15 month old too young for speech therapy? WWYD?

[Anonymous]

DS has always been behind on speech milestones; he just turned 15 months old and this week said Mama and Dada appropriately to refer to us. He has no other words. He chatters a little but not much. When he wants something he grunts, makes monkey sounds, or screeches. His comprehension seems good--he's been able to point consistently at objects when asked and follows some directions.

When he was 10 months old I called EI in Fairfax County for an evaluation because he was so quiet and he was not answering his name (that only happened around 11 months). We had his hearing tested and it was normal. He was evaluated as behind in speech and communication but I was told that it was too early for speech therapy. They recommended once a month "infant educator" visits but after 3 visits at $100/visit, we stopped because frankly there was nothing helpful happening. We read a lot, label everything, and the educator just kept telling us to keep all of that up.

At the 9, 12, and 15 month visit the ped has said "let's see where he is at the next visit." At the 15 month visit he said we’d talk therapy at 18 months if needed. He thought DS was ok socially (eye contact, affection) but said we'd "keep an eye out". DS continues to progress so maybe he's on his own schedule, but I am concerned that:

1. He has no words besides mama, dada
2. Has NEVER to mimicked or repeated words or sounds we make (though if he initiates a sound and we say it, he'll repeat)
3. He resists turn taking actions (won’t hit a ball back, for instance)
4. Isn’t so good at looking back at us when he wants something (so he’ll point or yell but not always look at us to try to get us to understand)

He’s quite physical and has met those milestones very early. My friends and family all say he’s normal, fine, that’s he’s just a boy and he’s busy now and he’ll talk later. I hope so and that’s all very possible but I don’t want to wait too late. I’ve heard too many stories of moms being brushed off and told to wait, only to wish they’d gotten help sooner. Hopefully I’m being a neurotic mother and worrying for nothing…but would you ladies get him in now with a ST? Or at least call my FFX county case worker and ask for another evaluation at this stage? Thanks for any advice.

[Anonymous]

Is he your first child? What frame of reference are you using to assess him (other kids his age)? Honestly I know quite a few boys who said virtually nothing until 18ish months and then had a "word explosion", so I don't think what you are describing is that unusual.

Ultimately, though, I think you should trust your mother's intuition. I think I would consult a private SLP because if you've had a sense that something has been "off" for months now, it might help ease your mind one way or another.

[Anonymous]

My first son had only a few words total by age two. Besides "yes", "no", "mommy", and "daddy", he only said "bye bye in car?".

[Anonymous]

I honestly have never known a boy with a lot of words before 18 months or so. Are you comparing him to baby girls you know? That's an age old mistake. He sounds like he's doing great.

[Anonymous]

This is a tough one. Trust your gut, stay on it. I don't see any huge red flags, but something could develop later.
My DS' speech was late, but it was an articulation issue. He is now 7, and is a sensory-seeker with ADHD/Inattentive.

He has been in ST off and on for 7 yrs, and I don't believe any of it did any good. Read to him, a lot! Get him involved in the story. reading to him is the #1 thing that will help his speech. IMHO.

[Anonymous]

I see tons of red flags for an ASD here, maybe because it sounds like my DS at this age. One of my pet peeves is this wait and see attitude with young children. The earlier the intervention the better. One piece of advice I read is that if you have a nagging concern -- and you sounds rational to me, not neurotic -- you should get it checked out. Dan Shapiro, a fantastic developmental ped in Rockville, is taking new patients under the age of four.

[Anonymous]

I thought that classes like Music Together with a very expressive teacher like Miss Amy (missamysmusicmakers.com) was helpful. My DC started singing a lot as a precurser to talking. I'd also think about adding some fish oil, it can be very helpful with language.

[Anonymous]

I would push for a ST at this point if you feel he needs it. I don't understand the "too early" explanation either. DD started ST at 11 months through ffx early intervention. Our main focus in the beginning was getting her to imitate sounds because she wasn't. (as an aside, we got her to do it by imitating her sounds and then she "got" the game...not sure if you've tried that. Anyway, I know all kids are different but I truly believe in a parents intuition. If you are uneasy, you should push to get him seen by a ST. It could be he is in the normal range and not an issue but a lot of what you do early on can be very beneficial if there is something there that needs to be addressed.

[Anonymous]

I am a early intervention teacher I would def call back the case worker and/or seek out a new ped. A good assessment of his language is the best way to determine what is going on. This can be done through your county or a dev ped (at his age this is where I would start).

