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Toddler Tips

Does My Child Need Extra Help?

From: NEW BEGINNINGS, Vol. 20 No. 4, July-August 2003, p. 152

"Toddler Tips" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help parents of toddlers. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.

Situation

My son is two years old and doesn't use many words yet. The other children in his playgroup have a much larger vocabulary and speak more clearly. When should I begin to worry? How can I tell if he needs help with language skills?

Response

If you have any doubt whatsoever about your child's speaking ability, I urge you to at least have him evaluated. It's painless and will give you a better feeling of what direction to take. Your community may have a program that provides a speech pathologist who will come to your home to evaluate your son. If he qualifies for treatment, the treatment may be given in your home.

I was very skeptical about someone judging my child's communication skills; after all, I believed I knew my child best. As his mother, I felt that I was the best one to give him additional stimulation.

My son was not evaluated until he was two-and-a-half years old because we were living out of the country. As it turned out, my son qualified for both speech and occupational therapy. Until his third birthday, Matthew received therapy in our home and it was much like a game for him with the therapists. They would each bring interesting toys used to help develop his speech and occupational skills. At age three, I reluctantly enrolled him in our local public school's preschool. I was all prepared for a big crying scene since he had never really been separated from me for such a long period of time. I was pleasantly surprised when he walked into the classroom and never looked back. There was so much for him to do with his class. I initially enrolled him for two days and gradually worked up to five days a week. Perhaps this attachment parenting style actually did make my child more confident and secure!

My son has recently turned five and will begin kindergarten in September. If his dad and I had waited until he was in kindergarten to begin any speech therapy, I believe he would have been taken out of his class during the day for his speech therapy, which could have led to him falling behind his peers academically. We'd be starting from scratch.

Because we decided to pursue therapy earlier, he will start kindergarten with the advantage of two-and-a-half years of work. He will have been in the same continuous preschool program with the same great teacher and speech pathologist-both of whom are challenging for my son-for two-and-a-half years. All the people Matthew interacts with at school tell me that Matthew will be ready for kindergarten and that he is at grade-level or above. Naturally, this makes me glad I followed through on a hunch that my son was behind in his speech.

I have also pursued other paths to assist him in his speech and occupational delay. About a year ago, I had him evaluated by a cranio-sacral therapist. Whether it was a combination of all the therapies or simply maturation, my son communicates significantly more and that makes our whole family happier.

Leslie Turner
Mansfield CT USA

Response

We started our family with twins-different as night and day-who have given us a wonderful perspective on child development. Any worry I had about one was solved by the other. Russell and Shelvin each had different strengths and took different paths. Shelvin walked first, whereas Russell talked first. It seemed that Russell liked to hear himself chatter, but Shelvin didn't talk until he understood what he was saying. I could almost see the gears turning inside his head. On the other hand, Russell never wanted to take a single step unless he knew he wouldn't fall. Shelvin never had that fear and fell often. I learned that by watching them individually without comparison I felt satisfied with each of them.

From that early experience, I have been able to look at their growth and development over 13 years without comparing them to other children. Sometimes their stages of development are pretty even and other times they are very different. I find that they are always okay as I continue to guide them into adulthood.

Sometimes a child will need extra help and an observant mother is the best person to determine what and when that help is needed. If you have any lingering concerns, discuss them with a qualified professional whose judgment you trust. In the meantime, just because other children do things earlier is no indication that your child won't do them in his or her own time.

Adrian Booher
Franklin KY USA

Response

My son did not begin to speak until he was 22 months old. My husband and I were a little concerned, but not overly so since his ability to understand us was excellent and he could easily communicate his needs and desires without the use of words. He did this through sounds, eye contact, and hand gestures. In fact, he was an excellent communicator completely tuned in to and engaged in the world around him. At his 18-month well-child checkup, his doctor expressed concern that he wasn't saying the standard 10-20 words. We took him to an audiologist to have his hearing tested. It turned out his hearing was excellent but the audiologist did give us a referral for a speech evaluation.

I talked to my father, who was an audiologist, and to lots of other mothers. I decided to trust my instinct that nothing was "wrong" with my child and that a speech evaluation was not necessary yet. I trusted that he was developing on his own timeline.

Language acquisition has a genetic component. Ask your mother and father when you began speaking. It turns out that my husband and I were both "late" talkers. So my son, Forrest, was right on schedule-his own schedule.

