No more at risk for later behavioral problems than chatty tots, study shows
Article Source: msnbc.com
from:msnbc.comToddler of few words? Late-talkers can catch up
Seeded on Mon Jul 4, 2011 12:30 PM EDT (msnbc.com)
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If you're concerned your child is talking late you can always get them screened to see what their current levels of development are...
Your toddler's pediatrician should be screening your child for developmental milestones at each visit.
For example, at 18 months, you may be asked what words or babble the child is using to communicate. Does your toddler seem to specifically understand a variety of words you use?
My child's pediatrician picked her up (she wasn't scared of nice strangers) and walked her down the hall, asking her questions and pointing out different pictures on the walls. He said that she seemed very bright and that she seemed to understand everything that was going on and being said.
With that, we were reassured and continued to follow up with her pediatrician as she got older. An experienced pediatrician can tell a lot about a toddler just by interacting with them and watching their expressions.
Your toddler may also have his/her hearing tested to see if that is delaying verbal skills.
I called my local public school and they do screenings... that's how my son got into speech therapy. Pediatrician checkups are random so easy to miss.
Don't rely on pediatricians, but get an actual evaluation by a Speech-Language Pathologist through Early Intervention or your health insurance. Our current pediatrician advocated a "wait and see" approach when my 3rd child was showing signs of delayed speech at 18 mos. We tried that approach with my 2nd child, and he didn't get any better until he started speech therapy. So I had my 3rd evaluated through Early Intervention & she qualified for services. She's now 2 1/2 and it's now very clear that she has an overall developmental delay. The pediatrician now says that it's good I went with my gut feeling & had her evaluated sooner rather than later.
This study is just plain stupid because they excluded children that were later diagnosed with serious disorders that are associated with speech delays. You can't exclude children that were later diagnosed with serious disorders and then argue that parents shouldn't worry about language delays.
Worse, the study is dangerous because it may interfere with early diagnosis of disorders like autism. My son's diagnosis of autism was delayed by over 2 YEARS because a pediatrician dismissed our concerns about his speech delay and told us to take a "wait and see" approach. Well, we DID wait and see -- unfortunately for our son.
What you do not discuss is that among those children who definitely do NOT catch up, a proportion of them have speech sound disorders like Childhood Apraxia of Speech (CAS). CAS is a very challenging and difficult speech disorder in which children have great difficulty producing sounds, syllables, and/or words, despite having good receptive language ability. These children require early, intensive and frequent help! They may appear to not have other developmental concerns, at least not early on, but many are at high risk of future literacy and language learning disabilities. This may not be apparent when they are young, as described in this story. Children who do not have intelligible speech by school age are at high risk of future academic difficulties. This story does a disservice to the many parents who have tried to get their pediatricians to refer for speech-language evaluation , only to be told "your child will outgrow it." No one can predict which ones do and which ones do not outgrow what is initially called a "speech delay" or a "language delay." Pediatricians - please, please, please refer for speech-language evaluation by a speech-language pathologist whenever a child exhibits delayed speech and language!! Please learn more at our website
My twins are severly apraxic and it is a struggle to educate people on this condition. It's not just a speech delay but a neurological disorder we are trying to overcome. Stories that tout 'all will be fine' make this horrible struggle and the need for understanding much worse. They do my children and me, as a parent who has quit her job to support the daily speech appointments, a disservice in how much we sacrifice, give up and work on everyday. My children have worked harder in the first 3 1/2 years of their lives than I ever remember working in mine.
CAS Twin Mommy - if you don't mind my asking, at what age were your twins diagnosed with CAS? I have twin boys who are both speech delayed - they are now 21 months and aren't saying any words consistently, just a few sounds. It terrifies me to think that they might never be able to talk. They have seen a speech therapist with not much success, and we are seeing a neurologist soon. BTW I agree that the "wait and see" attitude is the worst thing you can do for these kids!