[Anonymous]

My child was much like yours, OP, and also like pp 21:41 ... my son said "mom" at 19 months and his second word "moon" at 34 months, if I remember correctly. After that, language came quickly but at age 9 there is still a small gap between him and his peers ... I presume it will close soon at least from most people's perspective. He had a year of speech therapy in K and first grade and it helped his articulation a lot.

I personnally don't believe that early speech therapy would have helped him ... we had to wait until his brain developed to the point where he was able to speak. And being ADHD inattentive (as he was diagnosed around age 6) means he would not have been attending to the therapy very well, if at all. I'm pretty sure that was part of the reason for the delay anyway.

BUT you don't really know what will help and what will not, and ST certainly will do no harm at all, so if you can afford it then go for it. If not, you will probably being doing some later on. The most important thing is to ensure that while he can't talk to you, he CAN understand much of what you say to him. That indicates much less of a problem, in most cases.

[Anonymous]

I don't think you're a neurotic mother at all and I think you've got some very good questions. My DS is a lot like the PP in that he's ADHD (inattentive) and has expressive/receptive speech delays. He had ST for about a year but we stopped because the SLP thought his speech delay was more related to the ADHD and slower development than a communication disorder. He's also got executive functioning challenges (common with ADHD) which affect his speech (slower processing speed, poor working memory, sequencing, etc.). ST can help but there's a lot that you can do at home. We ended up getting a tutor for about 6 months and the tutor did many of the same things the SLP was doing. Maturing has helped the most and like the PP state, I don't know that ST or even the tutor did more than what the normal maturation process would have done.

Have you thought about an evaluation by a developmental pediatrician? I suggest it because there are many, many reasons why your DS's speech is delayed and unless you have a comprehensive evaluation, you won't really know. OTs and SLPs can do a lot but you really need a good overall picture of your DS to help you better decide if there's anything going on and, if so, what direction you should try. No matter what your family and friends say, if your instincts are telling you there may be something more, you should check it out. You want a developmental pediatrician to do that, not a general pediatrician. Good luck!

[Anonymous]

Have you tried Infant/Toddler Connection through Fairfax County? ITC provides services for younger children up through age 3. They did my son's speech evaluation (although he had just turned 2) and found him eligible for services and he new receives speech therapy once/week.

[Anonymous]

OP here. Thanks to all for the opinions, and for having read my LONG OP. I appreciate it. To answer a few questions.

Yes, he had an evaluation through Fairfax Infant and Toddler Connection. I technically discontinued services by declining the infant educator but can ask for another eval at any time.

Perhaps I am comparing him to other kids too much (such as talkative little girls, lol). And reading too many of "the books". Frankly, part of me wonders if I've been caught up in developmental awareness stuff. The plus of all the awareness is early diagnosis and intervention but the negative is that many of us drive ourselves nuts if our children look at a spinning fan! It's more than that here (no spinning fan obsession, that was just an example) but you get my point.

I had wondered if it was too early to go to a developmental ped but based on your experiences and comments perhaps that's a good idea. I'm in NoVA. Someone mentioned Dr. Shapiro and Rockville is doable. As you all know, visits with primary peds are rushed and focused on other things. I got the feeling that since my DS made eye contact with the ped, the ped checked that mental box and decided the wait and see approach was ok.

Btw, I picked up the book "It takes two to talk" (recommended by the infant educator) and am using methods such as those to encourage language development. And we do read a LOT to him and have from the beginning. If anyone has other tips, I'm all ears.

Thanks again, everyone.

[Anonymous]

It takes two to talk is a great book. If infant connection has the Hanen program for parents, take the class! It's a great one. MC I/T offers it to parents in their program and it is well received!

[Anonymous]

OP, my experience with my DS at that age was almost exactly the same as yours (the only exception being that we weren't dealing with #3 and #4 on your list). I decided to ignore everyone's advice to wait and see, and took my DS, at 15 mos, for a speech evaluation. The SLPs who evaluated him thought he had some red flags for possible apraxia (which can't be diagnosed until at least 24-36 months) and we started weekly speech therapy. DS is now almost 4 years old, has been officially diagnosed with apraxia, and continues to go to speech therapy twice weekly. It's impossible to say for sure whether starting speech therapy early helped, but my inclination is that that's one the reasons his apraxia is considered mild/moderate rather than severe/profound. I also have peace of mind that we did everything we could as early as possible to help him. All that to say, from my experience, I'd highly recommend getting him evaluated right away. If it turns out he's just a late talker, that's great, but at least you won't have any regrets.