speech development question - would you be concerned?

[mousemom]

DS will be 13 months old next week. He does not say any words - not mama, dada, bye, hi, etc. He does make some sounds, but they do not sound like words and he does not imitate sounds that we make, other than making kissy noises at our cats (which we do to call them). However, he does hear and understand language. When we ask him if it's naptime he goes into the bedroom and stands by his crib, when I ask him to bring his cup over to me he usually does, when I ask him to choose which sleeper he wants to wear he does, etc.

We have a regular check-up scheduled for next week (we're a bit late on the 12 month check-up), so we can bring it up with our ped then and ask if it's worth doing an evaluation for EI. But I'd like to try and get an idea of how concerned I should be and whether I should push for an evaluation if the ped doesn't think it's a big deal.

Thanks for any thoughts!

[brittone2]

Talk with your ped. It is hard to say without having a better/bigger picture. Does he gesture (waving for example)? Does he follow your gestures? Do you hear a lot of consonant sounds, not just "open vowel" sounds like aaaah, eeeeeh, etc.?

Not having a word at 13 months probably wouldn't qualify him for services in and of itself, but it really depends on what else is going on in terms of the sounds he's making, how much he understands, etc.

Typically SLPs look for about 1 word by one year, but in order to qualify for services a child usually needs to demonstrate a specific percentage of delay (depends on what area you live in but 25 or 30% is pretty typical. So for a 13 month old to qualify, they'd need to be functioning roughly at a 9.5 month old level in order to qualify if a 25% delay is needed). So it really comes down to how varied his other babbling is, how his receptive language is (how much he understands), whether there are other things that could put him "at risk" (chronic ear infections, history of family hearing loss, prematurity, etc).

It would be hard to gauge from your description...but not having any words at 13 months is worth mentioning to your doc but may not be enough to qualify him for services. Talk with your doc about his other skills and what you are observing.

[codex57]

I'd look into evals. In CA, you can get a free eval from a gov't agency. The earlier the better. Eval is free. The actual therapy is only free if they're delayed a certain %. It may be harder to hit that % at 13 months, but I met one of the doctors in charge of this region and she really stressed getting tested as early as possible. The sooner you start treating the problem, the quicker they catch up and it'll just be a minor blip in the road rather than a possible longer term problem. Plus, if it's a serious physical problem behind it, some surgeries aren't done past a certain age.

I had DS tested right at 24 months. I wish I did it earlier. And not all of it is cuz it takes so LONG to get everything started. He was tested early/mid November. Doesn't look like he'll start therapy until past the new year.

[bubbaray]

My dr was concerned with DD#2's lack of speech by 12m. I can't remember the magic number, but she wanted either 5 or 10 words by 12m. DD#2 did qualify for speech therapy on the basis of lack of words (IIRC, she started around 18m), but the SLP wasn't actually concerned. She said that it was common with 2nd children for them to have few words. DD#2 also had to have hearing tests prior to ST (which were normal).

[brittone2]

I wonder where she got 5-10 words as being typical by age 1? I'm not an SLP but have been on many evaluation teams through the years with SLPs and have been responsible for screening speech. I've known very few kids w/ 5-10 words at age 1, let alone that being average or not having it being a cause for concern. Those are some high standards!
http://www.mayoclinic.com/health/infant-development/AN01026

Mayo clinic says 8-10 words by 18 months:
http://www.mayoclinic.com/health/infant-development/AN01026

ASHA (American Speech, Language and Hearing Association) guidelines

Milestones up to one year
http://www.asha.org/public/speech/development/01.htm


Nice list of milestones here:
http://www.keepkidshealthy.com/welcome/conditions/speechdelay.html

[crl]

I'm not good on the milestones. But I want to encourge you to follow your instincts on this. DS always just barely squeaked through on milestones--like he'd meet it two weeks after he was supposed to. Our ped wanted to wait and see. I decided to self-refer to early intervention and they found DS eligible (for speech and OT--fine motor skills plus sensory issues that I had totally not seen). I'm glad we got DS help. His frustration level went way down when his ability to communicate got better.

Catherine

[mousemom]

Talk with your ped. It is hard to say without having a better/bigger picture. Does he gesture (waving for example)? Does he follow your gestures? Do you hear a lot of consonant sounds, not just "open vowel" sounds like aaaah, eeeeeh, etc.?

Not having a word at 13 months probably wouldn't qualify him for services in and of itself, but it really depends on what else is going on in terms of the sounds he's making, how much he understands, etc.

