Encouraging speech in toddler

[Sparrowlegs248]

Ds1 is 22 months old and doesn't speak. He used to say mamma a lot, repeatedly, but doesn't really do it anymore, though he does sometimes.

His hearing is fine, and he understands everything. Yesterday I asked him to choose a book (I've never specifically asked him to before) and he did, and then I said to choose a second, and he did. He follows instructions (wait for mummy, hold my hand, put your shoes on etc) and responds to questions - would you like a drink, shall we go for a walk etc with a smile or not.

But no real words. Lots of chattering away, reading aloud etc

Is there anything I can or should be doing to help him?

He's developed a bit of a whine which seems be frustration.

My son had no spoken words at that age. He caught up rapidly from 28 months and by 3 you wouldn't have known he was ever a "late talker". It's possible your DS will just catch up. Following instructions is a good sign. From what I read when we were worried about DS, the majority of children whose delay is only with spoken language, not receptive language, do catch up by 3 or 4 without much intervention. But it's impossible to know which children will need more help to find their words so there is a lot in favour of early intervention.

Based on our experience:

1. See your GP and get a referral for a hearing test. Even if you're pretty sure his hearing is fine, it's sensible to rule out an issue in that area.

1. See whether you can self refer to SLT and/or ask your GP or HV for a referral. Waiting lists are pretty long in most areas, for an assessment and then after that, for a block of therapy to start. So best to get on the waiting list sooner than later. Most areas will accept referals for children with no words at 24 months - though be aware some HVs don't like to refer until 36 months unless understanding is delayed as well.

1. Learn, and teach your son, supportive signing such as Makaton. It's helpful to ease frustration. It's also good in its own right as a way to practice back and forth communication which is a key precursor skill for speech. NB our HV told us that we were delaying speech by using signing. Every SLT I have ever spoken to, NHS or independent, has been appalled we received such advice. All the research suggests that supportive signing is beneficial and won't delay speech when the words are ready to come. Anecdotally, my DS dropped his signing like a hot potato as soon as he began using spoken words.

1. Talk to your DS all the time. Use short sentences and repeat key words a lot (at least 3 times - eg "Ball. Here's your ball. Your red ball.") Narrate actions as you do them. And leave lots of conversational pauses - even though your child doesn't fill them with words, you can respond to body language, signs, interest. "Observe - Wait - Listen" a lot. Play turn taking games (back and forth interaction again).

1. We were told not to push our son to speak ie don't pester to repeat a word, or ask questions specifically to "test" understanding. Ask questions you genuinely are interested in the answer to, and offer choices.

1. The Hanen Centre book It Takes Two to Talk is really good for ideas on what will help now, and also for later, to help at future stages eg moving from single words to 2-3 word combinations.

Finally, probably pointless to tell you not to worry - but try not to let worries take over too much and stop you enjoying your son being at this fantastic age.

Thanks for your really helpful reply!! I spoke to the health visitor at ds2 6 wk check, so ds1 would have been 20.5 months. She wasn't at all concerned.

I have heard and read that signing delays speech so hadn't been learning any of it, which is a shame as I was keen before I read that.

I've recently read about repeating and short sentences as you suggest so have started doing that. I wasn't sure whether to prompt him, when I did on one occasion he did say the word, several times. But hasn't since.

And thank you for your last point. He is just fabulous and growing up and learning every day, I don't want this lovely stage to be overshadowed. I do though keep getting 'when will he speak' comments.

I've found a Salt drop in session next week so will take him to that.

Sounds good! Hope next week goes well and you get some help and reassurance.

Oh God, yes, the "isn't he talking yet?" questions! Not helpful :-( Also the pointed looks that say "what a rude kid!" from adults who see a big toddler and expect (but don't get) a hello or thank you or an answer to a question. And the patronising advice - "oh, I talked to my baby lots and lots, and read her books all the time, and she started talking before her 1st birthday" [gosh, really, I'd never have thought of doing that...]. Our lovely SLT said that it was important to praise what DS could do and boost his confidence, so I hated saying he was "delayed" in front of him. We practised replies like, "no, DS hasn't found his words yet but he's great at communicating. This is his sign for "hello". " Through gritted teeth, generally!

At risk of offering similarly patronising advice, I've dug out my copy of "It Takes Two to Talk" and reminded myself of what tips helped us at your son's stage.

1. Let your child lead. Be face to face with your child as much as possible and Observe Wait Listen. Observe: Take time to observe your child's body language, actions, gestures to figure out what he's interested in at that moment/wants to tell you. Notice what he's looking at, where he's reaching or pointing, what's captured his interest. Wait: to give him the time he needs to start an interaction. Stop talking, lean forward, look at your child expectantly, count slowly to 10. [This was a big one for me - I found this really hard!}] This sends the message that you're expecting your child to send you a message. It doesn't matter if it's sounds, gestures or words. This may take time, be patient. Listen: to your child's message. You might not understand, which is frustrating for both of you. Look for clues. If you can't begin to guess, imitate the sounds or actions, see if he does anything to make it clearer. Even if you still don't understand, your child knows you're doing your best and his message is important to you.

1. Take the focus of getting your child to speak. "Asking your child to say words for you doesn't really help her learn language. In fact it can have the opposite effect because it takes the joy out of communication. Your child knows when you really want to communicate with her and when you just want her to repeat a word... If you need to remind yourself to take the pressure off, a good rule of thumb is, "don't say "say"."

1. Creating opportunities for your child to lead: Don't rush to give him something you know he'll want. Place a favourite object out of reach - then wait. Give it as soon as he points. Offer a little bit (of apple, drink etc) - then wait. Choose an activity he can't do without help - then wait. Offer a choice - then wait. Pause a familiar activity (singing, pushing a swing) - then wait. Change a familiar activity - then wait. Hide objects in surprising places - then wait. (You're looking here for interest and communication, which initially won't be words.)

1. Follow the lead: imitate his actions and sounds. Interpret - put his sounds and gestures into words and model the word for him. Eg you offer a banana, he turns away, you say "oh - no banana". This teaches him words he can use when he's ready. Join in with his play, narrate what's happening, use lots of fun sounds and animation in your voice. Create lots of opportunities for turn taking activities (eg doing an action or sound in a song).

1. Don't ask too many questions. Choice questions with real objects are good, when he has the sounds/gestures/words to make the choice. And "yes/no" questions. But don't ask conversation stoppers that he can't answer, or which are designed to test his knowledge, or don't have anything to do with what he's interested in.

1. Add language to the interaction. Talk to him as if he can talk to you. Model words or a few words to capture what he's telling you with gestures or sounds. Keep your responses short but grammatical. Your child needs to hear a word again and again to remember it and eventually use it himself. During one interaction try to repeat the key word at least 5 times. Match your words to what's happening in the moment. Use the same word consistently for the same thing. Looking ahead, your DS needs about 50 single words before he'll start combining.

1. Highlight your language - the "Four S's - Say less, Stress, Go Slow, Show": Say less, use short sentences. (eg "Put your shoes on. We're going to school. We're going to get Timmy".) Stress important words. Go slow. Show (by pointing, adding actions or gestures, or using pictures of what you're talking about).

Hope some of that helps!

So so helpful, I've just had a quick read while feeding the baby but will come back to it later and have a look.online for the book. He is a big boy, we went out yesterday and he was the same size as a 4 yr old girl he was playing with! She wasdainty and he's so tall they were the same. Obviously he's still a baby in comparison, and not two til the end of next month. Thank you again, I appreciate your advice.

This mornings reading has consisted of stick man. Gruffalo, and hungry caterpillar, on repeat........