Wednesday, September 05, 2007

Speech Delay - Question for Dr. Sheila Cason

Dear Dr. Cason,

My 15 month old hasn’t started to talk. Is this something that we should be worried about or just watch closely? I have read many books about it and most of them say that by 15 months they should be saying a hand-full of words by now. I was just wondering what your advice is.


Dear Anonymous,

I get this question a lot!! Parents look around, compare their child to others and then start to ask the question, “Does my child have a speech delay?” When a parent comes in my office and is concerned about a speech delay. I listen pretty carefully. It’s stressful to think there might be something going on. I first ask if the child points and if they make eye contact. I want to immediately assess if there are deeper developmental issues. At 1-2 years of age language should really start to take off. Because language is a highly complex task, speech delay can be an early presenting problem of a child who has other developmental disorders. After talking with them about their concerns, I then get a piece of paper, write everything down and really count up the words. Does he say up, down, mama, dada, papa, more, dog? Don’t worry about articulation issues at this young of an age. Sometimes I have noticed that parents will think their 16 month old isn’t speaking. But if you really break it down, it turns out they say one particular mumble every time for water. This is their word for it! Then I look at the other mumbles!

A 1 year old should have between 3-5 words and by the time they are 18 months then they will have between 10-20 words. Don’t get stuck on the number though! But I have to admit I’m a little stuck on the number and have written all of my boy’s words down!! He’s 16 months old has taken his time acquiring language; he’s much different than my girls were. Remember that the norms are guidelines and all children will have their own rate of language acquisition. When I finally couldn’t take him screaming duuuuhhh for everything I got very aggressive about teaching him American Sign Language. This is a great way to tap into the language capacity of the child. He now signs more: please, thank you, want, food and water and milk and his favorite “all done”. Speech is a good user friendly site to get some basic ASL and tips how to use the signs.

If you suspect your child has a speech delay, the best thing you can do is check with your pediatrician. They are trained to evaluate your child and refer you if there is a concern. But, having said that, many people – including friends, family and even your child’s doctor- will say don’t worry let’s wait and see. You don’t have to do that. If you really want an expert opinion then ask to see a speech-language pathologist certified by the American Speech-Language-Hearing Association for a professional evaluation. You can check your child’s milestones yourself by looking at the website of the American Speech- Language- Hearing Association. They have great articles and detailed explanations regarding speech delay. Good luck and don’t forget to read everyday and talk, talk, talk!! These two are the best things you can do for your child regardless of whether they have a speech delay or not.

Sheila Cason, MD



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