16 month old's speech delay

[Anonymous]

DD is almost 16 months, and she still can't clearly pronounce a real word. The only things she clearly says are Mama, Da, moo (for cow) and neigh (for horse). At her 15 mo appointment, the pediatrician said that by that age, kids have an average of 3 real words but didn't seem concerned. The pediatrician was extremely busy, though.

In the past week, DD has been attempting to say ball, bubbles, bye bye, bath, book, deer (we have them in our yard), and her nanny's name, but she can't pronounce the full words. And she clearly said apple a couple times when she wanted me show her a favorite video involving them. A friend suggested speech pathology or early intervention. Should I schedule another appointment with the pediatrician, or just wait until the 18 month appointment? DD was also a bit delayed in walking (13.5 months) but now walks constantly.

FWIW, DH, the nanny, and I read her lots of books and talk to DD quite a bit. However, DD spends very little time with other people, especially now that it's gotten too cold for outdoor playdates. She does not watch TV, which another friend says can help with speech. Also, our nanny sometimes speaks in Spanish, her second language. I can't imagine that has a significant impact, though, because it's mostly just a single word, e.g. identifying the food she's serving.

[Anonymous]

Anonymous wrote:DD is almost 16 months, and she still can't clearly pronounce a real word. The only things she clearly says are Mama, Da, moo (for cow) and neigh (for horse). At her 15 mo appointment, the pediatrician said that by that age, kids have an average of 3 real words but didn't seem concerned. The pediatrician was extremely busy, though.

In the past week, DD has been attempting to say ball, bubbles, bye bye, bath, book, deer (we have them in our yard), and her nanny's name, but she can't pronounce the full words. And she clearly said apple a couple times when she wanted me show her a favorite video involving them. A friend suggested speech pathology or early intervention. Should I schedule another appointment with the pediatrician, or just wait until the 18 month appointment? DD was also a bit delayed in walking (13.5 months) but now walks constantly.

FWIW, DH, the nanny, and I read her lots of books and talk to DD quite a bit. However, DD spends very little time with other people, especially now that it's gotten too cold for outdoor playdates. She does not watch TV, which another friend says can help with speech. Also, our nanny sometimes speaks in Spanish, her second language. I can't imagine that has a significant impact, though, because it's mostly just a single word, e.g. identifying the food she's serving.

Mom of a 4 year old and 13 month old. I wouldn't be too concerned about speech, since it sounds like her receptive language is there (trying to show you an apple with a video... btw if she doesn't watch TV how does she have a favorite video?) and she is trying really hard with the expressive language. I would wait until 18 months and if you have concerns at that time, bring a list of concerns and try to get videos of anything that could be meaningful to show as kids rarely perform at the doctors.

My sense is that doctors can push things a bit, but it's because there are fairly large ranges for milestones. For instance, you said that your daughter walked "late" at 13.5 months but the range for walking is between 9-18 months. If you look at it this way, she is in the middle of the range. It's hard as a first time mom because you have goggle and maybe a SIL or MIL whose kids all did everything early, but I would not worry.

[Anonymous]

It sounds like she’s getting there, so I wouldn’t be too concerned. But there is no harm in contacting early intervention if you’re concerned. If she doesn’t meet the criteria for an evaluation then you can rest assured.

[Anonymous]

A speech delay is generally less than 2 word by 18 months. Yours has 4 words by 16 mo. She could probably still benefit from speech therapy, but you would probably need to pay for it because it does not meet the strict definition.

That said, do the early intervention eval anyway, they will look at the child in her entirety (not just specific expressive vocabulary threshold), and may recommend therapy.

[Anonymous]

I have a kid with speech delays and always advocate for EI, but honestly I think your DD sounds well within normal range and I would wait for the 18m checkup.

Also not remotely late for walking.

[Anonymous]

Agree. 13.5 months is not delayed walking and your daughter has words. Most kids cannot pronounce words correctly. A consistent sound to refer to a specific thing is a word.

[Anonymous]

Anonymous wrote:Agree. 13.5 months is not delayed walking and your daughter has words. Most kids cannot pronounce words correctly. A consistent sound to refer to a specific thing is a word.

Hi Op, i completely agree with everyone. This does not sound delayed to me. She is not an early talker which is likely what you're comparing to in your mind, but she is well within the range of normal, it sounds like. Over the next six months it will just keep increasing and increasing until she really takes off. 13.5 months for walking is absolutely not delayed, at all. Anything up to 18 months is normal. My second walked at 16 months (normal) and at 18 months is just now getting more words, was probably in a very similar spot as your daughter at 16 months.

