18 month development delay

[RBSK1]

Hi all,

Just looking for some helpful advice and support really. My 18 month old is the happiest little girl you will ever meet, yet she still says no words, has never used gestures (pointing, clapping, waving etc). We are under the paediatrician and being referred for speech therapy but obviously we’re preparing for the future with her.
She has minimal understanding of instruction and it’s hard to just know how much she does understand. We are well prepared for the possibility of an autistic spectrum diagnosis, and I appreciate “all kids are different she’ll do it in her own time”. I’ve heard this every day since she was 4 months old (when my concerns started) so please save your thumbs from typing that one out.

Has anyone been in a similar situation and have some helpful advice re the ST process or the diagnosis process for toddlers?

TIA x

18 months seems so young still, my 2 have no additional needs but developed so differently, by eldest barely spoke till 2.5 and my youngest spoke full sentences by 2! I would try not to worry and just keep chatting and exposing her to new things!

It's not necessarily the lack of speech that sparks the thought, it's the lack of clapping, waving, pointing, shaking her head etc.

At her 16 month and 18 month development check, gross motor skills were excellent, she was an early walker but everything else, fine motor, communication, problem solving were all just about scraping a 6 month old level.

Its becoming a struggle as we know she understands some things but others it's like talking to a wall. I've done a running commentary of this child's life to her since she was about 3 months old yet still no response. She does however, hold brilliant eye contact

Slt here. 18 months is still very young, and there can be so much difference in rates of development. You may find that slt don't offer much at all for that age, though it's good to keep and eye on her and be open to anything.

I would look into the hanen programme techniques/ it takes two to talk, aimed for young children with language difficulties, but using the techniques would be beneficial to any child. Read plenty of books. Watch Yakka Dee on cbeebies, shows you how to develop vocabulary by looking at a word in different 2 word phrases e.g. "red plate, blue plate, big plate" etc. Remember that understanding language has to come before speaking it, so try not to put too much pressure on her to talk.

Well done for getting your head round it so quickly. If I had a tenner for every person that said 'every child is different, they just need x... y...z...' I would have had a nice holiday in those times!

The waiting is the hardest thing, but trust in the paediatrician, as they are usually the portal to other services.

I'm exactly in your boat. My little boy is 2 years 4 months old and since 18 months we've been pushing the HV etc about developmental delays. He has global development delay and we are expecting an autism diagnosis. I self referred to SALT to get the process moving as the health visitor was absolutely useless.

If you're commenting on this thread and don't have a child with these issues please don't say things like they might catch up, it's so bloody wearing. With delays like this they normally don't just 'catch up'.

Hi OP, I was you about 6 years ago. I have a few threads on my son from that time. The not knowing was the hardest bit for me, but it was around 18 months that I also knew something wasn't right. He didn't clap, wave, point but did doing those things gradually, although much later than expected. His understanding was delayed too and he didn't have any words until 2.5 and when he did it was a very slow gradual process. He's just turned 7 and can talk and communicate really well. He does to mainstream school and is academically bright however he has been diagnosed with ADHD and is on the waitlist to be assessed for ASD (which I'm sure he also will get).

At that age the fear of the unknown was hard, but he's slowly come along and is doing great.

I would get a GP referral to your local community peadtrician and take it from there. If you can afford to, I would recommend getting a private SALT too.

Happy to answer any other questions!

Oh and my GOD if I had a pound for everytime I heard "he's fine he'll catch up" or something along those lines, I'd be driving a Ferrari. Including from his own dad. My husband was in denial for a long time but it became clear as he got older that he wasn't neurotypical.

I'm so glad I'm not the only mum!

My HV is just plain awful, patronising, etc you know the type.

Those mums who have experienced this, was there anything you tried that you felt was key to making even a tiny bit of progress? We've tried flash cards, yakka dee, commentating on every minuscule part of her day and there is just point blank disinterest from her. She is however, a Hey Duggee obsessive fan. Is there anything you guys tried that you felt was key in bringing them on a bit or at least helping you understand them better?

Side note: she doesn't even try anything Makaton/sign related. She doesn't seem to have the coordination

@RBSK1

I'm so glad I'm not the only mum!