Typically SLPs look for about 1 word by one year, but in order to qualify for services a child usually needs to demonstrate a specific percentage of delay (depends on what area you live in but 25 or 30% is pretty typical. So for a 13 month old to qualify, they'd need to be functioning roughly at a 9.5 month old level in order to qualify if a 25% delay is needed). So it really comes down to how varied his other babbling is, how his receptive language is (how much he understands), whether there are other things that could put him "at risk" (chronic ear infections, history of family hearing loss, prematurity, etc).

It would be hard to gauge from your description...but not having any words at 13 months is worth mentioning to your doc but may not be enough to qualify him for services. Talk with your doc about his other skills and what you are observing.


Thanks for your observations. We do definitely plan to talk to our doctor.

To answer your questions, he does some gesturing, but not a lot (I think anyway). He'll raise his arm at the table when he wants more food. Doesn't really wave hi or bye. He does point at things sometimes, like pictures in books or our cats. When he wants something he can't reach, he'll go stand by it and just look up at it.

I don't hear a lot consonant sounds in his babbling, more just the open vowel sounds.

I was just looking into EI in our area and it looks like here they have to be functioning at half the level that would be expected of a normally developing child. So it seems unlikely he would qualify on that basis.

[brittone2]

Thanks for your observations. We do definitely plan to talk to our doctor.

To answer your questions, he does some gesturing, but not a lot (I think anyway). He'll raise his arm at the table when he wants more food. Doesn't really wave hi or bye. He does point at things sometimes, like pictures in books or our cats. When he wants something he can't reach, he'll go stand by it and just look up at it.

I don't hear a lot consonant sounds in his babbling, more just the open vowel sounds.

I was just looking into EI in our area and it looks like here they have to be functioning at half the level that would be expected of a normally developing child. So it seems unlikely he would qualify on that basis.


With a very young child they may have different standards if they truly require a 50% delay (and requiring a 50% delay would surprise me).

Not using a lot of varied sounds when babbling would be worth discussing w/ your doc. SOmetimes it helps to jot down what you are observing and/or concerned about so that you can give them a more detailed pic of what your DC is/isn't doing.

Best of luck.

[mousemom]

With a very young child they may have different standards if they truly require a 50% delay (and requiring a 50% delay would surprise me).



Yes, it surprised me too. But I'm in MO and here's the state definition of developmental delay that they have on their page outlining which children are eligible for their First Steps program:

"A developmental delay, as measured by appropriate diagnostic measures and procedures emphasizing the use of informed clinical opinion, is defined as a child who is functioning at half the developmental level that would be expected for a child developing within normal limits and of equal age."

http://www.dese.mo.gov/divspeced/FirstSteps/eligibilitycriteria.html#DevDelay


But you may be right too, that they may not really follow that standard that closely with a younger child.

[bubbaray]

I wonder where she got 5-10 words as being typical by age 1? I'm not an SLP but have been on many evaluation teams through the years with SLPs and have been responsible for screening speech. I've known very few kids w/ 5-10 words at age 1, let alone that being average or not having it being a cause for concern. Those are some high standards!



Like I said, I can't remember the exact number. But, there was definitely a number by 12m that she was concerned about and it wasn't 1. Maybe it was comparing to DD#1 (25+ words at 12m, which is highly unusual). It was also just shortly after the new(er) AAP autism screening guidelines too, so maybe that had something to do with her concern? Dunno.

Our SLP wasn't hugely concerned about the 12m number (whatever it was) b/c she said it varied more widely with second and later children (who have the older sibs to talk for them).

[brittone2]

You could also check into what your private health insurance covers (if anything). Obviously not fun to pay out of pocket but if you end up truly needing services, that might be something to consider (I personally would be very uncomfortable waiting for my kid to hit a 50% delay-if that's what is truly needed to qualify in your state). Also it mentions "informed clinical opinion" and sometimes therapists can swing that a little to your benefit if they are concerned about a very young child (where a 50% delay would mean they'd have to be doing virtually nothing to qualify).

[Dr C]

Agree with previous posts. One additional thing (in case your ped doesn't bring it up): Consider getting his hearing checked by an audiologist. Even though he follows commands, that doesn't 100% rule out a hearing deficit--some kids are really good at picking up on gestures and subtle cues.

[brittone2]

Agree with previous posts. One additional thing (in case your ped doesn't bring it up): Consider getting his hearing checked by an audiologist. Even though he follows commands, that doesn't 100% rule out a hearing deficit--some kids are really good at picking up on gestures and subtle cues.

:yeahthat: That's another thing that makes it tough to assess by parental report whether a child has adequate receptive language skills. Many parents use gestures, etc. along w/ their verbal directions, etc. and the child follows those gestures. When a child receives an evaluation, again, there are very strict criteria for this reason...to eliminate the influence of things like gestures, etc. in order to determine how well the child understands the parent or therapist's verbal direction. That's why it is tough to say..."well, if your child can follow verbal instructions they are doing fine for their age" without firsthand observation.

[crl]

I don't know about Missouri. VA had some thing about multiple areas of delay and uneven skills as well as a straight percentage to qualify for services as I recall. I initially called about speech and briefly mentioned fine motor skills. When they did the assessment, they found a percentage delay in speech and scattered fine motor skills (as I had thought he was on target for some fine motor activities and quite behind in others--really uneven) as well as sensory issues that I had not known about. There was something about the uneven development and the across skill sets results that qualified DS for services, even though I don't think he met any of the strictly by the percentages criteria. I don't know if Missouri has any wiggle room like that or not.

At any rate, the evaluation is free and would provide you with some information about where your child is. If the evaluation comes up with a delay, but not significant enough to qualify, you could take that information to a private ST and pay (or have insurance pay) for therapy.

Catherine

[JBaxter]

20% delay will get you services in Maryland. :) Jack says words but they all sound the same. HE knows what hes talking about.

[mommylamb]

When my DS was 15 months, he only had maybe 3 or 4 words and I was worried. The ped told me that I could make an EI appointment (it would take a couple months for the appointment) and then just cancel it if he improved, but that she wasn't worried. By the time he was 18 months he had a lot more words. Now he's nearly 2 and half and he won't stop talking. I don't think it hurts to set up an appointment for an eval, but don't let yourself get too stressed out yet.

[mousemom]

Agree with previous posts. One additional thing (in case your ped doesn't bring it up): Consider getting his hearing checked by an audiologist. Even though he follows commands, that doesn't 100% rule out a hearing deficit--some kids are really good at picking up on gestures and subtle cues.

That's a good point. In at least some instances (like asking him to pick between two sleepers), I'm certainly offering pretty obvious visual clues and I'm sure there may be more subtle cues I'm not aware of in other cases.

[nrp]

I ended up having my DS evaluated when he was making very few (maybe 3 to 5) words at 15 months. He had one word I think at 12 months. Like PPs said, it does take awhile to get the eval (around 6 weeks for me). He had acquired several new words by the time the eval came around, and he didn't qualify, although they said he was perhaps a couple of months delayed. The SLP seemed to think that he would catch up fine without any intervention. Since then he has really improved and is repeating a bunch and has a lot more independent words (maybe 30 or 40?). But, I don't regret having him tested. It pretty well confirmed what I thought, and it was free!

[khalloc]

I dont remember my daughter saying much at 13 months. I'm sure she could probably say a couple of words, if you listened real closely. Anyways by 18 months she could speak in full sentences. You could carry on an adult conversation with her. It was unreal. Anyways, I think you can see alot of progress in just a few months.

[vonfirmath]

This sounds like my son. He just now (last 2 weeks, and he is 28 months old) started imitating words we said, etc. He did have a few words before now. But he said his first "word" at 13 months ("all done") and had very few words (he did better at sounds) until after 2 years old. In fact, i was looking at calling EI and having him evaluated when this breakthrough happened. I kept talking to my doctor. But because he had such obvious excellent comprehension, she was even less concerned than I. Because my husband and I were late talkers, we finally chocked it up to "genes" :) And he was always a very quiet kid, very little of the "babble" you usually hear about.

Talk to your doctor. she knows the whole situation. But I don't think there is much to be worried about at 13 months

[codex57]

That's a good point. In at least some instances (like asking him to pick between two sleepers), I'm certainly offering pretty obvious visual clues and I'm sure there may be more subtle cues I'm not aware of in other cases.

An even weirder thing is, some kids can hear, but not some sounds. They only hear certain sounds, so when you talk, it's like a broken radio. That can cause speech delay too, which is why the hearing test is pretty important.

[mousemom]

Just wanted to thank everybody for your posts and information. I'm going to really pay attention to DS language, gestures, etc. this weekend so that I can have a good list of what he is/is not doing to go over with the doctor next week. While it seems like it's not something to be overly concerned about, it also sounds like it may well be worth having an evaluation done, on the basis that there's no real harm in doing it and if there is a problem, it is probably easier to deal with it sooner rather than later.