With that said, go have your son's hearing tested and express your concerns with your doctor. If his hearing is normal, then ask yourself the following questions: Does he follow simple one to two step directions? Does he engage with me when I talk to him? Can he communicate his needs? If he can do these things, relax and let your child's language development blossom on its own.

Rachelle Ortiz
Arlington VA USA

Response

Don't panic! Children learn language at different rates just as they learn to walk at different ages. Is your son communicating to you with body language or physical nods of the head? Does your son seem to understand what is being said to him? Is your son interested and engaged in non-verbal communication with you and others? Take some time to see all that your son is understanding and telling you without words. I'll bet you will be amazed and comforted. You might want to keep a journal of his words and your observations. This will be nice to have as a memory of his growing up, but may also help to reassure you that there is a lot of communicating going on that you may not have noticed or been aware of before.

My thoughts for you are to listen to your instincts. Do you think there is a problem or is it just because of comparisons? You have the answer inside you. Read to your son a lot and keep him close. Find wonderful opportunities to talk and talk! It may feel odd at first to talk to a child who does not speak, but it will help him learn.

Play some games and do your own observation. I found my son used his body very well in so many ways and that his strength was his physical ability rather than verbal ability. It did balance out as he matured and gained more confidence. Time and practice will probably make your son's verbal skills turn out just right. But if you have doubts and really feel that there may be a problem, then follow through with that. Just as we followed our hearts when our babies were young, this instinct and "knowing your baby best" does not fade with age!

Beth Volkmann
Northampton MA USA

Response

Late-talking children can certainly be a source of worry for parents. By age three our son, Theo, had worked out an impressive number of sound effects and made-up words, but could speak only a handful of English words. He used sounds for five different kinds of power saws and engaged in extensive fantasy play with his big sister, but could not say "Mama." A couple of months after his third birthday he began to talk. Now, at three-and-a-half, he has a lot to say and speaks in complete, complex, intelligible sentences.

We had his hearing tested (which I'd recommend) and took him to a couple of speech pathologists, and learned that there are a few known reasons for speech delay. Hearing problems, autism spectrum disorders, mental retardation, apraxia (trouble coordinating the muscles of speech), and a big category which I paraphrase as "He just ain't talking, we don't know why" are all reasons for delayed speech. In our search for answers, we ran across two interesting books, Late-Talking Children and The Einstein Syndrome, both by Thomas Sowell.

Sowell is an economist whose son learned to talk late. He conducted research on late talking with the help of Dr. Steven Camarata, a professor at the Vanderbilt University School of Medicine. Sowell and Camarata found that there seems to be a category of late-talking children who are analytically inclined, and whose parents work in math or engineering and play musical instruments. These children are certainly not mentally retarded or autistic, but many do not talk until they are four-and-a-half! Perhaps your son fits in this category?

We also found an article on the Internet by Lori Roth with a discussion of some of the differences between late talkers described in the Sowell books and children with apraxia. As I recall, apraxics don't play with sound much as babies, and may drool and have trouble eating. Camarata has an article on the Internet discussing helpful and unhelpful interventions for late talkers. He also runs a parents group for "Early Thinking, Late Talking" children.

When we were worrying about Theo I complained to my sister that I wished a speech pathologist would say to me: "That's a remarkable little boy you have. You just take him home and enjoy him." So, in addition to any other steps you choose to take, I'd like to tell you, "That's an amazing son you have. Take him home and enjoy him!"

Nancy Norris
Santa Cruz CA USA

Response

Your situation sounds familiar. When I took my son for his two-year well-child exam, the nurse practitioner suggested waiting six months to see if his speech improved. If it didn't, she gave me references for speech therapy. My son could mimic every animal sound you could imagine, but barely used any words that were understandable to anyone but his big sister and me.

By two-and-a-half, my son's vocabulary had increased, and now, at almost three, he talks constantly. Some of his speech is difficult for some people to understand, but he is able to carry on conversations with his friends. A speech-therapist told me that if I can understand him, that's all that matters.

Kelly Booker
Louisville KY USA

Response

When my daughter turned two I noticed other children were saying more words and combining words that she wasn't. But I also heard other children her age saying about the same. We are in a program called "Parents as Teachers" through our school district and they tested her and felt she could use a little help. One thing that helped was learning sign language. She can say more now, but she still signs. Follow your instincts and remember that all children talk at different stages.

Allison Knight
Kansas City KS USA

Last updated Wednesday, October 18, 2006 by njb.
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