I have b/g twins who were both late to speak... around 2.5 my daughter was working up to saying more words but my son was mostly indicating/having sister help to communicate what he needed. Since she tends to be very charming and outgoing with people, she tends to get more opportunities to speak. Last fall when they were 3.5, I was making calls to the public school about pre-k and I found out that they did free screenings. My son got enrolled in speech therapy for a 30 min weekly group (2 other kids) session. He also tends to be very high energy (not in a hyperactive way) and is not as socially sensitive as his sister. Before speech therapy, a lot of kids his age or older wouldn't care to play with him - missed out opportunity for him to engage/grow. However, we are much more careful now to try to look him in the face when we are trying to correct his pronunciation (so he can see how our mouths form the words) and make sure that he feels that we care about what he has to say. He says many more words, tries to engage us more, and is much clearer.
One of the challenges of parenting twins is that even though we know there is no comparison of twins to singletons, you still feel like they should meet the milestones at the same time as singletons, even though their resources are halved.
First off thank you for bringing up a topic not spoken about much (pardon the pun) But please accept a counter point to this article. In theory this article is correct as 75% of late talkers will be just that. Ignore most late talkers and yes "most" will outgrow the delay and be just fine. But what about the other 25%? Early intervention is benign for 100% is essential for the 25% that do have a speech impairment, and may stimulate speech to come in sooner for the 75% even if it isn't needed.
The typical pediatrician who is frontline to most children may not be aware of a condition called apraxia or dyspraxia here in the US -more frequently diagnosed as dyspraxia in the UK. Apraxia is a multifaceted communication impairments and for some reason not mentioned in your article. Most pediatricians will rule out autism, hearing impairments and if those two conditions are ruled out, they may not see a reason to continue any further investigation. Many pediatricians are still not aware that most children with apraxia present "normal" when they are little. Typically as apraxia is rarely today limited to affecting speech many have mild hypotonia and or motor deficits in the body. There can be sensory integration dysfunction with apraxia today as well. While severe deficits would be obvious to all, the typical parent or pediatrician may not be able to spot mild hypotonia or motor deficits which is why when apraxia is suspected an evaluation by a pediatric neurologist or developmental pediatrician is highly recommended. As apraxia doesn't in itself affect social or cognitive abilities these children know and are fully aware of what they want to do and will push themselves. The younger they are the easier it is to keep up on skills outside of speech.
I co authored the book The Late Talker (St Martin's Press) with my son's neurodevelopmental pediatrician. It was due to early intervention and hard work that may son was able to overcome his apraxia. One does not outgrow apraxia -one overcomes apraxia just like any other impairment of speech. For this reason apraxia is not a childhood condition, and by taking the wait and see approach you can end up with teens and young adults who are still unable to communicate verbally and be understood. I have just started a support group called YADA (young adult, apraxia, dyspraxia, association) for those that grew up with apraxia or another impairment of speech and are now teens and young adults who need support. While again there is no downside to early intervention -the ramifications of the wait and see approach for those that do have an impairment of speech will affect all aspects of life -far beyond simple behavioral aspects (if only that was the only issue!) We have one 21 year old who lives with her parents and works at the market down the street who is still not able to talk and be understood -and she writes how she dreams of doing so much more. Please contact me so I can put you in touch with parents of teens and young adults -or in some cases with the adults that grew up with apraxia and can now speak for themselves on this issue. You so need to look at the other side with this. Our nonprofit has a few websites -but please if you have a late talker child look at the new member doc on this at You can also visit our websites at We have a few groups at Yahoo and BigTent and you can follow us @thelatetalker on twitter. If you need any information on this please email me lisa@cherab.org
my daughter was 2 almost three and was not talking much. within one year she was talking and reading. at first i thought the words she pointed to were just her recognizing the words because she knew the containers they were printed on. she turned out to be an exceptional student and went on to become an attorney. she also turned out to be a rather introverted person ---thinks alot but often doesn't feel a need to verbally express her opinions . her late talking i think was just apart of her personality.
I had a similar experience as Granny with my eldest. She was a late talker and I thought there was something wrong. Yet when she did begin talking she never seemed to use words that she could not pronounce clearly and she spoke in complete sentences. It ended up where because she was tall for her age everyone thought she was older than she was because of her speech. Turns out she too was advanced academically and has done very well since. What I learned was don`t panic yet.
