Speech Delay in 22 mo old

Anonymous
Hello, my 22 mo old son is not speaking yet. He doesn't say mama or dada, or try to mimic words (although he will mimic us if we make strange noises, such as vroom for a car, or blowing raspberries.

We have had his hearing checked and he passed. His comprehension is excellent, he can follow directions like, "go to the closet and bring me your shoes". He maintains eye contact, points to things he wants or things he wants to show us, can identify objects in a book, and shows significant interest in other children. He can feed himself with a fork or spoon and can suck through a straw. We've also taught him a few sign language signs, and he picked them up immediately.

He appears to be developmentally on track in every way - except speech. When he babbles, it is mostly vowel sounds, although i have heard him use some consonants. His pediatrician says its an unexplained delay, possibly because we understand his needs and body language, so he doesn't NEED speech. But I can tell he gets frustrated sometimes. We've reached out to our county's early intervention program. But they have yet to recommend a treatment.

I am curious if any other parents have experienced such a thing with their child. If there is such a thing as an "unexplained speech delay"? Or if anyone with similar circumstances saw an improvement with speech therapy? I'd also like to know if anyone can give me a comparison or benefits of EI (paid sessions) versus therapy given at a local public school (free).
Anonymous
OP, virtually all delays at this age are unexplained. If someone tried to give you a diagnosis at this age, it would be suspect unless it was based on a genetic disorder or actual physical abnormality. It's virtually impossible at 22 months to say whether this is just a "behind the curve" kid or this is true developmental delay or this is MERLD or this is aphasia. You can't predict which kid will be talking perfectly at age three and which kid will go on to need years of speech therapy. It just is an unexplained delay.

It's strange that EI can't give you any exercises to do with your child. I would seek private speech therapy.
Anonymous
OP, Your kid could have an expressive delay. I would call Infant & Toddlers for an evaluation. (I would also consider getting a new pediatrician.)

Speech delays can be caused by a variety of reasons, but a pediatrician and/or an ENT can look for fluid in his ears. My kid had chronic fluid/not infected but it contributed to his speech delay.
Anonymous
I would take him to a private speech therapist for an evaluation (ours ran about $450 fyi), particularly if EI is not being helpful. My DS also had very few consonant sounds as a toddler--pretty much just d and m. He is 27 months now and started private speech therapy at 19 months. He has suspected apraxia but is still a little young for a definite diagnosis at this point. But, I agree with PPs that it could be any number of things for your DS, ranging from a speech disorder to just a "late talker." The private speech evaluation (and then private therapy) was the best thing we have done for him.
Anonymous
My son had a handful of words at that age, enough not to qualify for services. My pediatrician did, however, recommend private therapy or maybe I should say that she enthusiastically supported my idea to go for it. It took a few months of therapy for the SLP to come up with some ideas that explained the delay. I think she was spot on and her suggestions for home exercises helped him a lot. He graduated from speech therapy after a year and now at age 4 talks non-stop and has a huge vocabulary. He continues, though, to have some odd speech quirks (mixing up words he obviously knows, for example), which I imagine will always be unexplained.
Anonymous
I agree with the PPs in suggesting an evaluation by a private SLP (speech language pathologist = speech therapist). At 22 months, my youngest had very few words that anyne outside the family could understand. After an evaluation by an SLP from our county's EI, we had his ears checked and he had unresolved fluid even though he had no history of ear infections. He got tubes and started therapy. The therapist suggested we also teach him sign language. He acquired signs far more quickly than words but once he got the word, he dropped the sign. You can look at your library for a signing video (that's where we got ours). Start off with simple signs like "more", "please", "thank you", "milk", etc. (I'd also think about getting a new pediatrician).


Anonymous


If his receptive is good it wouldn't be MERLD, it would be an expressive language delay (or disorder). Although it can be tricky to parse out receptive language at young ages.

You can join Dr. Jim McDonald's Communicating Partner's Yahoo group. It's a very active group of parents with kids with language issues, and Dr. Jim is an speech therapist and former Ohio State professor with decades of training and comes on frequently to comment and offer tips. His website is http://jamesdmacdonald.org/Articles/MacDonaldStart.html

You can also join us at www.naturallatetalkers.com, although most kids there also have receptive delays.

There's also the Hanen method:
http://www.hanen.org/hanen-programs/programs-for-parents/it-takes-two-to-talk-parent-program.aspx

Also, I've met parents whose child wasn't saying anything at 2 but was caught up by 3. So you never know. But a good evaluation, followed by using some of the therapies above, can go a long way in easing your child's frustration.

Good luck!
Anonymous
DS is now 21 months, and we jsut went through the county a couple months ago. We also saw nutritionist, Kelly Dorfman, for other issues, but she did recommend a high DHA dose for speech delay. 1.5 weeks later, he had doubled the amount of words he could say (4 words to 8 words). It may be coincidence, but to us, it was worth seeing Kelly. Also before, he had a hard tim emaking sounds come out, but that has also improved drastically. At that point we hadn't had any speech therapy sessions, but we have started that since.
Anonymous
Anonymous wrote:DS is now 21 months, and we jsut went through the county a couple months ago. We also saw nutritionist, Kelly Dorfman, for other issues, but she did recommend a high DHA dose for speech delay. 1.5 weeks later, he had doubled the amount of words he could say (4 words to 8 words). It may be coincidence, but to us, it was worth seeing Kelly. Also before, he had a hard tim emaking sounds come out, but that has also improved drastically. At that point we hadn't had any speech therapy sessions, but we have started that since.


