To be worried about my (nearly) 18 month olds speech?

[TheWhoOfWhoville]

Sorry for the length, but wanted to give all of the details. Ds is 17.5 months, was a little early so corrected age is 16.5 months. He speaks very little, well below the average for 18 months which I've been told is a minimum of 20 words.

He can say mama (occasionally) and dadda, but these seem to be directed at anything and everything! Makes a noise which sounds like the name of our cat, again this isn't consistent but he's definitely does it a few times a week and says 'duff' which seems to be yes and is very consistent and his main word. He shakes his head for no, waves goodbye, points at what he wants with lots of angry 'urhhh, urhhh' noises - so there is some communication but not many if any definite words.

He understands some basic instructions eg where is your ball, clap hands, where are your feet, where are the apples, but looks at bit blank at some things I say. I find it hard to tell just how much he understands as he's such a busy and wilful little boy, he doesn't want to stop and listen or do what I ask as he seems to have a very clear idea if what he wants to be doing most of the time which he doesn't want to stop. Should probably mention that he does make eye contact, socialises well with other children and adults and will listen and concentrate when in the right mood. He also chatters quite a bit, it's just not actuall words.

Aibu to be concerned? I keep getting told that they'll all do it in their own time, he'll probably come out with full sentences, my kid was the same etc but to me this seems behind for his age and I wonder if people are trying to be kind rather than tell me straight? If there is a problem I want to do what I can to help him at home and/or get a referral, not just stick my head in the sand.

Under the DSM V criteria one of the diagnostic criteria for ASD is "impairment of social communication and social interaction in multiple contexts..." Poor eye contact, non seeking of social interaction and lack of protodeclarative pointing (not just normal pointing) are early markers for social and communication difficulties. Which is why their presence or absence will be referenced in autism reports. It doesn't mean that other features won't be prominent in other children.

"just in case" referrals in children without actual delays but who might be later on with no other concerning features clog up services and produce unnecessary anxiety. But each to their own, I suppose.

And if you can point out in my posts where I was recommending "wait and see" for a child with a genuine disorder. Wait and see is reasonable for a 16 month (corrected infant) with a few words and normal social development.

haven't read the whole thread so apologies if all this has been said already. HE sounds similar to my DS (full term) who is now 19.5 and at 18 mths had around 5 words, depending on how generously you counted (ie including everything such as woof woof for doggy, BUH for bottle/ bath/ bird.) He now has around 30 words but most of them are very difficult to understand and a stranger probably wouldn't know what they were.) WE live abroad and have an 18 mth check with a pediatrician as standard. She said she wasn't at all worried, that she sees lots of similar kids, and that she would only really be concerned at around 2 if he didn't have a big word explosion before then. I think he was on the low side of average but in the normal range.

However, he had a lot of ear infections and we took him to the ENT a couple of weeks ago and they said his ear was full of fluid and he needed grommets. he didn't do a formal hearing check but said that his history/ examination was consistent with not really being able to hear fully- he can hear enough that it doesn't seem like he is deaf, but can't distinguish consonant sounds well apparently which effects his ability to reproduce them obv. he is having the grommets next month so we'll see. Worth checking out for your DS too? But overall, it really does sound like he is wihtin the normal range, especially for his adjusted age. Try not to worry.

Children develop so differently. I have four - one was speaking in sentences at 18 months whilst her sister only had a few words at that age.

Eqially, one of mine didn't sit until 9 months. His five month old sister can sit unaided. He didn't walk until 18 months, his younger sister walked before her first birthday.

Your son sounds fine to me, I definitely don't think 20 words at 18 months is expected.

When DS2 was about 2 years old we had an appointment with a paediatrician because of possible mobility problems. As part of the fact find that the doctor conducted at the beginning of the appointment I was asked if he was beginning to string a couple of words together yet.

It was clear from the way it was phrased that that was the level considered to be usual.

It's 6 words at 18 months, not 20, but he sounds exactly like my son. Hearing test showed glue ear - repeated tests over 3 months showed it was getting worse and he had grommets just before his second birthday.

Within a couple of weeks of the operation he had several new words, 6-8 weeks later they started coming in a flood and now he's a real chatterbox!

May well be nothing, but these things take time (we ended up doing his grommets privately as the wait was so long) so I would take him to the GP. They can start by checking his ears for wax and referring him to audiology to see if he can hear.

Good luck with it all. happy to discuss further by PM if you want to, it's very stressful

zzzzz -

1. The DSM V is exclusively used in Australia and NZ as well. No one here uses anything else.

2. Health surveillance with a GP, Health Visitor, Child Health Nurse etc should be the first point of call for a developmental review. A lot of the time "wait and see" surveillance is appropriate. Not rushing off to specialists just in case something that is still in the normal range now MIGHT become abnormal later.

The OP describes a boy whose speech is a bit below average but not delayed, with normal receptive language (body parts etc), normal social skills and who is communicating normally non verbally (protodeclarative pointing) yet you're accusing posters who are being reassuring of "minimising" the difficulty. My question is : what difficulty?

3. I'm at a loss as to why you feel it's appropriate advice to ignore ASD stereotypes. Especially when the stereotypes involved are associated with "impairment of social communication and social interaction". The fact that there are other, more subtle, manifestations of the social and communication difficulties in perhaps more highly functioning children on the spectrum does not mean that there aren't a whole heap of children on the spectrum with classic poor eye contact and limited social interaction.

It's an integral part of the diagnostic criteria on the ICD 10 criteria as well so I'm not sure how you can "ignore" a typical presentation because there are some people on the spectrum whose social and communication skills - in some areas only, by definition - are better developed.
In fact, on the ICD-10 the first example of "qualitative impairment in social interaction" is "a failure adequately to use eye-to-eye-gaze".