My HV is just plain awful, patronising, etc you know the type.

Those mums who have experienced this, was there anything you tried that you felt was key to making even a tiny bit of progress? We've tried flash cards, yakka dee, commentating on every minuscule part of her day and there is just point blank disinterest from her. She is however, a Hey Duggee obsessive fan. Is there anything you guys tried that you felt was key in bringing them on a bit or at least helping you understand them better?

Side note: she doesn't even try anything Makaton/sign related. She doesn't seem to have the coordination

Does she copy or echo Hey Duggee? You could incorporate Duggeespeak into your lexicon, for example when you hug her you could say 'Duggee hug'

I was about to comment when I saw your update, and suggest some makaton! My dd has learnt bits of makaton at nursery and I think it really helps her. It's not just her doing it but she'll understand me better if I'm doing the makaton as well as talking. Eg I was telling her not to go near the oven qhile I'm cooking, and I kept saying it's hot, and when I did the "it's hot" gesture she got it and shrank away from the oven

Hi OP, she sounds similar to my son who has just had his ASD assessment. He is now nearly 3 and a half and started talking just before he was 2 and a half. He started with animal noises and the alphabet rather than any actual words. He loves to group things so he started learning words for groups of objects so after the alphabet he could label foods then shapes. He seemed to find it easier to learn things in ‘groups’ if that makes sense so we tried to teach him things like verbs in groups with picture cards and it’s worked really well.

They referred him for the assessment after his initial paediatrician appointment and after a long wait the assessment consisted of a parent interview style appointment and then a play based assessment which lasted just over an hour. Nursery have been brilliant with him and he gets 1-1 support there

Has she been referred for a hearing test yet?

I think you need to focus on building imitation as this is key to speech. Before working on verbal imitation you need to work on teaching her to imitate actions. I recommend this book which I used to help my autistic son to speak.
teachmetotalk.com/2012/04/05/building-verbal-imitation-in-toddlers/

My son was quite delayed with things and especially with Speech. He has with a lot of support from me and private speech therapy, caught up really well, he's now 6. He was an early walker and very busy exploring. But my council ( family support service) did send me on a speech course and I must admit I wasn't really demonstrating things for him. I didn't point to stuff, I just spoke to him in long adult style sentences. I never clapped. I have never really been around young kids. So whilst I was initially very offended they blamed the parents, I think it was in part my fault.
And that my DH is away a lot with work so I was quite isolated, although we went out lots. I am in contact with many of the others that stuck with the 10 week course and few did get ASD diagnosis, but they also improved with the focused time with using single words.

The speech therapist that recommended yaka dee programme is right, it's great and baby club if you can find them on iPlayer and the toddler version too.

I have been very different with my second child and they again walked by 10 months, but their speech and communication is great. I learned to parent, I thought I was doing it right but kids can't learn what a ball is if they hear "oh look it's a wonderful striped bouncy ball. Do you remember Granny got that for you? Yes on holiday last week"... just stick with Ball.

So what I'm saying is there maybe something wrong, maybe , but you still can improve and work on things now, because a diagnosis isn't magic and services really are limited even if you get that.

Hi all,

Thank you so much for your responses. It's made me feel so much less isolated and alone with the situation!

She has had a few hearing tests, passed the newborn with no issue and subsequent have been 'inconclusive' where they're torn between a hearing impairment and just plain ignorant.

We have now toyed with the idea of getting photographs of her day to day items, juice cup, bottle, nappy etc and having a Velcro board. Has anyone tried this? If so, please send me recommendations!

We have them for my 3 year old as we were really struggling to get out to nursery in the morning without meltdowns. highly recommend them for understanding! We picked up a set off amazon..

I am so torn with him as nursery say there is nothing to be concerned about and I look at a little boy with limited understanding and only just starting to talk now... And even then.... It's limited to specific things.... Same sort of phrases and I'm still not convinced he's actually put words together.

He didn't point until 2, clap until nearer 2, eye contact is wonky at the best of times but improving... Appears to have a lot hate relationship with sensory things like showers are a total write off but he loves to bounce and spin all day.

