WWYD? Nearly two year old not talking, no words, barely any sounds, not understanding speech

[HarumScarum]

Hi there. I am asking this question on behalf of someone else. But they don't know I am asking. I'm worried because they aren't worried, ISWIM.

In brief, my SIL has a baby of very nearly two years old. He has never made many sounds and most of those that I remember from him have been high-pitched squeals or guttural croaking. No vowels, no consonants, no babbling at all. About 6 months ago, he was diagnosed with glue ear and was fitted with grommets around two months ago. There has been no improvement in his speech at all. But I know a lot of children take longer to talk and this on its own wouldn't really concern me that much. The thing that really worries me, apart from the lack of babbling and sound production is that he appears to have very little understanding of what is said to him. He cannot follow any type of instruction, like show me your toy or point to grandma or similar.

I'm really worried about him and have tried to talk to SIL and MIL to suggest that he may need some help but they don't seem to understand what I mean. They insist that he can understand everything that's said to him and interpret the fact that when you ask him where someone is and he looks randomly around and the questioner reacts with delight when he happens to scan the correct person as evidence that he understands what's going on. I really really think there is a problem of some kind. You can ask him anything at all and he looks randomly around the room and waits until approval is shown before fixing on the 'answer', if that makes any sense at all. So he understands social cues (he's very smiley and likes to wave at people) but he doesn't seem to understand speech, not even if he is looking directly at you while you talk to him. I don't think he understands when you say his name.

Can anyone give me any pointers as to how I should handle this and should I just butt out? I am just worried as I feel that he does need some help and the earlier this could happen the better. I have a child of my own and do understand how worrying any idea that your baby may have a problem could be.

Or alternatively, is this normal for this age? It doesn't seem normal in my experience (lots of younger brothers and sisters and cousins as well as my own child) but perhaps my experience is too limited?

Sorry, said I'd be brief but that's a bloody essay!

I just found this list of what a typical two year old can do somewhere. Would you say this is about standard? It sounds about like what my two year old was able to do and I think it's fairly reasonable. I've commented after each point.

Attends to communications addressed to self no

Begins to listen with interest to general conversation no

Understands 2-3 information carrying words no

Responds appropriately to common adjectives,
[big/little/cold/tired/hungry], verbs and prepositions [in/on] no

Responds to ?what ? doing?? no

Indicates body parts/facial features on request can point to head on request, but also points to head when asked to find his feet/tummy/legs/hands/whatever

Repeats words constantly no

Names familiar objects and pictures no

Uses 50 ? 200 recognisable words no

Constantly asks names of objects and people no

Puts 2+ words together to form simple sentences no

Talks to self in long monologues which may be incomprehensible to
others no

Often omits initial and final consonants, e.g. bus = ?us? no consonants whatsoever

Joins in with nursery rhymes and songs no

Refers to self by name no

Greets and uses ?please? and ?thank you? when reminded waves hello

Makes simple requests by gesture only

Makes simple comments no

So that sort of answers my question. I'm not being alarmist.

he does sound very much delayed (I have a severely DC myself).

it could be down to hearing but there could be a host of other issues as well.

does he have a 2 year check up with the HV?

Do you have a good relationship with SIL and can talk openly with her? She might be in fact very worried but could still be in the head-in-the-sand phase. I had this as well and it took me a while to wake up - I was in denial.

If you can, I would raise it with her. She might in fact be relieved that somebody else opens the topic.

it really does sound as if your DN does need help the earlier the better.

If you can convince your SIL, these are the steps I would take:

• referral to a hearing test
• referral to SALT (in most places you can self refer, just find the number and also stress that DN does not only have lack of speech but also lack of understanding etc)
• go to GP and ask for DN to be referred to a developmental paediatrician.

good luck, you sound like a lovely aunt!

I am sorry for what you are going through with this and I am sorry for the little boy.

I am amazed that no one professional has picked up the fact that he is significantly delayed in this area.

I believe that there is a compulsory 2y health check everywhere - I'd imagine that these issues would be flagged by any right thinking HV but then some children will slip through the net.

I am not sure what else you can do unless you can subtly find out where her HV team is based, and give the office a call in confidence mentioning that you are really worried about one of the babies in their care and could they make sure he has been assessed for hearing as you can't convince the parents there is a problem.

It's all I can think of.

Thanks for answering.

I do have a generally good relationship with SIL - she has asked and taken my advice on quite a few other things so I know she values what I have to say. And we do get on generally pretty well. I wouldn't say we are close but there aren't any particular issues between us. We don't see each other that often, maybe once a month or two months or so.

I don't know if he has a two year check but I'm going to ask SIL if he has one coming up as a way of opening the conversation.

I am going to try to talk to her without MIL being there as I think when MIL is there, she kind of stops the conversation before I can get it started - maybe head in sand, maybe she just doesn't get what I mean, I don't know.

Thanks for the steps we can take if I can get SIL to see that help is needed. I had no idea you could self-refer to a SALT so that is really useful.

And thanks for the good luck wishes! Am pretty sure I will need them!

Thanks, Rooners. I assume that what has happened is that he was diagnosed with glue ear at around 18 months and so probably it has been assumed that that was the issue. But as I say, there has been no improvement at all in the two months since the operation.

Harum, my DC was not talking and understanding little. Also glue ear and everything was blamed on the ears/hearing. We also had grommets with next to no improvement. This is what triggered then also further investigations.

but if it is hearing that gets sorted with grommets, then you usually see improvement very quickly.

and tbh - the lack of talking would not worry me as much (a lot of 2 year old children have only few words) - but the lack of understanding language is rather worrying.

maybe you can do, as rooner suggested, give the HVs a call to see if they can arrange for a 2-year check for DN.

Hi harem the birth to 5 version of Universally Speaking by the communication trust might be a good resource; and might be useful to sensitively share wil SIL? It gives indicators of where children should be in terms of communication at different ages. It's easy to read and the booklets are free to download or order here.
Btw I don't work for them or anything haha!
Good luck!

Thanks to you lovely people I have found a list of drop in Speech and Language clinics near my SIL. And I have downloaded that leaflet. Thanks so much.