21-Month Speech Update

Three photos of my son playing with Megablocks, oversized plastic Lego-like blocks. He is intently building a tower in the first photo, then turns his back as the tower makes an arc as it begins to fall over and in the third scene my son is running around the tower base to retrieve the fallen blocks.

Our son is 21-months-old with no progress on speech. He can say one word — Mama — but it’s simply used now to signal distress or a desire. He’s unusually quiet, but a hearing test turned up no problems. It’s a far cry from his sister’s 18-month word list.

He has a short attention span for anything that doesn’t intensely interest him. And, he has difficulty understanding when his actions might hurt someone (such as pulling hair), but he is quick to comfort that person, usually his sister, when she cries.

We’re not too worried about his intelligence. He exhibits great problem solving skills, whether it’s defeating our babyproof door knobs or fishing an unreachable ball from under a futon by lying down, backing in, and pulling it out with his feet. But of course, intelligence has many measures.

The speech issue is huge for us. It’s distressing that he doesn’t have a word for Mom, Dad or Sister. He clearly understands and follows many of the directions we give him, but other times he’s oblivious. I wonder whether he understands why, for example, he receives a time-out.

Our health insurance doesn’t cover developmental delays not caused by a physical injury — almost no US insurance policy does.

Our first, best option of assistance from state-funded specialists failed at 19-months when a speech pathologist assessed him as being at a 15-month level while a developmental specialist said he’s at 6-months.  You’d think such a discrepancy between specialists would warrant a third opinion, but not in California.

Meanwhile, our county office of education rightly sees a need to help with speech delays. If they don’t do early intervention, they pay more later when he enters public school and requires extensive attention.

We’ve begun a weekly appointment with a county special education teacher who works with all sorts of childhood issues. A generalist is not what we’re looking for, but it’s free, so we’ll give it a try.

We’re doubling up though. A couple weeks ago we began paying cash for a weekly session with a speech pathologist. The difference between the two forms of assistance is extraordinary. I feel sorry for anyone in our sort of situation who cannot arrange to see a pathologist.

We’ll be teaching him sign language and working on techniques we observe the pathologist using.

There’s no question. My son does have a developmental delay (at best) and the faster we address it, the better off he’ll be over the next few years.

At worst, or at least the worst I can imagine, is speech apraxia, which is a physical/mental disorder preventing speech. My mind turns to that scenario because my son makes almost no sound, no babbling, except when extremely happy or in extreme distress.

We’re hoping our son has just a ‘normal’ delay and will start talking in the next few months. If not, then we hope to have the nature of the problem narrowed down by then.

In the meantime, we’ve filed paperwork contesting the state’s denial of treatment, which we feel was driven more by the state’s fiscal crisis than by the statutes they are required to follow.  I don’t expect a positive outcome, but ya gotta try.

Anyhow…. The block building you see in the photo above is a new development last week. Until now, he’s had little interest in any activity that isn’t physical or food-related. We’re delighted to see him be able to sit (or stand) for a few minutes building — not throwing — towers with Mega Bloks. He really is, most of the time, a very happy little boy.

My original point was to just to share the Mega Bloks photo with you. My wife was playing a children’s reggae CD at the time, and I absolutely, positively hate reggae, but my son was softly swaying back-and-forth to the music in the cutest little way.


23 Responses to “21-Month Speech Update”

  1. RobMonroe says:

    We have a nephew that had great luck with therapy – typical no-talker to can’t-get-him-to-stop-talking routine.

    We have had wonderful experiences with sign language. Your daughter would probably learn as quickly as he would, and that would give everyone the ability to communicate. We are HUGE fans of Signing Time (www.signingtime.com) and you can find some of their video’s on YouTube, though none of the “basics” of communication.

    Best of luck to you and the whole family as you continue to sort things out.

    December 9th, 2009 at 6:18 am

  2. My Boaz's Ruth says:

    My husband and I were both VERY slow to talk. So when my son was slow, we were not too worried. It does happen, with time. I’ve been ecstatic, over the last two weeks, to hear him using more words. (He’s 28 months old)

    He said his first word at 13 months (All done) and got up to about 5 words very quickly. Then stagnated there until 22 months. He started doing more babbling, animal sounds, etc. after we had to put him in a childcare setting at about 22 months. And gradually has started picking up more words, etc. Over Thanksgiving week, though, his vocabulary blossomed. Now he’s looking at letters and asking us to write them and identifying them, etc. Still very hard to understand, but making progress.

