and lots of parents are in denial.  We don't want to hear that our child is struggling or having challenges. It can be a very difficult and heartbreaking thing to admit to ourselves and the worry about the future is overwhelming.  It is no wonder parents struggle with whether or not to even accept the possibility that our children may not just be simply talking late. 

Also, there is absolutely no harm in seeking an evaluation and doing therapy.  It is a no-lose situation.  The alternative of standing by and doing nothing when there is an problem is a big time losing situation.  There is a reason Early Intervention is so important and it is because it does makie a big impact on how a child does long term.  It is truly impossible to know with any late talker if they are just a late talker, or if they are likely to have more significant developmental issues long term.  There is no crystal ball that will tell us that.  Given that is what parents have to work with, I really think being proactive is a much better route than the watch and wait game.  Just my opinion...

[Mosaic]

Well, put me on the list of "I think everything is A-OK" but I may be a total idiot!

DD2 is 19months old and has been seeing a SLP since birth for feeding issues. In one of our many (fruitless) attempts to get to the bottom of her feeding issues, we did a developmental eval via EI that showed her quite delayed in communication skills as well (NOT related to the feeding issues, though I understand they frequently come together). We had a second speech evaluation done about a month later to see if she really, really tests as delayed because DD is bilingual. In that month she gained a lot of ground and tested out at about 12 months expressive and 15 months receptive. We have not started speech therapy because the services coordinator thinks that she'll catch up, especially given how much she gained in the month it took for the second evaluation. She did, however, flunk her hearing test (both ears, all frequencies), so I need to follow up on that even though I think that was a fluke (fluid from a cold or something). We just moved last month and are looking for a new ped, hence the delay.

I definitely don't talk to people about her speech delay. At this age, a kiddo not answering could be anything from a speech delay to a cranky kid!

[APToddlerMama]

Originally Posted by Mosaic 

Well, put me on the list of "I think everything is A-OK" but I may be a total idiot!
 

Just have to say that I am guessing OP's son is totally going to be fine too.  Especially with the recent gains as well as the fluid in the ears.  My big post earlier was really just to say that there is no harm in doing early intervention no matter what boat someone is in and I see a lot of parents on here sharing their kiddos success stories when there are serious red flags in the original posters (not *this* OP, but others) narrative.  I see a lot of MDC mamas trying to settle the worries of other mamas and I see the point for those who have had good outcomes, but it is a massive problem when a child really does have a developmental delay and is not just a late talker.  Just trying to balance that I guess.  A parent can never go back and capture those months or years when they did nothing and it turns out the child really could have used some assistance.  EI makes a big difference for kids long term.