Coming in to second and third to still consider getting hearing tested. It cannot be overstated how much you can’t tell as a parent. My child had one or two words at 18 months. I would have told you the same thing you said - no hearing issues, responds to requests etc. We did the hearing test and what do ya know, hearing loss due to fluid in his ear. That we also had no idea about and the pediatrician couldn’t see. He ended up getting tubes (hadn’t even had that many ear infections he was just a kid who really held onto the fluid) and after that his language skyrocketed. By 3 he was far ahead what was typical in verbal skills.

We learned that with fluid in the ears basically they can hear and will respond to you but it’s muffled. During this crucial time that actually makes a HUGE difference for speech. Because they can’t differentiate the sounds. They can hear enough to get by but not enough to learn and make the sounds.

So anyway, don’t dismiss the hearing even if your child can hear.

Anonymous wrote:My eldest didn’t say his first word until 19 months. We were referred to early intervention at his 15 month appointment and started speech therapy at about 18 months.

By 24 months, he was completely caught up and talking in full and complex sentences. We placed out of early intervention after six months (basically, that’s as fast as possible as they only test every six months).

He’s now a smart, vivacious, neurotypical five year old thriving in kindergarten.

Similar situation with my second child. Pediatrician referred to early intervention at 18 months with zero words (or “words”) and by 24 months he was totally caught up. I’m not sure early intervention was even necessary but it did help me feel better to be doing it.

Anonymous wrote:It’s common for speech to be the only issue. Don’t assume lifelong issues at this point.

+1 at the eval they will look at eye contact, "joint attention," basically how the child is engaging with you beyond speech.

We had this - flagged by ped and then did both county (moco) and private services. DD "graduated" from speech therapy by preschool and so far no other issues. And actually talks a lot now! I think the early services were great as we got parenting tips as well.

I have had two children with a speech delay. One of them turned out to have moderately severe hearing loss that we were totally unaware of. The other one I really thought couldn't hear but his hearing was perfect. It can be very hard to tell with small children whether they can hear or not. They can compensate surprisingly well.

Both kids ended up catching up on speech. The older one has ADHD. The younger one probably does too but isn't old enough to diagnose.

Anonymous wrote:OP here. Thanks for all the help. I got a referral to infants and toddlers who will evaluate her to see if she qualifies for services. I have thought about hearing and will have that looked at, but she responds to her name and simple directions (if I say “go get your shoes” then she’ll bring them to me) so I don’t think hearing is the reason for no words.

Op, I would not hesitate to have hearing tested. It's easy enough to do for the child and that way you can at least rule that out hopefully.

Anonymous wrote:OP here. Thanks for all the help. I got a referral to infants and toddlers who will evaluate her to see if she qualifies for services. I have thought about hearing and will have that looked at, but she responds to her name and simple directions (if I say “go get your shoes” then she’ll bring them to me) so I don’t think hearing is the reason for no words.

The receptive speech part is key. I have one child who was very slow to speak, but had excellent receptive language and is now scoring in the highest English language percentiles. I had another child who was slow to speak, but also delayed in receptive speech. He ended up having asd (due to a genetic mutation).

None of my kids were really talking until 3. We tested hearing and got speech therapy but they seemed to just start when they were ready. No other issues today.

Anonymous wrote:OP here. Thanks for all the help. I got a referral to infants and toddlers who will evaluate her to see if she qualifies for services. I have thought about hearing and will have that looked at, but she responds to her name and simple directions (if I say “go get your shoes” then she’ll bring them to me) so I don’t think hearing is the reason for no words.

Great update. I am the pp who mentioned the GUH audiology lab. For us, it was important to rule out hearing issues, as there were complications at birth. It turned out that the expressive and receptive speech delays were part of a broader issue--early intervention is key.

OP here. Thanks for all the help. I got a referral to infants and toddlers who will evaluate her to see if she qualifies for services. I have thought about hearing and will have that looked at, but she responds to her name and simple directions (if I say “go get your shoes” then she’ll bring them to me) so I don’t think hearing is the reason for no words.

Absolutely get an appointment. No one can assess a kid from a description over the internet.

In the meantime, if you aren't already, talk to her constantly. Narrate what she's doing, narrate what you're doing. Repeat stuff over and over. "You have a blue ball! That's a nice blue ball! Do you like the blue ball?" It may feel silly but that's the first thing my speech therapist mom would do with kids (my cousin's son was a but delayed and she taught my cousin how to talk like that).

The Child Find services are in VA, MD as well.
Just in case. The service is free, the sooner the better.

Early Childhood Assessment Sites
Dunn Loring Office Bull Run Office Virginia Hills Office

2334 Gallows Rd, Rm # 233 (Entrance # 3)
Dunn Loring, VA 22027
Phone: 703-204-6760

15301 Lee Highway
Centreville, VA 20121
Phone: 703-456-2200

6520 Diana Lane,
Alexandria, VA 22310
Phone: 703-317-1400

My kid pickup a few signs the one he used very often was, "more", it was really cute!

More
To sign "more" in American Sign Language (ASL), bring your fingertips and thumbs together on both hands, forming a "flat-O" or pinched shape, and repeatedly tap the fingertips of your hands together, often used for babies to ask for more food or toys. It's a simple, common sign that looks like you're gathering a bit more of something.

Anonymous wrote:Get an appt. for your local Early Intervention Infant and Toddlers Program. Also an audiologist to rule out actual hearing problems. (long ago we had a good experience with the Georgetown Hospital audiology lab). Good luck.

Another vote for this. Get a broad evaluation not just speech.