No Comprehension skills 18 months?

[Landladymews]

Hi

I’m feeling quite concerned about my 18 month old who shows limited signs of comprehension when we are talking to him, doesn’t point/wave and probably as a result has no words. He won’t for example stack blocks despite my showing him how (he just likes re arranging them). I ask him if he wants milk or yum yum and he looks at me blankly. He won’t imitate words that I say. I ask him to bring me a particular toy and he ignores me.

He is sociable in the sense that he loves meeting people and babbling away (has a lot to say in his own language), makes eye contact, smiles, has lots of funny expressions etc. He will hand me toys of his own volition so I think this is an example of what’s called ‘joint attention’. He loves peekaboo. He has clapped a couple of times when asked but now refuses to do that too.

My husband thinks he’s too young for investigations and that we should wait another 2-3 months before seeing the GP.

Has anyone else had a child who didn’t seem to be developing comprehension skills at this stage? Is there anything I can do to help his comprehension? Should I push my husband to have him seen now?

Does your health board have something like this

www.nhsborders.scot.nhs.uk/patients-and-visitors/our-services/general-services/early-years-co-ordination-assessment-team-(eycat)/

Our twins were very premature so we automatically got this service, think we started this at 18 months corrected age, it was truly brilliant, followed them through up until summer just gone when they were discharged with a 1 year automatic recall. School and home physio, speech, o.t. Has helped them so much.

No speech at that age isn't an issue really, neither of my boys did and both have above average communication skills for their ages now.

I would be concerned about the rest though, my 11 month can clap and wave and will respond to some commands. Sometimes she doesn't respond because she doesn't want to but I'm never concerned that she doesn't understand really.

@mumwon My son hears rustling sounds for sure! We can’t open a packet of crisps or bar of chocolate quietly enough ever he will always hear it and hound us for it! He generally responds to his name but sometimes will ignore me if he’s busy. I will check the hearing to be on the safe side

@mistermagpie yeah I’m less concerned about the lack of words as I am about the comprehension. I feel like he doesn’t want to do what he’s told though. When I ask him things he will just giggle and if I say pass me the toy for example he will often just throw it away like he’s purposefully refusing to do what he’s being told?

I took ds1 to the go at 17mo and we had a paediatric referral when he was 20mo. They said it was too early to dx anything but made notes and I went back every 6 months till he was 5. So I don’t think it’s too early if you have concerns. Ds1 was similar.

@MrsKoala How did things turn out in the end??

DC1 had glue ear with associated hearing loss. We got directed to fill in this questionnaire ican.org.uk/i-cans-talking-point/progress-checker-home/ before we could be referred. The other thing we found useful was the Ages and Stages development questionnaires. If you Google they have them for every 2 month age step (or 14, 16, 18 months etc). You can find the scoring guide as well, so if you fill it in you can get a sense of whether they are where they should be across the board.

DS didn't say anything until 19 months and only had about 20 words by age 2 but his glue ear then cleared up and you'd never know he'd had a problem now. We did find using Makaton helpful, he picked up signs linked to his interests best (farm animals and vehicles).

He’s just turned 8 and still has no official dx (apart from dyslexia, colour blindness and asthma ). He doesn’t sleep well or much, has an extremely self restricted diet, is described as ‘quirky and impulsive’ by the school and the paeds said it was ‘complex needs’ but not enough of anything for a dx unless it became an issue at school - which it hasn’t been so far. School have suggested we go for a private dx for both him and ds2 (6) as neither are difficult at school the peadiatricians won’t see us despite them both clearly struggling with many things.

Is he not yet walking either OP?

I agree with a hearing test. There's a type of hearing loss that involves the mid-range of sounds, which is where most speech is. A child with that type could hear someone making a low noise just fine but still miss pieces of words, making comprehension difficult.

@MB90 nope not walking but I’m less concerned by that as he’s very close. Cruises a lot, stands without any support and walks around holding my finger. He just needs to have the confidence to take steps without holding anything which I think he will probably have in another month or so.

For everyone who is suggesting a hearing test, surely he should be able to follow visual instructions Or examples eg when I show him how to stack 2-3 blocks or cups, he refuses to do this? He has another toy where you do different things to make an animal pop out of a box eg push a button, twist a button, move a button wide to side. For the longest time he would only do the one where you push the button despite my always showing him how the others were done and has only in the last two weeks started to do the others...

No that kind of hearing test is for older children, they will play sounds and see if he turns to them.