I referred him to speech and language and waiting for a call to check in but feel they were unwilling to look beyond covid and nursery saying there is no issue.

Our speech therapist always said use their interests, so you could teach her the names of the hey duggee characters or their animals. We have this hey duggee book and it's great. You can read the bits, but also just go through and label each page by pointing and saying a single word ( crocodile or Happy) Repeat, repeat, repeat.

We have a book with a clock by peppa pig about her busy day. So maybe look for something similar for characters that interest her.

OP - it’s really important to get a conclusive answer re her hearing so I advise in doing some research and finding the best paediatric audiologist you can as well as an ear nose and threat specialist. I assume that her vision has also been properly checked? Just don’t take “dong know” as an answer.

@Mummyof2Terrors

I'm exactly in your boat. My little boy is 2 years 4 months old and since 18 months we've been pushing the HV etc about developmental delays. He has global development delay and we are expecting an autism diagnosis. I self referred to SALT to get the process moving as the health visitor was absolutely useless.

If you're commenting on this thread and don't have a child with these issues please don't say things like they might catch up, it's so bloody wearing. With delays like this they normally don't just 'catch up'.

The opposite I think….the gap gets wider

We’ve been pushing for a retest since September and are yet to hear back. We know she’s not deaf as she can hear the theme tune to Hey Duggee from 20 miles and gets whiplash trying to see it.
its almost like selective attention, if she doesn’t already hold an interest in what you’re about to say then she won’t interact.

Note about books: we’ve tried booked with her for a while not but she grabs the books and either rips them up or chews them. EVERYTHING goes in her mouth, doesn’t matter what, everything has to go into her mouth!

How does your little girl communicate what she wants? Does she lead you by the hand to the fridge/hand you her cup? If so, I wouldn’t confuse things with pictures at this stage. Try offering choices - show her the milk and juice - can she indicate what she wants? Reaching or looking is fine. Does she like any games that need you? Bubbles/row row row your boat? Do it once, then wait. Does she indicate she wants more? This could be a movement or looking at the bubbles or reaching for them. Any communication, whether it’s intentional or not, is fine. Watch carefully, it could be really subtle.
Then add one word - repeat it several times - say it as she would if she could. Keep everything you say to her really simple and try to make the words useful - more, juice, biscuit etc.
I agree with the previous poster about Hanen but, if you are thinking autism, I’d go with More than Words. It’s a great book, but it’s very expensive so maybe see if your library can get it for you.

Oh, and get onto the Tiny Happy People website- loads of great advice there. Also, lots of SLT departments are on Twitter and post good links to advice. It doesn’t have to be your local department. All the advice you get from there should be evidence based.

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Hello i was absolutely in your shoes, my son sounds very similar.

We raised concerns before he was 2, around 20 months. HV was rubbish and sent me to the BBC communication website

He had a private diagnosis of autism at 2, he very clearly fit across the three areas they look (communication and play, social communication and repetitive behaviours).

Local authority didn't accept diagnosis even though the Dr was a leading authority on the topic. Did their own diagnosis 7 months later.... Surprise confirmed he was autistic
It took some time to access SALT and OT, we also have weekly portage (worth looking into this, it's play therapy, they come to the house)

My son is 3.5 now, still non verbal but we are making progress with picture communication. He's still a joyful boy and so happy.

Just go with your gut, you know your own child. I would say, most of the support at this age is quite basic, it's all play therapy based but good to learn these techniques as most of the work will come from you at home.

Also to add, using pictures as communication only came in the last 5 months for us (so he was around 3) he couldn't process them before, we used object based communication. He started taking us by the hand about 2 years 9 months.

Here is you want to chat 💐

Oh that's so embarrassing I've managed to post my do-list above my post! Wish wish there was an edit!!!

Thank you all for the advice again today!

I’ll check out the tiny happy people and see where we get with it.

She’s a complete communication block at the min. OH and I know what she wants based on behaviour, she doesn’t lead your hand or point, or choose if two options are there. She wants both, and now. It’s definitely a struggle, if we had the slightest form of communication it would definitely make life easier.

Think we’re gonna try the THP page and the pictures and see where we go from there. Thankfully we are under the paediatrician now so we bypassed the HV, thank god!