Please eliminate all screen time.

Talk to your ped of course but I just went through this about 3 weeks ago. DS, 19 months, has his 18 month appointment and I was concerned he didn't have many words. When the doctor asked me to list off what he says I was surprised to see that he has more than I thought (ex- bebe for baby or blueberries depending on context). Every kid is different and our doctor offered a referral if we wanted it but said he was not at all concerned. His receptive language is great and he communicates through head nods and pointing pretty well. We're a few weeks out and he has a few new words - so we're feeling better! If we don't see some more progress we will seek an evaluation but for now we're encouraging speech and kind of letting him do his thing.

My son was slow to develop verbally (in no small part, I think, due to the fact that he had an older sister more than willing to talk “for” him). He’s five now and is exactly where he’s supposed to be. I did get some early intervention when he was about 18 months - 2 years.

Anonymous wrote:0600 here- I should add I felt really judged by the county for declining testing. I felt the virtual assessment they did was completely wrong (12 month level even though she was gaining several words weekly by the time we had the virtual assessment, which is NOT 12 month level) and they suggested intensive and expensive therapy-but not with a speech therapist. When I didn't respond right away they kept bothering me to start the services- the communication was sales pitchy to the point I wondered about if there was a budget problem, and was even a little concerned they would call CPS on me if I declined. They did finally leave me alone when I signed the paperwork declining services. So.. be prepared for something like that if you do get the process started and your child takes off in the meantime.

Of course they kept bothering you - they had to close the case out. Why wouldn’t you take care of that immediately? Don’t blame them for your own disorganization/procrastination. Lol at “budget problem”!

OP - you don’t have to go through the county. You can do private speech therapy. In fact, my experience is that the county is very stingy with speech services. Even if you qualify, they will likely not have you work with an actual speech therapist, it will probably be a special educator who will work with them on vocabulary. A friend who used to work for Infants and Toddlers in Montgomery county (as an SLP), said it’s because the speech services are in such high demand they are only able to accommodate the “worst” cases. They can’t come out and tell you that so they pass you off onto a special educator (in Montgomery County they refer to the service as “SPIN”, which stands for “SPecial INstructor”.

Also, you can always go to a private speech therapist on your own. The advantage to using the county is that they will do a comprehensive evaluation across all areas of development. It’s nice to have.

Anonymous wrote:0600 here- I should add I felt really judged by the county for declining testing. I felt the virtual assessment they did was completely wrong (12 month level even though she was gaining several words weekly by the time we had the virtual assessment, which is NOT 12 month level) and they suggested intensive and expensive therapy-but not with a speech therapist. When I didn't respond right away they kept bothering me to start the services- the communication was sales pitchy to the point I wondered about if there was a budget problem, and was even a little concerned they would call CPS on me if I declined. They did finally leave me alone when I signed the paperwork declining services. So.. be prepared for something like that if you do get the process started and your child takes off in the meantime.

I don’t understand this - the county services are free. My son was in the program and therapists came to our house, for free.

DS just went in for his 18m checkup this week and we have referrals. He loves singing his abc’s but has fewer than 10 words he uses on a regular basis.

You should contact Infants and Toddlers now.

It takes awhile to get the evaluation and start services. Your child has to be at least 25% delayed to qualify. There’s no harm in getting an evaluation.

Ask your ped to give you a list of places where you can get a hearing evaluation and then make an appointment. We found MoCo’s early intervention service very helpful for the 13 months my child received services.
But you can also contact a speech therapist directly. In this area many of them are not in-network with insurance plans and anyways insurance might only cover speech if you have a formal diagnosis.

Is your child a boy? My son hardly said anything but mommy at 18 months, I thought. It was only when we were on holiday and walking around the airport wasting time and we passed by some train looking thing - I hardly noticed it and my son said his usually gibberish. He repeated it a couple of times and I tried guessing with no luck. He got more and more upset. When I kept walking, my son said, clear as day, "I want to go there!"

Point being, trust your instincts - he may have more words than you think but you just may not recognize them as words.

Anonymous wrote:All four of my children didn't really start talking until around 2. Hardly any words before that. Our pediatrician wasn't concerned because they were pointing, making lots of sounds and could follow directions (indicating they had high receptive language). Every pediatrician is different though.

It doesn't hurt to get a referral for speech if that is the recommendation. The county is fine at this age. You can start the process and then bow out if your child starts talking.

My DD didn’t have more than 5 or 6 words until 23 months. Speech therapy was lightly suggested by the pedi but I didn’t do it because she was meeting or exceeding all other milestones and communicating in her own way. Her vocabulary exploded right before her 2nd birthday.

Anonymous wrote:Thanks, all. Is the county the only way to go or can I just call someone?

Go to your pediatrician first. They will refer you for a hearing evaluation. Most speech therapists will want that anyways. You should have some kind of early intervention services in your state - a previous PP pointed out in DC it’s strong start.

Our timeline basically went: handful of words at 18 month ped appointment. First hearing test at 19 months. First speech evaluation about a week later. Second hearing test at 20.5 months. Strong start speech evaluation around the same time. Third hearing test at 23 months. Started speech therapy just before 24 months.

So the whole thing takes time and they won’t be able to gather all they data they need in one audiology appointment. So I’d just get started, it sucks up a lot of time, but insurance covered most of it.