Language Delay - Feedback Please

[twins r fun]

We took the boys for their 15 month checkup and the doctor (who is normally really laid back) is worried about their speech and wants them evaluated by a therapist. Now I know that they are somewhat delayed since what I've read says they should say 4-8 words, follow some simple directions like "get your shoe," point to a few body parts as you name them. Caleb can say 2 words (cat, daddy) and Jacob doesn't say any. Neither can do any of those following direction things and the only words they seem to recognize are cat and ball. Now I was a kindergarten teacher and I know how important it is to catch delays early, but this seems a little excessive to me. I just feel like they will do it when they are ready and at 15 months there's not much we can do to make things progress faster or really any need to. What do you guys think? I don't want to be one of those parents who is just in denial and let's their kid fall further and further behind. But I also don't want to make a big deal out of trying to get them to talk when they will do it on their own soon anyway. For those of you with kids this age, what is their speech like, how did it develop, did you really work with them on labeling things? I should say that I feel like we have a pretty language rich environment (reading, talking, singing, labeling, describing) but I guess it is more conversational/natural as opposed to a concerted effort to teach them specific words. My mom was the one that got Caleb saying cat and she DRILLED him constantly on it-to the point where I wanted to scream!

Any thoughts would be helpful.

Nicole

[egoldber]

Personally, I wouldn't worry too much about SPOKEN language at 15 months. Many perfectly normal kids don't say much until 18 or even 24 months. I would be more concerned about their receptive language. If they really only know two words, that is probably something to be a little concerned about. Since you are a bit concerned about their speech, I know you probably think you are hyper sensitive, but you may find it helpful to make a list.

Something you might want to try is when you are going through your daily activities, write down every time they seem to understand a word. EVERY word counts, like their own name, each other's names, mommy, daddy, food, coat, lunch, whatever their favorite foods are, milk, sippy cup, TV, their favorite shows, etc. Once you start writing everything down, it may make you feel better to see how big the list really is. If the list really is only two words, then it may make you feel better to talk to a speech therapist to find out what the normal range of language acquisition is and see if there are other signs you should be looking for and simple things that you can be doing.

If it's any comfort to you, I would say that Sarah, at 17 months, probably only has about 10 spoken words. She is only just now learning body parts. (But like you say, I have never really drilled her on this, so she is just picking it up on her own.) But I can tell that her receptive vocabulary is huge.

Also, I just wanted to share that my sisters-in-law are identical twins. When they were toddlers, my mother-in-law, an early childhood development specialist herself, took them to a speech therapist because of slow language acquisition. What the specialist told her was that this is apparently not uncommon with twins because they tend to be very into interacting with each other as opposed to with others. Of course, this was 30 years ago, so the new wisdom today may be quite different.

HTH,

[COElizabeth]

Nicole,

I think Beth's advice is good. My niece is 16 months old and to date says only "Ba Ba" to mean "Baby" and occasionally says Mama. She obviously knows lots of words, though, and can identify many body parts (nose, cheek, etc.) when asked, "Where is your ...?"

Her older brother was slow to talk, too, and was over 2 before he said anything besides "Da." "Da" was used for everything from dog to truck. He didn't even say "Mama." It turned out that he did need speech therapy because some of his mouth muscles weren't developed well, but he had no cognitive problems, and once the therapy started he began talking up a storm. One thing my sister did hear from the speech therapist is that sometimes kids who drink exclusively from sippy cups have trouble developing sounds because they need the muscle control used in drinking from a regular cup. Now I know there are plenty of kids who speak clearly and use only sippies, but you might consider trying regular cups at least some of the time in case that might help. BTW, I have always heard the same thing about twins, that they communicate with each other in their own way and so may be slower to speak in words adults can understand. Again, it's nothing wrong with them cognitively.