    Since he could follow directions (even fairly complex directions) and we made sure his hearing was not affected, we decided not to worry about it (Well, we decided, mom still worried some time).

    December 9th, 2009 at 6:42 am

  3. My Boaz's Ruth says:

    Meanwhile, his second cousin and friend’s daughter who are three weeks younger than him have been speaking in sentences. The girl at childcare who just turned 2 yesterday has better vocabulary. Another girl who is about 8 months younger seems to have better vocabulary.

    But I am told, over and over, NOT to compare like that. Girls get their words faster. Girls mature faster, in general. And this will continue all the way through teenage years.

    December 9th, 2009 at 6:44 am

  4. Steve Webb says:

    I’ve got a 5 year old boy and a 2 year old girl. My boy talked at 18 mons and my little girl still has yet to speak any real words. She’s in a sheech therapy class once a week now and my wife and I are getting a little apprehensive waiting for her first real words, but the specialists tell us that there is nothing really wrong, she is just taking her time getting the brain synapses to connect and she’s not confident that she can make the right noises to form words. We try to get her to make different sounds all of the time, but it seems to be pretty normal for the second child to lag a little with language development skills.

    We were told that when she decides to talk, she should quickly start on 3-4 word sentences and catch up quickly. I’m still not really worried yet, but only time will tell.

    December 9th, 2009 at 9:37 am

  5. Heather says:

    I hope you find some answers and solutions. It is too bad that insurance can get in the way with such important matters.

    I had a severe speech apraxia – which was unusual for a female. I was in speech from age 3 to grade 4. I had to learn every sound. My parent’s were told I may never speak properly. We worked on it at home – my brother (2 years older) helped out. We used games and made it fun.

    I am 30 now – no one would know I had a speech problem- my spelling is terrible as I have problems hearing sounds – and I think my understanding of how to speak is slightly different then other – as I “know” how to move my tongue in my mouth to produce sounds as I was taught all of this.

    We taught our daughter sign language as a baby – just in case. Sign language is fantastic – and I encourage anyone to use it. “Signingtime” taught us all many signs.

    Just keep your chin up – and make it fun for him – whatever challenges lay ahead! If it feels like a game it makes it so much easier for him.

    December 9th, 2009 at 10:24 am

  6. AJ says:

    Thanks everyone for their comments.

    The entire Signing Time series is $750. I requested a review copy of their introductory stuff, but they declined. No worries. It led me to this better advice: check your local library. Our public library system has the entire series, as well as competing sign language DVDs.

    December 9th, 2009 at 11:06 am

  7. Beckie Tetrault says:

    My son, who will be 4 on Saturday, has Apraxia. He’s been in speech therapy for about a year, first through the school district (very disappointing) and now through the local university Speech department. If you have a university near you, you might want to check to see if they have a program for speech therapists. My son sees a WONDERFUL therapist, who he loves, who is working on her Masters degree. She provides his therapy under the guidance of her professors, and the price is super reasonable. It’s a win-win for all of us! Not to mention, his language has grown by leaps and bounds because I am able to utilize what I see his therapist doing, and continue to reinforce it at home :)

    December 9th, 2009 at 12:44 pm

  8. Penguinmommy says:

    Thanks for sharing this, I know it can be hard.

    As a social worker, definitely appeal the decision and keep copies of everything. Find out who the head of the office is and e-mail them weekly to “check-in.” It will keep you in their mind instead of at the bottom of a stack somewhere.

    Also, get documentation and assessment from anyone you’re working with, particularly your pathologist you’re paying out of pocket, his/her evaluation will count for something in the appeal.

    Hope it all works out!

    December 9th, 2009 at 1:01 pm

  9. smurfett says:

    My partner’s uncle supposedly did not talk (youngest of 4 kids) till he was 4.

    December 9th, 2009 at 1:06 pm

  10. Elizabeth Wickoren says:

    Just wanted to check and make sure that you are taking advantage of everything that your local school district has to offer. They usually LOVE to get at kids as early as possible and take a proactive approach instead of just getting delayed kids thrown at them in kindergarten. I know ours offers all sorts of free therapy and services from birth so if you haven’t already, do check them out.