4. I do agree about the hearing.

Tree- the 20 words comes from a health visitor and nhs guidelines

op you are right to be concerned. you are also right to relax a little.

20 IS CORRECT RIGHT DOWN WORDS AND MONITER. CAPS JAMMED ON SORRY. FOLLOW HIS LEAD, GIVE HIM NAME FOR THINGS.

I doubt mine will be saying 20 rods by the time he's 18 months.

He's currently 13 months and all we have is bye, cat, balls and shoes

My friend has a 22 month old boy who doesn't say a single word - he just grunts.

Honestly, they're all very different - DS1 was barely able to string 'more sweeties' together at 2 (I think he might have had a couple of words at 18 months) - he had very limited speech. He didn't point, didn't wave goodbye, generally just did his own thing and assumed I'd know what he wanted. Now at 4 he's a total chatterbox, and comes out with very unexpected turns of phrase, and is absolutely average at school, no issues at all.

DS2 I can already have a conversation with at 18 months. He clearly understands what I'm saying and can communicate back on a wide range of subjects. Completely different to his brother.

Obviously keep an eye, but don't fret too much - he's still well within the bounds of normal.

My 17 month talks all day long, just not words as we might know them. He says daddy (a lot), mama (occasionally), what sounds like pigeon (when he sees one) and "dee"! He can do one makaton sign, points and makes his feelings v clear about things. He is also much more interested in running, climbing and causing general chaos than talking. There is no way he is going to have 20 words by 18 months. His background means he is more prone to speech and language delay but at the moment I think he is doing ok. I hope. He is a real charmer, though and is very communicative in terms of smiles and eye contact.

Sounds normal.

17month old here had about 8 words (I seem to remember). She's now 2/5 and her speech exploded about 2 months ago. Literally.

The best advice I got was...Do they understand you? If so, unlikely to be any problems.

zzzzz - I agree you and I will remain at cross purposes. However I suggest you actually read the ICD-10 before you cite it. Its criteria match the "stereotyped" view of ASD that you suggest the OP ignore. For a reason (likely anecdote?) that remains unclear.

THE POINT IS, IF - IF - IF THERE IS ANYTHING TO BE CONCERNED ABOUT MUCH BETTER TO INTERVENE ND GET BALL ROLLING EARLY

Coffee1234 - Do you mean to be so rude?

I "know" zzzzz, I haven't come across you before.

OP - my GP always say go and talk to them if you are concerned - a parent being concerned is a good reason to look into things. It will probably be "fine" but getting on those waiting lists and having things flagged can help later.

Former SALT here. It is very difficult and indeed dangerous to speculate about a child's development simply from vague anecdotal evidence. The OP needs to get her child assessed by a paediatrician/SALT/ENT to rule out problems and decide on best course of action. I could not begin to make a diagnosis without having taken a full case history, parental interview and most importantly seeing the child.

thewho - like most people have said, every child develops differently. However, if you do have any concerns I would raise them with your GP or HV. My DD has severely delayed speech as she is deaf, (not suggesting for a second that is the problem with you DS OP), but being exposed to ENT i was surprised to learn how many children (c. 20%) have temporary hearing problems due to glue ear (build up of fluids in their ears). It may be worth asking for a hearing test if you are concerned, as glue ear can normally be resolved by grommets.

Honestly honestly honestly this sounds totally standard!! Mine were the same (and I was (wrongly) a bit stressed too) but at 24 months they started doing lots more words, and by 2 1/2 they were talking in complex and complete full sentences.

Funnily enough I was telling DS about is first words just the other day so I am geared up for this!

DS was saying mama and dada for quite a while and trying to copy us with words like food becoming foo, water being war then, when he was exactly 17 months old (we moved house at that time and this was two weeks after we moved in), a friend was sitting with him showing him a book. As the page turned DS said 'baby' as he pointed to a photo of a baby and that was that! The following week it was 'bear' then 'clock' (tho that sounded a bit like cock but there you go...). After that it was a word a week - gave up measuring within a few months and he's not stopped talking since (he's now 8 years old)

You could encourage him by doing what we did (which I think a few others have mentioned). If he pointed to something - say a chair, we'd say 'chair. Say chair'. If he did, or said something that sounded like chair he'd get a lot of dancing round the room (always made him laugh and encouraged him), if he didn't we'd just ignore it but would put our hand on the chair and saying 'do you like the chair?'. Then a couple of days later we'd ask 'what's this?' again putting our hand on the chair (don't point - it's not specific enough).

But, if you are at all worried please see your GP. My DS's BF is autistic and wasn't speaking at 19 months - not a peep. His GP referred him, got a diagnosis, his nursery (and DS's) taught the children Makaton so they could 'speak' to him. The nursery workers worked very hard with him as did his parents and, by the time he started school he was speaking. You'd now never know the difference - he too doesn't shut up!

What is the biggest indicator of ASD at the age of around two?

My friend expressed concerns about her DS and mentioned she was thinking about speaking to the HV but then her DH said not to and so she hasn't. I don't know how to encourage her to do it without offending her or worrying her

As the mother of a child with speech and language difficulties (autism) please let me reassure you that there is absolutely nothing in what you have said that is any cause for concern. At all! What is important at this age is non-verbal communication (like pointing) and having some comprehension (like all the things you say he does understand) and babbling (which you say he does).

As a comparison, at your son's age, my DS had never pointed, had very poor eye contact, understood nothing at all and said nothing at all. These are all red flags. (Now at 2.6 we have lost count of the number of words he has!).

Hope that reassures you somewhat!