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?

@SinkGirl Thanks for sharing your experience. It’s interesting that there was a regression around 18 months. I feel like my son has regressed somewhat too over the last week or two when it comes to responding to his name. Previously he would always respond to it and look really happy now he will sometimes ignore it which is something he never did before even when engrossed in something.

@SinkGirl with the squint was he doing it a lot? My son has also started to do it like 1-2 times a day for a minute or two but he’s always smiling or laughing when he does it so it seems like he thinks thinks he’s pulling a funny face?

It gradually worsened between 12 and 18 months - he was squinting a lot by then, and now it’s constant. He has something called optic nerve hypoplasia but they don’t know if the squint is related to that or a coincidence. So it was mainly found by accident, and then a MRI to confirm also found some minor damage to his brain. He’s quite a complex one!

Regression is a strange thing - DT2 literally stopped mimicking, using basic words, clapping, playing with toys pretty much overnight. DT1 it was much more gradual to the point where we barely noticed it and just thought he was becoming more interested in new things, but he just stopped paying any attention to anyone quite slowly.

@Landladymews

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...

Hearing test will also determine a glue ear. That might mean that he can hear the sounds but the voice might not be clear enough to him to understand instructions.

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...

This demonstrates a lack of copying - mine are the same. They can work out how to do complex things themselves but they won’t copy what I do basically ever. Just doesn’t occur to them to copy what I’m doing

Today one of them was saying bababa to himself over and over again so I copied him. He then did it again, and then pointed at my mouth to get me to do it again and we went back and forth about six times.

This is really new for him, and is the sort of early communication that builds language skills - it’s a little conversation.

I’d recommend looking at intensive interaction - essentially where you copy him rather than getting him to copy you. If he’s stacking cups, you stack cups. Copy his actions and his sounds. We’ve got a lot more awareness from them than they had previously using this technique.

So today we got out the shape sorter out for the first time and initially he didn’t get it because it’s not an easy one to do (animal shapes) so he was just throwing them about. I showed him a few times and after that he started copying :) I made sure there were no other toys around to distract him so he was forced to focus on the shape sorter. For some reason he just refuses with stacking blocks and would rather bang them, line them up or occasionally put them inside each other.

I do copy what he says quite a lot and he copies back eg at the moment his favourite thing is to say mumumumum. I don’t think it’s a reference to me as I’ve been naming myself something else which he refuses to say so far. It could be his way of saying yum yum yum which is what I say when he’s eating.

I also got a wave back and a flying kiss before bedtime. I guess it shows that whilst we aren’t there with copying words I need to make a bit more effort with gestures to get him to do things and he has the potential to learn. I did try clapping several time’s which he had been doing for a long time but he’s really not interested in it any more.

Have you tried some signing, while saying the word at the same time? Signing hasn’t worked much for mine because they don’t copy but they have learnt a couple of signs with a lot of persistence and supporting their hands to show them how to make the sign.

Nope haven’t really tried signing. I suppose I should give it a go. It’s a bit hit and miss with copying gestures though. Sometimes he will just smile at me when I do them and other times he will copy. It seems to really vary.

Just thought I would update that since I realised that lack of pointing was putting him at risk on the mchat i’ve started pointing a lot myself and giving him options eg beaker or plate of food and he’s learnt to point to show me what he wants and today he was pointing at a lady that came and sat down in the waiting room at the doctors! Phew. Made me feel very happy.

The GP checked his ears and said they are totally clear. He’s referred him for a hearing test to rule out any hearing issues. After that he said he can refer us to a paediatrician so we can see what’s up with the receptive language delay.

Hi, very similar to my little one who i've been worried about since she was about 14 months old.

I first noticed her delay in language when i saw a similar-aged child responding to the simple command "get your shoes". My partner and I were gobsmacked and it all spiralled a bit from there because we kept noticing things she couldn't do, rather than what she could. You mention block stacking - I kept noticing things like -- she doesn't assist when we dress her, she can't sort shapes, etc etc. We agonised for months and tried testing her constantly: Can you say this? Where's your tummy? Bring mummy the rabbit! We had no luck and she is now turning 20 months and I can honestly say that it's only in the past week has she finally started to indicate some understanding - and not of concepts or commands, just of single words. (mummy, dog, ball, door, window). Nor did she point when we asked about them, we simply noticed she looked at the objects.
She doesn't mimick or attempt to speak but she does wave bye bye (and has done for a while).
On pointing, another thing that was driving me to disctraction and then one day around 18 mth she pointed at something, and then a couple of weeks later the pointing became constant. Now she points at everything and seems to genuinely want to know the words for things. Honestly - this has only happened about 5-6 days ago.
I guess I am trying to say try and be patient - things do change and 18 month is still so young. But I am totally with you and I get it, and panicking myself quite a lot over here too. Delays are absolutely horrible.

@RedC83 Thank you so much for sharing this. I really think more of us who have seen some positive signs a bit later than expected need to share these. I didn’t panic with delays with physical milestones because I read so much about how it normal to roll, crawl or walk a few months later than the average child. With speech delays however everything I was reading online had me convinced that if they aren’t for example pointing by 18 months there is a really serious problem. Nobody online seems to say my child pointed at 19 months and was totally fine! Obviously we want to pick up on things that could indicate something it wrong but at the same time we need hope so I think we should share the positive stuff too :)

@Landladymews Absolutely. I have a close friend with a neurotypical and very bright, happy little 4 year old boy and she said he was just such a late bloomer in every regard. Similarly a cousin's child is autistic (high functioning) and in her case, some of her concerns were valid. It's a minefield!