HTH,

Elizabeth
Mom to James
9-20-02

[darebear]

Nicole,

I would not worry that they are not saying words. My DS was a very late talker. He said 2 words until he was about 23 months. My ped was not concerned when he was not talking around 18 months but I was. I live in NY and they have an excellent early intervention program run by the state to catch delays, so I called and self referred him. He started speech therapy at 19 months, it was mostly play therapy but it must have worked because the way he talks now you would never know he had any problems. Somethings his therapist said was to cut out the sippy cup, try to use cups with straws, if your boys want something and they make a noise for it, before you give it to them say what it is and try to get them to at least make a sound. Also late speech is common in twins and is also hereditary, so if you or your husband were late talkers there is a chance they will. I am not sure what they would do at this age as far evaluation, have they had their hearing checked? But if the ped wants an evaluation I would get it done, they will probably just watch how they play and ask you some questions about what they do in different situations and then make a recommendation, and it might set your mind at ease if you have it done. You are right though they will talk when they are ready, but if there is a muscle problem, like my DS had, then the earlier they start working on the better. the

I have a developmental speech and language profile that my son's therapist gave to me that outlines what they should be doing from 0-3 months up to 45-54 months. I'd be happy to e-mail it to you if you would like.

Allison

[brubeck]

My ped told me that at 15 months my daughter should have 3 words MINIMUM. Well when we went to the appointment she had 'nose' and 'mama' and that was it. The ped said she would re-assess at 18 months (and 21 months if necessary) and if she still didn't have enough words might look into treatment programs. Well at 17 months she finally started to get a few words (with a lot of help from Sesame Street) and had about 12 by 18 months, which was above the minimum of 10 desired by the ped. At 24 months she had so many words there was no way I could count them and she was regularly using 3 and 4 word sentences. Basically there was a word explosion at about 20 months, and I just had to wait for it.

Another thing that helped a lot was that at 18 months my husband and I went away for 10 days and left my daughter with my parents. When she wanted something her usual technique with me was to point at it and make an 'uh uh' noise. My folks pretended they didn't know what she was referring to and 'forced' her to tell them what she wanted. I am convinced that this helped enormously in her desire to start talking more.

To make you feel better, my friend has 24 month old twins (fraternal) who have NO WORDS whatsoever. Her ped is only just now starting to be concerned, and has recommended they be put into the play therapy groups. So you've got another 9 months before you reach that 'critical' stage.

[twins r fun]

Thanks guys, for all the info! Sounds like the spoken language isn't too abnormal. I have heard the thing about twins language delay and have read a little bit about it. They say it is in part due to the prevelence of low birth weight and prematurity in twins as well as the fact that they don't get much one on one time, have to talk quickly before they get interrupted, etc. So it sounds like my inital intuition to not panic is okay there, but...

I guess I should be more concerned about their receptive language. I will try your suggestion Beth about writing down what words they seem to recognize, but here's what I honestly think they know (meaning I get some type of reaction from them):

Caleb: Caleb/Jacob (unfortunately I think they both answer to
either), cat, daddy, no, yucky
Jacob: Caleb/Jacob, cat, ball, hello, no, yucky

They don't seem to know any foods, objects, clothes, actions or at least they are not giving me any indication that they know anything. Not even bye bye, night night, mommy, milk, bottle-the essentials of thier life! So are they more delayed than I realize in this area? Also, they don't point to things they want! I don't know what they do-I guess they either go get it or they forget about it or I give it to them before they realize they want it, but they just don't reach for stuff and make it obvious what they want. I get some generalized whining that I try to fix, but it's just blind luck if they get what they wanted. Okay, so now I'm making them sound like they've really got problems! They're not just lumps that sit there-they interact, chatter, respond, mimic. Actually Jacob sounds like he's having a conversation-just not in English.

Anyway, I guess I'll persue the evaluation/therapy but from my perspective more for receptive than expressive language. And Allison, if it is not any trouble I would love for you to email me that profile ([email protected]).

[atlbaby]

Hi Nicole,
Like I just wrote you--check your email :) --Arielle too doesn't have many spoken words, just up, again, and mama (also used for general displeasure (why?). And 'da' for everything else. So given this 3 word minimum, which I hadn't known about, I'll be interested if my ped tells us at Arielle's 15 month appt on Monday that we should re-assss her at 18 months.