I am the PP with the child with suspected apraxia. We haven't seen Kelly Dorfman (and it seems opinions of her on this Board are mixed), but we do supplement DS with fish oil. We use the regimen and brand recommended in the book "The Late Talker" (which is primarily about apraxia). We also saw some good progress on the fish oil.
Anonymous
Get him evaluated if you are worried. I have a child with MERLD and another with apraxia. The first child started speech at 2.5 and the second at 20 months. I, of course, feel that if you are worried have him evaluated.
Anonymous
Definitely have your child evaluated. Children's Hospital is a good choice, if you have BCBS it may even be free, ours was. Once you have the evaluation go from there. Our son had 3 words at 18 months, we had a speech and hearing evaluation, he had expressive and receptive language of a 9 month old. We started speech therapy right away at GWU speech and hearing clinic. We also gave him fish oil supplements (following the advice in the book the late talker). He was on track after 10 months and now that he is 6 years old people are shocked to learn that he had delayed language. DO NOT wait for services through school. The private therapy included me in the room for the session and taught me to play at home with him in a way that encouraged language. They also gave me assignments to work on over the course of the week. A great book that was recommended to me by the therapist at GWU was "the New Language of Toys". It has suggestions for toys and books at various ages (and for kids with various disabilities) but explains way to use them to encourage language. Has ideas for homemade toys as well as store bought toys.
Anonymous
Personally I would at least go to a reputable private ST and get an evaluation. Our DS started ST around 20 months. He had no receptive delay but expressive. Of course we will never know whether the ST helped him or he would be where he is now without it, but I am so glad we did it. The thing is, at this age, it is impossible to know whether your child will be one of the kids who will "outgrow" the issue on his own or whether ST is necessary. IWaiting until it becomes clear (some parents wait until 3+) and you miss a window of opportunity to change the trajectory of your child's development. I had one friend whose DS had expressive speech delay and her family discouraged her from getting ST, ped was wishy-washy, and she didn't do it. 2-3 is a hard enough age but speech delayed kids can have so many more tantrums (from frustration, not being able to communicate, etc.) and I think her DS could have benefited big time. She only started right before his 4th birthday and I think he'll be in ST for a while (longer than if she'd started before). However, it's a lot of guessing for most. You have to do what you feel comfortable with.

I highly recommend the book "It Takes Two to Talk" put out by the Hanen program. Available on Amazon.
Anonymous
OP here. Thanks for all the responses everyone! I wasn't expecting to get so much feedback, and I really appreciate it.

We have taken our son to an otolaryngologist to have his ears and hearing checked. There was no evidence of fluid in his ears, and like I said before, he passed his hearing test just fine.

A rep from our county's EI program has come out to determine eligibility, but they have yet to do an assessment (scheduled for later this month). I guess I'm just an anxious, worried mom - it's taking longer than I had hoped.

I'm going to look into having a private evaluation done (hopefully our insurance covers it - we have BCBS, but it's HMO). Can anyone recommend a speech pathologist/therapist in/around Reston, VA?

In the meanwhile, I've started DS on DHA supplements. Thanks for the recommendation!
Anonymous
OP, I'm glad you're on the right track. I would also search this forum for speech therapists also sometimes referred to as SLPs for (Speech Language Pathologist). And speech therapy is somethings written as ST (at least here). ASHA find a pro is useful: http://www.asha.org/findpro/

Also, here's the link to the Hanen book:
http://www.amazon.com/It-Takes-Two-Talk-Practical/dp/0921145195/ref=sr_1_1?s=books&ie=UTF8&qid=1334486834&sr=1-1

I really got a lot out of it as well. It's expensive so you could always see if your local library carries it.
Anonymous
Anonymous wrote:OP here. Thanks for all the responses everyone! I wasn't expecting to get so much feedback, and I really appreciate it.

We have taken our son to an otolaryngologist to have his ears and hearing checked. There was no evidence of fluid in his ears, and like I said before, he passed his hearing test just fine.

A rep from our county's EI program has come out to determine eligibility, but they have yet to do an assessment (scheduled for later this month). I guess I'm just an anxious, worried mom - it's taking longer than I had hoped.

I'm going to look into having a private evaluation done (hopefully our insurance covers it - we have BCBS, but it's HMO). Can anyone recommend a speech pathologist/therapist in/around Reston, VA?

In the meanwhile, I've started DS on DHA supplements. Thanks for the recommendation!


I'm one of the PPs, and we go to the Springfield office of Children's Speech and Language Services. I can't recommend them highly enough. I know they have some patients that come in from Reston. They do not take any kind of insurance. You can, however, take your bills and submit them to your insurance company for reimbursement if they cover speech services. Make sure you read your policy coverage closely. E.g., our insurance (FEHP BCBS Basic) does not cover any type of developmental speech therapy. Our previous insurance covered rehabilitative speech therapy but not therapy for a delay. It can be difficult to find an SLP that takes insurance.
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