17 month old not talking and developmental concerns

[Mamatotwoboys]

Hello
My 17 month old is not talking yet. He can say ‘dada’ and sort of says ‘duck’ and ‘hot’ but he doesn’t seem to be able to repeat sounds or learn words through depiction or copying. I have read many threads and would feel comfortable trusting it’s completely normal for them to speak later, only we also have some concerns about his physical development so I thought I’d write here in case anyone has a relatable situation.
He crawled at a normal time and his crawling is straight / even, however when he started trying to walk (assisted) we noted him dragging his right leg - his leg externally rotating. Our health visitor organised a scan to rule out hip dysplasia and we have since been seeing a chiropractor who believes he has a tight sacro iliac joint. We have had five sessions with her and his walking is getting stronger but today our nanny raised some concerns about his physical development- he is generally more dominant on his left side (when he walks his left shoulder/chest/hip/ leg lead the way), and sometimes his right arm seems to take a back seat as well as his right leg. He dribbles a little bit and isn’t able to do things like ‘blow’ or blow a kiss. He does clap, high five, point to his nose and head, and has good fine motor skills like picking up small crumbs etc.
When we saw the GP before the hip dysplasia scan she said the other thing to rule out / consider is cerebral palsy, but this hasn’t been considered since.
I really hope it’s just a bit of late development - he had a three year old brother and often people say it’s common in younger siblings. But with the delayed speech and dominant left side of the body and a few other bits, I just wonder if there’s anything else going on.

thoughts would be appreciated

Is he left-side dominant with his left hand for fine motor stuff as well? Clearly able to do more with it or uses it quite a bit more than his right? If it's primarily gross motor stuff where he leads with his left, it might just be related to the tight joint, and resolve with some more treatment. Possibly consider seeing a physical therapist as well as the chiropractor?

For an overview of development, have a look at https://www.socfc.org/SOHS/Disabilities%20Mental%20Health/ASQ/ASQ%203%2016%20Months.pdf and https://www.lakepediatrics.org/storage/app/media/asq2017-1820months.pdf. Do check the scoring sheet at the back – it never takes 6 yeses in a section to for 'development appears on track'. A section or two in the grey is quite common, and usually resolves itself, but more than a couple, or sections in the black, and I'd get in touch with the HV or GP and ask for a developmental review.

Technically, the 18 month questionnaire is 'right' for his age, but if he's okay on the 16 month one, I wouldn't worry too much about slightly low scores on the 18 month one – a month can be a long time in toddler development.

What was his birth like? My ds has a form of cerebal palsy and (effects his left side) it wasn't a huge surprise to us as he was starved of oxygen at birth and I had to have a emergency c-section.

@DamnAllTheJellyfish
i had a vaginal birth and as far as we know he was ok - what are your daughters symptoms like with the left side body? I suppose they wouldn’t necessarily have known if there was a problem - I did have myconium and at the end he did get a bit distressed according to the monitors.

@skkyelark thank you so much - we will do those forms this weekend and see what we think. That’s very helpful

Get back in touch with the HV see what they say. My child is a similar age and speech delay and some physical delay and because we have autism in the family the HV is making me do some courses and advise sessions but will then refer for assessment. You HV will be able to refer you for advice at the least.

Consider getting hearing checked. This can be a contributing factor in delayed speech.

I would chase the CP up with whoever mentioned it previously. I nannied for a family and felt one of the twins had signs of CP, I didn't mention CP to the family but raised my concerns and they had had CP mentioned to them from other source. They didn't chase it. A couple years later the child gets a diagnosis of CP. you do need to chase. Has your child had meningitis? It was meningitis that caused it for the little girl I'm thinking of

I think this is a case of it's probably nothing, but it could be something.

Things moved slowly and waiting lists are long. Chase this up now just in case. See your HV. See your GP. Get the ball rolling.

There's every chance it will all sort itself in the coming months, but if it doesn't you'll be a step ahead.

I would go back to gp to get CF ruled out in regards to the physical ability and get redeem. There are quite long waits for portage/occupational therapy/ speech therapy but it's worth getting the ball rolling even if he doesn't end up needing it in the end you can always cancel. He should also be having a two year old check witching the next few months which you can flag any concerns with a health visitor.

In regards to his communication does he understand simple instructions? For example go and get a book/ put this on the table etc.

I work in a nursery and a lot of our children born around lockdown are delayed in speech, it's become a lot more common than we usually see.

To encourage speech give choices when offering items - would you like the dinosaur or the giraffe? Would you like a breadstick or some pear? Etc. If they cannot say what they would like and instead point to what they would like then repeat the name of what they have chosen. Speak clearly with one or two words. Lots and lots of reading, repetition and singing simple songs/ nursery rhymes at home.

Sorry that was meant to say get seen not redeem!!

Such brilliant advice from everyone thank you. I left a message for the HV yesterday so hopefully I’ll hear back from them soon, I’ll try again today.

In terms of CP, is anyone able to tell me what the diagnosis process is like - what tests are done and under which team? Do I just go back to my GP or is there a particular referral I need?

It also feels tricky because the things we’ve noticed are such small intricacies, every time we go to the chiropractor he doesn’t walk so feel it would so hard in a CP assessment!

Will definitely try to encourage language development through simple clear words - I think we did a lot more of this with his big brother, so I’ll commit to really focusing my attention on it.

My ds cp is diagnosed as left hemi-plegia and was diagnosed at around 2 years old by a paediatrician. He was referred to the paediatrician at about 18months by the health visitor for development delays and we had a few appointments (just questions and observations) before he had his diagnosis.

He walked at 19 months, but didn't choose that as his main method of getting about until just before he was 2. He was unsteady on his feet and had trouble with steps etc initially.

He is 14 now and certainly hasn't let him hold him back, there's not much he can't do physically.