But like you say, it sounds like their receptive langauge is what's more concerning. It's hard bc they may actually recognize a whole bunch of words but don't 'feel like' pointing to them. Are they pretty laid back personality wise? Arielle is definitely NOT laid back, when she wants to eat she'll go over to her high chair or the fridge and if I don't notice in 2 seconds she'll whine or something. But maybe they are just ok with waiting or like you say, they'll forget about it! And I know that the mimicing and chattering is important too, which you say they do. (Jacob's foreign conversation sounds adorable, does Caleb respond to him? :) )

-Rachel
Mom to Arielle Jill, 10/30/01

[AugBaby]

There is a pretty good book called "How Babies Talk" that you may find interesting and may ease some of your concerns. As others have already pointed out, any real concern would be regarding the twins' receptive ability. You mentioned that "unfortunately" they react/answer to both names. This is actually a good thing and indicates that they understand both names and that the names apply to them. It isn't uncommon for a child to call all men "Daddy" or use the name of one sibling to refer to both siblings. It doesn't mean that there is any cognitive problem, just that the sorting and refining of definitions is taking place.

Also, when you say that the twins only react to a few words, are you only looking for overt recognition? If you say, "oh look, Daddy is coming!", do they look for him? My hunch is that you've been conservative on their receptive capabilities. I think that the idea of having them possibly referred to a speech therapist is more to have them evaluated for problems with their receptive language. A problem with receptive language might indicate more significant problems than just a speech delay, such as autism. From all that you've said, it doesn't sound like this is at all the situation that you and the boys are in. Having your background, I'm sure that you are providing an optimal environment for their development. They'll increase both their receptive and expressive vocabulary in time. While it is certainly your choice to drill/not drill them, I just wanted to add that I don't think that it's necessary. It's my opinion that language should be fun, not tedious.

[Sheila]

Hi Nicole,

My 23 mo old daughter has not yet experienced the "explosion of words" that all the books talk about. At 21 mo, she had about 10 words (some actually just sounds - like mooing when she sees a cow) so her ped suggested an early intervention program.

The speech therapist told me what everyone else here has been saying - that the ability to understand is more impt than actually saying the words. In our case, we so far suspect that my daughter's poor vision is somehow related to her delayed speech (I neve realized how impt eye contact was for talking until now). She unfortunately inherited EXTREME nearsigtedness which runs in my family (I have it too). But, we got her glasses about 2 mo ago, so we are hoping they will help.

Her speech therapist has actually theorized (is that a word?) that she made up in listening what she couldn't see, because she understands EVERYTHING that is said around her and reacts to it (the first time she came running in w/ a lost slipper that I was muttering to myself about freaked me out). But, the actual spoken words are few and far between.

I bring up our situation just to illustrate that many things can be related to speech delay. And, there are always the babies that just happen to start a bit later. I know for me, I debated about whether to start the early intervention, but ultimately I decided we had nothing to lose and everything to gain. It is actually working out great for us because it also opened up the opportunity of attending a playgroup for her (she has never played w/ kids before) and she is absolutely loving that.

I think it is great that you are concerned so early. We didn't really start thinking about the speech (or lack thereof) til about 18 mos. It sounds like you are doing all the right things. Hang in there! I know I am trying to :)

Sheila


________
YZF-R7 (http://www.yamaha-tech.com/wiki/Yamaha_YZF-R7)

[darebear]

Nicole-I justed emailed the profile to you. Let me know if you don't receive it.

Sheila- Your daughter sounds just like how my son was. Said 2 words, but understood everything, that it would sometimes freaked me out also. But right before he turned 2 he got into the repeating phase and then all of a sudden he didn't stop. They said that his problem was weak muscles because of tongue tie. But the therapy was great because like your daughter they had a speech group that he went to that worked with separation issues and I was just going to enroll him in a class so I saved myself the money.

She will start talking though and then the trouble starts. We live in New York City where you hear people curse when you are out and about, well my son picked up the "F" word and decided to practice it in the middle of a crowded post office. I was so embarassed.