    December 9th, 2009 at 2:41 pm

  11. Tiffany says:

    Best of luck with the speech issue. My brother didn’t talk till he was 3, but apparently it was just because he didn’t feel like. Stubborn still. Since your son loves the blocks, how about a positive diversion to this discussion? I’d like to recommend something my son LOVES- and, even after almost a year and a half of having the toy, still will play with for almost an hour straight (in a 3.5 year old boy!). They’re called MagnaTiles. They’re clear, colored shaped flat tiles with internal magnets to hold them together in shapes. A set comes with squares, isoscoles triangles, right triangles, and tall triangles. Because the magnets are internal- no magnets to come off and kill the kid (unlike other magnet toys). In a year and a half of rough play, including being stepped on many times, ours are completely intact- haven’t broken a one! It’s a little hard to explain: http://www.magnatiles.com. You’d be amazed what can be built- car washes, garages for cars, tents… but the good thing is they don’t need your help taking it apart after- just pull lightly. Might be a good conversation/word-example tool. I doubted them when my mother in law bought them- I was wrong. Fantastic boy toy- seriously!

    December 9th, 2009 at 5:06 pm

  12. Robert, SLP says:

    Kudos to you for getting him in with a speech-language pathologist. It’s not cheap, but it sounds like you’ve already noticed a benefit. He’ll get even more benefit from his therapy if you follow a daily home practice program. If he were taking piano lessons, he’d have to practice every day, right? The same principle applies to speech therapy–daily practice increases the effectiveness of the therapy. If his SLP has not already given you language-stimulating games and activities to do with him, you would be well-advised to request them. I have a few examples on my web site, if you’d like to take a look.

    December 9th, 2009 at 7:34 pm

  13. LARRY says:

    Junior colleges have the best free testing ever. They find 80% of all students have learning disabilities. JCs have developed this testing out of the need to satisfy noncredit English classes. Anyway everyone develops differently not by a statistical average. BEST WISHES FOR ALL YOUR EFFORTS.

    December 9th, 2009 at 7:43 pm

  14. Ilana says:

    You are doing the right thing for your child. The earlier the kids get help the better. My son had a speech delay and they thought it was apraxia – no babbling as a baby or imitating etc. The only sound he made was “da”. Speech therapy made a world of difference for him. So did early intervention programs (turned out he had sensory issues too). He ended up being diagnosed as low tone and did not know how to move his tongue, mouth, jaw etc. He now speaks amazingly and you would never know he had problems.

    One great DVD we purchased for him and have since spread it around to friends is Baby Babble by Talking Child. It is made by speech pathologist and the little ones seems to really respond.

    I wish you luck. It is a challenging time but you will get through it. Always remember that you are not alone and there are many others going through similar situations. And always trust your instincts. There will be many who tell you you are over-reacting but you know your child best.

    December 9th, 2009 at 8:53 pm

  15. anjii says:

    I have to agree, as far as signing goes, Signing Time is HANDS DOWN the BEST!!! I’ve owned and/or borrowed from the library, baby/child signing DVDs from at least 6 or 7 lines, and NOTHING made it as fun and easy to learn as Signing Time. We currently own all 4 Baby Signing Time, and 14 Signing Time, and all the music CDs to go with them. My boys still LOVE to watch these, even though they’ve stopped signing for communication, since they don’t “need” to anymore. The music is excellent and catchy, and really reinforces the signs also.

    December 10th, 2009 at 12:46 am

  16. Sandy W. says:

    I commend you on seeking early intervention. I think it makes all the difference in the world when dealing with delays in children.

    My son was mostly non-verbal at age 2 until we started intensive speech therapy and ABA. He improved so much over the years. By age 3 he was still only at an 18 month level. By age 4 he was at a 3 yr old level but didn’t understand any who, what, when, where and why questions. And by age 5 he was exactly where his peers were. Now, at age 6, you’d never know he had a language delay. He does have autism so he has lots of sensory issues and social delays. But his language is right on track. We doubt the outcome would have been as good if we hadn’t gotten early intervention. It was slow and steady work.

