Why is my 20 month old so behind?

[RebeccaTee]

Hi all!
Just wondering if anyone can give me a bit of advice or even better reassurance!
I have a 20 month old girl (first so really have nothing to compare her to personally) and I love her dearly but myself and my husband have had ongoing concerns about her. She is not yet speaking at all (she does babble and says 'mumma'). She has only just learned to stand and is starting to take steps when we hold her hands. She took about 11 months to sit unaided too. Another issue is she seems to grow incredibly slow, she is barely in 12-18 months. We have an advisory teacher at nursery and have mentioned to the doctor who has checked her and said her measurements are fine she's just petite (she's on the 2nd centile and always has been). She mostly has a good appetite too. It's just her development we're so worried/upset about. I always feel so heartbroken when I see so many babies younger than her doing so much more. :( I'm just scared for the future, is she going to have severe disabilities etc? I will of course always love her unconditionally but I just want her to be OK and independent. I'm thinking about paying privately as have not heard from NHS physio or speech therapy for over 6 months. I just don't know where to start... Should I pay for an ADHD or autism test? Has anyone got any tips or positive stories to cheer me up? To end on a positive note her processing is so good. She knows her name and will sit down and turn pages of books etc. Also to end she has hypermobitly and she's always suffered with acid reflux so don't know if any of these could influence.

Speech wise this sounds a little like my daughter. Nursery called me during her 18 month assessment as they were concerned she didn’t have as many words as she should. Since then her speech has really come on and she’s saying new words every day! Not sure if your little one goes to nursery? Moving up into the toddler room was a huge help for mine x

Based on the information you give i would be pressing to get a proper assessment, all put together it jumps out as a potential problem though maybe just something they need a helping hand with. Individually none are that alarming is putting them together it sounds like my dsd who has a recognised syndrome (but is an independent adult, educated to university level and working so nothing too alarming I stress). If nothing is wrong and she's just late developing no harm is done by an assessment after all.

What you describe does sound like something that needs investigating further, speech varies a lot but that with being very small and only just pulling up to stand at 20 months does suggest there might be something going on for her. I’d speak to your GP and ask for a paediatric referral.

Sounds very similar to my DS. Stomach issues and hypermobility. Late sitting by himself, never crawled but bum shuffled around 10 months iirc, and just on the cusp of being late with the right amount of words for every stage. But years later when I found a video we'd made of him when he was heading towards 3 years, he was speaking in full sentences with appropriate grammar, it's just that his speech was so unclear we could only pick out some words.

I'm not in the UK so it's a different system but he had speech therapy both privately and publicly starting from around 4 years old. We had known most of what he was saying before that but others found it difficult, naturally enough. He had no language difficulties, it was all just speech. He also had difficulty with fine motor skills and still has a very strange pencil grip, but it works reasonably well for him.

Anyway he is not disabled, he is still hypermobile with all that comes with that, still has stomach troubles from time to time, but otherwise he's completely fine.

You might keep an eye on possible genetic conditions that cause hypermobility and see if other symptoms appear.

She sounds quite ikea my DS1. He was very behind in most of hid physical milestones - didn't crawl until 13 months, didn't walk until 18months. The health visitor referred him to speech therapy when he was 2. I was really upset that he seemed so behind compared to other babies his age. He was also tiny.

He's now 28, no issues whatsoever. Has a job he loves, loads of friends, chats away to me on the phone for hours. He's bright, funny and kind. He's also 6ft tall.

Have you had her hearing tested? My eldest didn't walk until 19 months and barely had any words at 2. Turns out they had serve glue ear causing severe hearing ear loss and problems with balance. Getting grommets was life changing for us.

Has she had checks with your health visitor? Probably the best first port of call for reassurance.

Just to add another reassuring story - my son was behind in most of his milestones too. He couldn't even bear weight at a year old, even with me holding him up. But now, at 5 years old, he's winning medals for running! He has been diagnosed with autism. But he's doing brilliantly, is above average at his selective private school, and is a brilliant little boy. When he was a baby/toddler we were terrified about what his future looked like, so we are relieved. Do push for a paediatrician to assess your daughter though.

Are you in the UK, OP? Have you seen your HV lately? My DD1 has always been suspected hypermobile and she didn't walk until 19months. In fact, we were in the process of sorting an OT referral when she walked. For us it was all being sorted through the HV, so based on our experience, I'd say that maybe some further investigation might be worthwhile? Your HV can also help chase services - mine has been fab at chasing up SALT referrals (for my youngest) and is currently doing a physio referral for DD1, so if you've been left waiting for 6months, see if the HV will escalate on your behalf.

Ask the gp for a referral for a hearing test.
Once you have the results of that, ask for a referral to SALT.
We've just got to the top of the waiting list for SALT after over a year's wait - DC is now 3.2

His speech has come on leaps and bounds in the last 9 months so I'm less concerned now but up to way beyond 2 he was saying nothing at all.

I would ask for assessment by a paediatrician (DOI - trained as one, although I work in another area now). They'll be able to look with an overview at all the possibilities, consider if any investigations are needed, and refer on to any other services (SALT, etc). If she doesn't bum shuffle, not walking by 18 months is a bit unusual, and it doesn't sound like that's your only concern. With any luck she'll catch up in her own time and be fine, but in that case a proper paeds assessment will put your mind at rest as well. Was her delivery and neonatal period uneventful? Thinking of you, this is a stressful situation to be in x

Thank you for everyone's responses and to all of you that gave me positive stories. :) So to answer some questions on here the strange thing is is the pregnancy was absolutely fine, no issues at all and my labour was actually fine. She was born at 37 weeks + 2 days but she hit all her early milestones such as smiling and rolling over. She also began babbling at 6 months. The only time we became concerned is when she was unable to sit unaided for a while. That was when she started to fall behind. She does crawl very well so at least that's one thing. Like everyone's saying the only thing to do is get her investigated by a professional. I really appreciate all advice though. :) xx