Btw, you also mention regression up above and just to let you know my little girl seems to drop and then pick skills back up a lot. Regression is of course very serious but it's another one that's just not black or white. My daughter stopped waving, stopped clapping, etc etc and then one day just picked the skill back up again - and usually then does it more than ever before!

One thing we did, was we started a spreadsheet about 3 months ago, and started keeping track of new things she did & when she did them, or the day we noticed she stopped doing something. Eg- "15 September --pointed, clapped. Seems to have stopped signalling to be picked up".

It's not for everyone, but I personally found it helpful because I second guess myself and often my partner and I disagree on things: "She hasn't waved for weeks. No she waved 2 days ago i am sure!"

Now when i look back i see that actually there has been SO much progress. For example i marked down on 6th September that she had sat down with a book for the first time & turned the pages. Well, now books are her absolute favourite thing. To think that 6 weeks ago i found it noteworthy to say she sat down with a book seems crazy!

I have no idea if she's developing normally, or how worried I should be but I guess I'm definitely seeing progress and I wouldn't have been able to say that 2 months ago, so with any luck soon you will too.

My son has been under SLT from he was just over 2. He was on the waiting list for about 6 months. He is now 8, and still umder SLT, well was if covid wasn't around. Id imagine waiting lists now are crazy so better sooner rather than later

My child is similar also 18 months, I asked my GP to refer to the community paediatrician, they called me recently, they said some areas are possible flags for autism but much to young to say at this age so he will be seen in another 9 months but he's in the system which is a relief as the waits are long. She also said the HV should refer him at 2 for SLT and has wrote to tell them that.
We have actually hired a private SLT already to help us with speech and language as everything says early intervention is key even if it isn't just a delay. We also paid for private hearing test. Realise as someone said early not everyone is able to do this.

@RedC83 Sounds great! I think the spreadsheet is a good idea. I sometimes get a little worried about things eg my sons current disinterest in clapping but I have to remind myself there was a time when he did it constantly with soo much enthusiasm and he’s probably just moved beyond that now which is why he will only do it occasionally.

@LittleDoveLove It definitely seems like a waiting game with this stuff. What sort of things are you concerned about? I was considering private SLT too but because I’m finding the “teach me to talk” podcasts very useful I’m going to see how I progress for the next couple of weeks with trying some of the strategies suggested in those podcasts myself.

Hello
I am mainly concerned around the lack of pointing or words, we have more babbling since we started with the SLT so that's positive but it's the lack pointing that concerns me the most, he brings stuff to play with me for shared experience but I know pointing is a major flag

@LittleDoveLove I'm sure you are already and sometimes it is annoying when people tell you to do obvious things, but someone gave me the advice to point to everything in sight myself, and they might just copy. In my case my little one started pointing around 18 months and the frequency has just increased since then. She's nearly 20 mth now.

@RedC83 thank you, yes we point to everything and will keep doing that so I am hoping he picks it up, it is good to know your little one has and also reassuring 😊. We have found the SLT great, we are doing the Hanan course which teaches you skills and we've found that he has been much better at non verbal and much more babbling so I am hoping it is just delay. Hoping the pointing follows soon too 😊

@LittleDoveLove I was really worried about pointing too but I managed to get him doing it very quickly. He loves his mealtimes so at lunch and dinner I would hold his bowl and his cup in at a little distance from him then my husband would point and get whatever he pointed to. We did this a few times and he figured it out after a day or two. Now he’s constantly pointing at things and we almost always give them to him which is getting a bit tiresome! It did involve a bit of crying because he’s very whingy and has no patience for food but because he loves it so much the motivation was there to learn how to get it.
How is receptive language/understanding?

@Landladymews2 seems to under stand no, and you do it and will copy with a toy. Not body parts though. So will copy me with a toy but for example won't copy me raise my arms above my head. Won't collect an item I ask for yet. Will being things to me and take me to things he wants. I will try that method with my husband this weekend thank you

@LittleDoveLove Sounds so much like my little one. I think it would be good to provide updates on this thread of any successes we have in case we can help each other out :)

@LittleDoveLove I’m supposed to have an initial consultation with a private SLT this week. I was wondering whether yours had provided any insight on what the issue could be? There’s very little online about children with receptive language delays at 18 months other than it being an autism red flag but I’m guessing it could be other issues eg that it’s simply a delay or that it’s a development language disorder. Did your SLT discuss with you all the different things it could potentially be?

Hi @Landladymews2 no because of the age. He is too young for any sort of diagnosis so they are very wary of that, and to be fair I wouldn't want one at this point. He did say he wasn't too worried about our son but did recommend the Hanan course so we have hired him to do that as helps us to look out for communication signs and being receptive to them. We have found after 5 of the 12 sessions he is much better at non verbal and has been babbling more with more sounds. He's also started nursery so that's probably an additional factor. We aren't expecting miracles overnight but everything says about early intervention being key to helping if it's any sort of delay - no matter what the reason. So we just thought we would do it as nothing ventured nothing gained and I wasn't going to wait until he was put on a long list as they won't do anything until 2-2.5 in terms of referring to SLT :(

But in terms of other reasons yes he said they develop at different times and could be development delay :)

@LittleDoveLove Thank you that’s super helpful to know. I’m probably going to have a private speech evaluation done and will take it from there too. I’m so glad you’re already seeing progress. We are also going to make a decision about nursery this week. I’m currently on maternity leave with my 2nd so once our nanny ended her contract in March he’s been at home with me. If it weren’t for Covid I would have put him in nursery in September but I’m beginning to feel like we just have to put him in now.