My daughter was found to be deaf at birth so we have lots of experience with hearing tests! One of her little friends is 3 and was only found to have hearing loss at 2.5. Amazing really.

Please get a hearing test. My son as a small boy fooled everybody with his hearing problems even a speech therapist. I was told he was delayed.

He had glue ear that our GP missed. It seems that my son could hear some of the time and filled in the rest of the time with lip reading which he must have taught himself and picking up visual cues. The ENT specialist sighed heavily when she told us that the very first thing to suspect with speech delay is a hearing problem.

It affected my son's speech and comprehension skills despite the fact that he got grommets within a week of the hearing test at age 4. He was fairly old for grommets and would have had far fewer problems if it was picked up earlier.

He is having a gap year now after finishing high school with respectable marks. Bad timing with the gap year! I know but he has picked up a few university papers and is learning to drive.

I'd have vision checked as well.

Yep I will definitely do the hearing test but it just doesn’t explain the delay/refusal to do physical stuff that I’ve shown him

Some things sound normal but I’d be a bit concerned by the combo of not walking or talking. I’ve seen a real variance in the development of my friends children but the ones that were slower to talk all seemed to be physically ahead instead. Eg my first was waking by 11m but was flagged as a concern on the 1yesr check for communication but by the 2year one was very verbal. My second has a much more even profile.

On the stacking question, I remember there being a Qs in the ages and stages about copying. My first never copied me for those sorts of things. For her it wasn’t a sign she was behind but a reflection of her stubbornness to do her own thing. She’s in reception now and was set a task to copy some beads and apparently told the teacher she didn’t like the pattern and wanted to do her own thing.

@Ratatcat Do you know what the combination can potentially mean? I doubt the hearing issue which keeps coming up on here effects walking ...

I do sometimes feel like my son is stubborn because the way he reacts when I’m trying to get him to do something i.e. the sound he makes and the way he throws the thing it always feels to me like he’s saying “no I don’t want to do that!”

All children develop of different rates, DD2 has been slightly slower to do things than DD1 but I'm just sat here with her now (at not quite 19 months) and I think if I were you I would speak firstly to the health visitor and if you don't have any luck with her I would go to the GP and ask for a referral to the community paediatrician.

@Landladymews An inner ear problem would affect balance, which could delay walking or attempts at walking.

The more recent examples you give are of a child who is strong willed and very much understands! Perhaps more like a 2 year old than 18 months. Saying "no" to instructions etc

When I ask him things he will just giggle and if I say pass me the toy for example he will often just throw it away like he’s purposefully refusing to do what he’s being told?

Toddlers often do things like this! To test your response

when I show him how to stack 2-3 blocks or cups, he refuses to do this? And maybe he's not fussed about blocks or cups? And he's learned how to use the other button toy, proving kids develop when they are ready

I’m a private SaLT and we would see 18month old. At this stage it would be advice for you and your DH. ‘Hanen’ do some good books about how to modify your communication style to maximise his language development. I think you should get his hearing checked even if you have no concerns just to rule it out.

Hmmmm. DS has some similar ‘delays’ at this age. He wouldn’t repeat words when we said them, he didn’t really imitate actions, he didn’t express much desire or preference... he did follow directions though. When he had his 2 year check, he was referred for SALT assessment (he was borderline for assessment, but this was because his receptive language was ok - his expressive language was very low scored so I pushed the HV very hard until she agreed to refer him. His gross motor skills were also a little low scored though not in the worrying range). We had two or three SALT assessments over the course of the year - at each one they said he was JUST within the normal range but that they’d see him again in a few months, until he turned 3 and his speech had caught up. He’s nearly 6 now and speaks normally - in fact people often comment on his advanced vocabulary which I assume is partly because he’s an only one - but his school is now saying they think he may have dyspraxia.

Anyway. What I would say to you is to flag to the HV if you haven’t already done so. She’ll almost certainly say you need to wait, it’s too early, etc etc. But at least it’ll be flagged so when you DO get your 2 year check, you can make more fuss then if you need to. Early internet ion is key if there is an issue. I would say try not to worry too much - chances are it’s nothing serious or disabling - but to keep observing. Mother’s instincts are often dismissed by the ‘experts’ but we’re the ones with our little ones most of the time and we do notice things.

I’d also say, you have to be pushy and you have to be an advocate. Don’t let them fob you off.

I could of wrote that my son is now 26 months in last 4 months he’s come on loads and in the last 6!weeks he has had a language explosion and is meeting all his mile stones x