    One suggestion I have is to document your son’s progress along the way. That way, you can truly look back and see how far you’ve come.

    December 10th, 2009 at 10:04 am

  17. Dani says:

    Not sure if you’ve done this yet but definitely check out early intervention. We were referred by the NICU (as my son was a preemie) but were told that our pediatrician could recommend an evaluation at any time.
    We didn’t require speech intervention but we’ve done PT, OT, and for a short time vision therapy. They have been godsends to us. I can not begin to express how much progress has been made with their help.

    Also, we very heavily relied on signing with my son and it helped a great deal with his communication, lessened his frustration and made us all a bit more comfortable.
    Good luck. Just make sure to be a good advocate and don’t take no for an answer.

    December 10th, 2009 at 2:29 pm

  18. Kara says:

    Signing Time is wonderful. We signed with our 5 year old when he was a baby and he signed complicated 6 or 7 word sentences before he was verbal.

    Our library has a lot of the DVDs and also they’re on PBS around here sometimes.

    December 10th, 2009 at 6:06 pm

  19. Angelique says:

    Regarding the sign language, I found some really great board books at my local teacher supply store. The series is “Early Sign Language,” and is published by Garlic Press (www.garlicpress.com) The board books are really sturdy. Each page has an illustration of the sign, and uses photos of real children and objects. I thought I’d share them as most sign language for the very young is in video form.

    December 11th, 2009 at 1:14 pm

  20. P.A. says:

    Just to echo what others have said, applause for following up with early intervention. I had to fight my pediatrician for a referral (shocking, because he never took the time to listen to my child talk) and we’ve seen leaps and bounds of improvement in 3 years of therapy.

    Here are two additional resources for you (that may apply now or later).

    One is super duper publications: http://www.superduperinc.com/

    They have tons of great resources, and we’ve purchased several at the recommendation of our SLP. Perhaps you could review some of their products.

    The other is one I happened upon at the library. These are CDs that have been slowed down for kids with language issues–though they still sound fun and upbeat. The words are just a bit slower. We chose the Christmas one (not realizing how it was different until we came home). This has been fantastic for us. I can’t find a link to the folks who produced it, but if you search on Amazon for Time to Sing, you’ll find it, though it doesn’t look like they are still being sold at regular prices. (Or perhaps at your library as well.)

    Best of luck.

    December 12th, 2009 at 1:46 pm

  21. Anne says:

    I haven’t read your blog in a while, and happened to see the pics of the MegaBlock towers. The picture made me think of my first daughter, who was making exactly those same towers with her MegaBlocks at exactly that age. I only later saw that the picture was accompanied by a post about speech issues. I guess I want to say that your instincts that other problem solving skills are on track were probably correct and that can only help in this situation

    December 12th, 2009 at 5:17 pm

  22. Uta says:

    I don’t have much to add to the many great suggestions above, but wanted to let you know that I feel your pain. My son was diagnosed with PDD-NOS at age 4 after years of people telling me that he’s just being a boy. Fortunately, speech is not an issue for him, and the most dominant issue is impulse control, so he seems more ADHD to most people. He has made great progress in our district’s preschool program to which he was referred after mandatory early childhood screening. Definitely check out similar options in your area, even if it’s not the only therapy you may choose, it may be a great basis and may be free if he qualifies. Best of luck and know that you have the support of a great community!

    December 17th, 2009 at 8:25 am

  23. Sue Allegra says:

    I have a sister 7 years older than me, and a brother 5 years older. When I was small, there was a 45rpm record (that’s a small black vinyl disk one played on a “record player” back in the olden days)that was a recording of them visiting Santa when they were just over 2 and 4 years old. Santa asked my sister what she wanted, and she replied “a tea set, and a table with chairs, and a dollie and an ironing board.”
    Santa asks my brother the same thing, and he says “ish”, and my sister replies for him, “he wants a tea set, and a table with chairs” etc. My sister’s name is Marcia, and he called her Ish. That was his only word. She talked for him until he entered kindergarten and then he finally got a chance to talk for himself. On another note, my sister didn’t grow up to be the Susie homemaker it looked like she was destined to be. She was a career woman who never married or had kids and retired at 50.

    December 18th, 2009 at 4:06 pm

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