One of my sons said his first word at 8 months and didn't have much to say after that. Even into his third and fourth year he preferred to observe and listen more than talk.
We were a little concerned because our older kids never stopped talking. But a specialist reassured us that once he started talking we would find that his vocabulary was at age level or even better.
The doctor was right. In grade school testing his vocab scores were always above the 95th percentile. His speaking/communication skills are an important asset in his career today.
My older son didn't talk until he was 3 and now he's the one all of the teachers want in class as he aces pretty much everything (he's 10 now). My younger son didn't talk until he was 4, everyone except me panicked, and now at 8 he talks just fine and is also doing exceptionally well in school. In contrast, my ex MIL's kids all talked before they were 1 year old and none are that bright. My ex husband will tell you that himself as he told her that while she panicked. Early speech does not a genius make and late speech does not an idiot make.
True, but starting speech therapy at a younger age won't hurt those kids who would've turned out OK and is essential to those who wouldn't.
I agree. My son did not say a word until he was three, and he turned out fine. Every child is different, don't compare you child with others. You as the parent is the one that will set the tone of how your child will turn out. There are no guarantees but family core is big when raising your children.
My daughter didn't actually talk until she was three. She babbled but nothing intelligible. Her older brother spoke in full and complete sentences at age 13 months so I was worried. Turns out I needn't worry. We now joke that once she started talking she never "shut up". She is 36 years old now and doing quite well as is her brother. Her talkative brother is now the one who is quiet. You just can't ever predict. Obviously had I felt she had a serious problem I would have had her at the pediatrician. Actually he is the one who told me to give her another year (she was not quite three at the time) before I started worrying.
This article is just a reconfirmation of information that's been commonly known for at least 40 years. It was confirmed back then that if a child didn't talk until age three it was nothing for a parent to get overly excited about. Just continue giving the child a lot of mental stimulation, loving attention and (most of all) don't lose sleep worrying about it.
There are exceptions, but in most of these slow-to-talk toddler cases it's slow development; once they start talking it becomes a total non issue and has nothing to do with the child's I.Q.
I think the fact that the research did not include information regarding intervention, if any were done, makes it deeply flawed. You cannot tell parents to "relax" and at the same time say "oh, but we don't know if these children merely outgrew it or if they had help".
I have four children. All were late talkers. My oldest started talking after two as if a light bulb turned on. My other two had good reason not to talk--they are both in the autism spectrum disorder. The fourth one was a micro preemie. But I sought help early and aggressively even when doctors told me they'll outgrow it. I think it does parents and children a disservice when their concerns are brushed aside, especially when we know early intervention is a good predictor of the success of children being "typical" when they grow up.
I understand that for the majority of children, no intervention is needed but this research with its flaws sends a dangerous message because parents may not seek help for their kids who may truly need it. I have seen first hand the difficulties of speech delays when parents wait too long to get help because they were told their children will out grow it, especially when these speech delays are symptoms of underlying medical issues.
I have custody of my two grandkids, my boy was an early walker and talker. My little girl was delayed. She was two before she got her first teeth. When she wasn't talking at two, then at three...We had her checked.
The doctor said not to worry.
It's funny. When she finally started talking ---She hasn't shut up since.
My second was a late talker and now won't shut up either! I ran into his old speech therapist the other day and she couldn't get over what a little chatterbox he is now.
I hope that the parents of toddlers who aren't talking some by age two get the childs hearing checked. Even slight hearing loss can alter the way a child understands what is being said to them and how they respond to different people and sounds.
The research didn't distinguish between children who have an expressive language delay but good receptive language (e.g. they can understand the words but just not say them) and those children who have both expressive and receptive delay. Children who fall into the latter category especially need early speech therapy. An evaluation by a Speech & Language Pathologist can help determine whether the child's receptive language falls within the normal range.