Allison

[jubilee]

My son, who is now 11, was tested for language delay when he was 2 years old. He only said three words... mama, dada, and exit (why exit, I have no idea!) I didn't think anything of it until the doctor said that his vocabulary should be higher. Jacob did an audiology test first to check his hearing, which he passed fine. Then they had us go to a center where they did testing and schooling for developmental delays. They had Jacob do a variety of things, like stack a set of blocks the same as the evaluator, take his jacket off and hang it up, pick up a red ball out of a dozen balls, etc. (by the way, he failed the red ball test- but it's because we later found out he is color blind) The evaluator interviewed me and asked what activities Jacob could do, and they found he was actually ahead of his age group except for the speaking. The whole test lasted about 1-2 hours. They told me to come back in 6 months if there was no change. Well, we never went back, because Jacob began speaking a little more. There never was a huge leap forward, but I believe by the time he was 4 he matched the other kids his age. Now he is in 5th grade, and is incredibly smart... in the "talented and gifted program", very top of his class, reading at a high school level, etc. Don't be worried, this early "lable" of speech delay can be broken. It doesn't hurt to have your child checked, and can actually be reassuring. I hope my son's story sets any of your concerns at rest.

[twins r fun]

Thanks again for the recent replies! I'm going to call the county program on Monday and set up an appointment to evaluate and make reccomendations. We've gone through them before for physical therapy and they've been good so I think I'll see what they offer before going privately. I think the physical therapy experience was part of the reason I was hesitant to start therapy over this. It's been my expereince that we are jumping on these things slightly too early because by the time we get the evaluation done, have the meeting and fill out the paperwork to get the therapy going, and then get started the problem has resolved itself. That's happened once with each child now! Maybe it's like the guarantee that you'll go into labor if you unpack your hospital bag!

Allison, I emailed you back before I read your recent post about your son's tongue tie. Jacob is tongue tied also, but the ENT didn't think it was severe enough to cause problems. I guess we'll see if that will come into play here. Will look into the book you mentioned AugBaby and thanks for the perspective on the name thing. As a mom to twins one of the biggest guilt trips is making sure you treat them as individuals so them not knowing their individual names is like proof that you failed! And Rachel, got my email and will write back soon!

Nicole

[Melanie]

Ds is just about 15 mo. and the only word he says besides "mama" & "dada" is "do." He does follow directions, when he feels like it, though. I just wanted to second the recommendations for a hearing check. Ds had one at birth and passed, but they said that doesn't mean that a problem couldn't develop later on.

BTW, two other boys in Ds' playgroup were the same with language at this point. It's hard, for me, I know when I hear the little girls speaking perfectly clear and rattling off phrases, but for some reason they are just faster at this age.


Good Luck to you and your boys!


Mommy to Jonah

[mspacman2]

Just want to add to the mix, my 14-mo daughter has only one word (up) where she both says it and seems to understand the meaning (she says "up" whenever she approaches stairs or we go up the stairs). Everything else is just babble, like right now she's into "yup yup yup yup" and "baahhhh". She says mama and dada but says them to anyone, even other small children. When she wants something, she just makes a high-pitched whine, making mealtimes literally a noisy trial-and-error session. :)

However, she does understand a LOT more than she says. If I say "where's your ear" or "where's the bear" or "where's Mommy's ear" she'll point to those things. So she does know words, but she doesn't say them for some reason!

I've been getting increasingly nervous after reading that everyone else's baby says "cup" and "Mommy" and "Spongebob Squarepants" at 9 months. This thread has been reassuring; thanks for starting it.

[Elaine]

Just adding my 2 cents -- my first reaction is that your ped is jumping the gun. I think this for several reasons. One, I have a friend with twins who barely spoke (except to each other in their unique twin language) until 18 mo. Second, I'm on an online group of moms, all of us with kids in the 14-18 mo. range. I'd say out of 25 of us, there are at least 10 who have had their ped's worrying about "speech development" at the 15 mo. checkup. I think that's a ridiculously high number. Given my experience with peds who want to run every test in the book (for no other reason than "it's just routine", i.e., "you have insurance so what the hey"), I am more and more prone to suspicion when I hear things like this. I'm almost expecting my daughter's ped to bring this up to me next month at her 15 mo. checkup! Third, moms I've talked to about this issue, who have older children, have nearly all told me their first child took much longer speaking than their subsequent children. None of them thought 15 mo. was drastically "delayed" in speaking.

Obviously you have to trust your gut instinct, and if you feel taking your twins to a speech therapist is the way to go, by all means, go! I guess I'm just saying, don't freak out and think your kids are the only ones not giving speeches at 15 mos.

GOOD LUCK!

[darebear]

Nicole- Has Jacob had any feeding problems because of the tongue tie? I know alot of doctors will not clip it, instead they take the wait and see approach and if there are problems they will clip around 4 or 5. Darren had his clipped at 16 months. His speech therapist believes it played a big role in his late speech and feeding problems, because his tongue was so restricted. She is still working with him to strenthen the muscles, because he will chew and chew his food sometimes for 30 minutes. Is it noticable when you look at his tongue, can you see the indent?

Allison

[twins r fun]

Jacob's tongue tie is noticable (heart shaped tip), but he has not had any feeding problems. He wasn't able to nurse, but there were other circumstances involved so I don't blame that on the tongue tie. We took him to the doctor when he was about 10 months and he said he would advise waiting to see if there were any articulation problems. I think Jacob can produce most sounds-the kid literally chatters constantly-just not in our language!

Nicole

[Sheila]

Allison - thanks for posting about your son's situation. It's always reassuring to hear about children that have had similar experiences. Though I don't want my daughter to start swearing (love your story!) I do think I would rather have her saying too much than too little!!! I think she is making a bit of progress, though. She picked up 2 new words this past week and is experiencing w/ new sounds, so I am encouraged by that. I keep hoping the "explosion" might come by her 2nd bday. We have about a month to go, so we'll see!

Sheila



________
AMATEUR FACIAL (http://www.****tube.com/categories/52/facial/videos/1)

[kathsmom]

Hi, Nicole!

I just wanted to thrown my 2 cents in here!

I think that you should go ahead with having them evaluated. It doesn't hurt anything, and the therapist can keep an eye on them and they will already be in the "system", so that if you do notice any problems, there will already be some background for the therapist to go by.

I think your doctor just wants to be sure about their language skills, because it is better to catch these things early on.

I will have to look up the website, but if you are interested, the American Speech-Language Hearing Association (ASHA) may have some information on the website. It is the professional and credentialing association for the profession.

Good luck with everything!

Toni - mom to Katherine and Andrew

[alandenisefields]

Nicole,

Hi! Thanks for using our message boards.

Your post caught my eye, because I have a bit of experience with this. My oldest son was not speech delayed, but he has other severe learning disabilities that benefit from Speech/Language therapy. And one of his friends did have a speech delay. So, take you doctor's advice and see a speech therapist. We regret greatly not seeking help for our son much earlier. And what's the harm? Then you'll know if there is really anything to worry about, and if not, you can tell your doctor to "bugger off."

best wishes,

denise fields
authors, BABY BARGAINS

[spu]

This is all so fascinating to me. My twins are 6 months old. What kinds of things should I be doing with them to help them along the way? Most of what we do and play is in normal 'conversation'. Now I'm afraid that they won't have any vocabulary words too when the time comes, and my ped. is kind of old-school so who knows what he would do.

So, how do you start or introduce the names of objects without getting conversational? or Is that what I should be doing? We watch the Baby Einstein DVD that has the reading and vocabulary. Both babies are really vocal and expressive with their sounds, so I don't think they have any physical or tongue-tie issues.

Thanks in advance!

susan

twin girls 7.20.02
charlotte & else

[egoldber]

Susan, I really wouldn't try to do anything special. Kids generally acquire language just fine through normal conversation and interaction. The "experts" say, talk to your kids a lot and use normal words (not baby talk, or at least not exclusively). Also, don't correct them for saying something incorrectly but just repeat the word or sound correctly to them.

(Example, Else says "ba" for ball. You say, "Good job, Else, that's a ball!")

And just talk to your kids a lot. Apparently a lot of parents are pretty uncomfortable talking to their children before they are able verbalize back (not saying you are, this is just what I have read). Even when they don't respond, they are soaking it all in.

HTH,