Words at that age are not dependent on pronunciation. A sign for a word (like all done in sign language) is considered a word. Making a sound for an animal is considered a word. Is she able to understand what you say a good bit of the time? Receptive language is far more indicative of a concern than expressive. So if you say to her go get the ball sweetie, most of the time would she? (if she's interested in the ball I mean). If she seems to understand what you're saying and she's starting to slowly add some more effort at words, pointing, trying to communicate with you - it's very likely you're good.

[Anonymous]

Also, no TV does not help with speech holy moly. That is not research based at all. Sounds like you're doing all good things, she will get there for sure. If you have concerns about receptive speech (feel she never understands what you're saying and can't follow basic instructions at least some of the time) then I would raise a flag. Otherwise I would give her more time. There is a huge range before two and sometime during that time they'll usually have word explosions. It just happens at different times for different kids.

[Anonymous]

Anonymous wrote:Agree. 13.5 months is not delayed walking and your daughter has words. Most kids cannot pronounce words correctly. A consistent sound to refer to a specific thing is a word.

This. Your daughter has several words. Clarity is different, and it's normal for kids to be difficult to understand. See where she is at 24 months. More of her words will likely be clearer by then.

[Anonymous]

Sounds very normal to me and I’d be more concerned if your kid didn’t seem to be attempting communication/speech at all. See where they are by next appt.

General tip - it can also help to take good notes and even videos to show the pediatrician. They are all so rushed nowadays. Ask questions like - can you explain why you are not concerned? What would be concerning? What should I watch for? This gets them to slow down a bit and share their rationale.

[Anonymous]

First of all, your “real word” distinction is meaningless. As long as she’s consistently associating moo with a cow and neigh with horse, that counts. Throw in apple, mama and dada and you’re at a solid 5 words. Your child is not speech delayed. Attempting to copy words and only getting the first bit out or garbling them is also a great sign. Do NOT show her television that is terrible advice.

Similarly, 13.5 months is not a delayed walker. That’s a perfectly normal, healthy time to start walking.

It sounds like you’re falling into the trap of comparing your child to the average (the average kid walks around 12 months) and then because she’s slightly slower than average, declaring her delayed. Slightly slower than average does NOT equal delayed. Each kid develops at her own pace, and the range is wide. My kid walked at 17 months, still normal. If they haven’t walked by 18 months, that’s when they’re considered delayed. Again, three words is AVERAGE - I believe delayed is if they have no words at 15 months - zero. My kid had not a single word at 15 months - no mama, no dada, no moo, nothing. He was speech delayed (though very quickly caught up).

Take a deep breath. Relax. Your kid is doing fine.

[Anonymous]

OP, please don't worry. As a mom of two late talkers, I have spent my share of time worrying and researching about speech delays. In the end, mostly a waste of time. At each 24 months wellness check, the pediatrician recommended early intervention, and each time, it didn't happen (for first son, covid hit, second son, he started catching up before we could get any intervention scheduled it took so long).

Just relax and enjoy your DD. Nothing you mentioned sounds concerning. She is just not an early talker.

[Anonymous]

Anonymous wrote:OP, please don't worry. As a mom of two late talkers, I have spent my share of time worrying and researching about speech delays. In the end, mostly a waste of time. At each 24 months wellness check, the pediatrician recommended early intervention, and each time, it didn't happen (for first son, covid hit, second son, he started catching up before we could get any intervention scheduled it took so long).

Just relax and enjoy your DD. Nothing you mentioned sounds concerning. She is just not an early talker.

Forgot the important part. Each time intervention didn't happen and each time is fine. Each went through huge verbal leaps at their own time somewhere around 2-2.5 years.

[Anonymous]

I would wait til 18M appointment and go from there - in MD and DC you can self refer to an EI eval, not sure the rules in VA. My son had maybe 1 word at his 18M appt and our ped told me to self refer. He was evaluated at 19M and qualified easily for speech therapy. We started very quickly (got lucky with timing and availability of someone in our county) and his language exploded by our second session on its own, when he was 20M. He was talking in full sentences before our 2year well visit. If her receptive language is good, that’s where the biggest concern is at this age. Likely she will be fine, but it doesn’t hurt to see where she’s at at the 18M check up and go from there after a conversation with your doctor.

[Anonymous]

Thank you everyone! You have all been so reassuring I'm not around other kids often, so I didn't realize that it's common for toddlers this age to struggle at fully pronouncing words.

I think DD's receptive language is very good. When I ask where her hair, nose, etc are she points to them. When I told DH I was going to feed her, she climbed into the glider where I nurse her. And if I ask her to hand me a ball or other object, she does.

Sorry I wasn't clear about the apple video. Lately I've been showing her the videos I've taken. There's one that gets her so excited she claps when she watches it, so I feel pretty sure that when she said "apple" she was asking me to play that one again. In this video, she's putting apples into the refrigerator, DH and I cheer her, and she raises her hands over her head in excitement.