My son has mixed receptive/expressive disorder. He is 2. He has a prolem where his ear drums do not vibrate and recently has lost all hearing in his left ear. We have Speech Therapist to our house twice a week but he's still extremely delayed. I hate the pediatricians "wait and see" approach.
My Child is almost 4 and he just started talking full on sentences about 6 months ago when he attented pre-school and before that he had his own language but usually used one and two words at a time but he's always been able to comprehend and understand everything being said to him, directions and questions...funny though because he refuses to say the word yes unless arguing no and yes Lol, my doctor was concerened and we had his hearing checked which was great and I slacked on getting him to the speech therpasist but now it's no longer needed, he still has his own words for things such as cars he calls ragana and buses something else, but he knows the proper names...
Children are so independant and curious and a lot of parents don't seem to realize that, it's like children that don't walk until they go to school...the parents will almost always hold them and carry them for everything, I've worked with tons of toddlers and anytime a child has come to school and not walked it was because of the parents holding them....GIVE YOUR CHILDREN TIME TO BLOSSOM AND GROW! I know thats not always the case but a lot of the time it is especially if there an only child like mine...now he talks 24/7 and I love every moment of it =)
I hope more research will occur as far as the possible effects of fetal-alcohol syndrome upon speech development.
Our daughter is 18 Months old, and very "selective" with her speech. She does have a limited vocabulary that she uses when she wants, but not at our prompting. her babble is filled with consonants, and vowels, but very few words. She understands a great deal of what we say, and we know this by observing her reaction to our speech.
We're first time parents who're a little concerned that she is not verbally communicating more than she is. Please note that we are not even CLOSE to being in panic mode, but we are wondering if we are doing enough to help her develop her verbal skills.
My wife is Latina, and we are a bilingual household. could this be an asset , or a hinderance to our daughter?
My brother's wife speaks fluent French and has been introducing it to my niece since she was born. She is SO fortunate to have this opportunity; it will make learning other languages easier for her as she grows up! Kudos to you and your wife for introducing both languages to your child at an early age! :)
Bilingual children do tend to run a bit "behind" monolingual children when they're young, and there is a *LOT* of language development between 18 and 24 months. Most SLP's won't evaluate children until 24 months unless there are known risk factors like hearing loss for that reason. But if you still have concerns when she turns 2, do pursue an evaluation.
Bear in mind that there is often a waiting list, so if you want to get an evaluation at 24 months, you may need to request one at 21 or 22 months.
There are all kinds of reasons kids talk a bit late; some have parents who anticipate their every need and the kids don't HAVE to ask for anything, some grow up in bilingual households (*incidentally, introducing two languages early is a GREAT thing!), etc.. My nephew has a friend who didn't talk normally until age 4 but everything is fine with him now. Even so, if parents notice other warning signs (ie, lack of responsiveness to sounds, signs of difficulty with simple, age-appropriate tasks) then maybe hearing and other tests wouldn't be a bad idea.
My son was also a late talker. He was screened by a speech therapist through our school district. He was found to be a good candidate for therapy, and was followed through preschool and elementary school. He has done well and we anticipate him being discharged when school starts again in the fall. He is an excellent student, all A's in third grade, and expresses himself well. Perhaps he might have done this well without speech therapy, but I'm glad he had it. The best part of all is this service was provided free through our school district.
I would strongly encourage any parent with questions about their child's speech to talk to their child's doctor, and inquire about speech services through your local school district, as out physician was not familiar with the offerings of our school district. It may make the difference between an average student and one that excels, and we all know that kids can be cruel to other kids that are different, including ones that don't talk, or talk a little differently.
It's encouraging to learn that parents need not worry too much if their child is a late talker. On the other hand, sometimes this can be an indicator of serious problems - and these should then be dealt with promptly. So, the skill of the good specialist, is being able to know when to reassure, and when to intervene.
Readers may be interested to watch my 16 minute documentary about children with speech disorders. It was produced in the 1980s, but the issues remain the same – and much more needs to be done. "Speaking Out – children with speech disorders", can now be freely viewed on my YouTube channel at www.EyesEars.com: