21-month-old using signs but no words yet, seeking experiences and advice

[Wickedin]

21-month-old with lots of signs but no words yet – looking for advice/experiences

Hi everyone, I’m hoping to hear from parents who might have been through something similar.

My son is 21 months old and doesn’t have any spoken words yet, but he communicates quite a lot using signs and gestures. He uses around 20 signs consistently (things like more, eat, drink, help etc.), points to what he wants, and seems to understand a lot of what we say. He can follow simple instructions and will usually point or sign to show us what he wants.

We recently had a speech and language therapy assessment. The therapist said he actually has many of the foundational communication skills they look for (pointing, understanding language, intentional communication, copying signs). Because of that, she felt it might just be that speech is taking a bit longer to come through.

Her main advice was to simplify the way we speak to him. She’s asked us to:

• reduce the number of questions we ask him

• try to speak in very simple 1–2 word phrases as much as possible (for example “more banana”, “car go”, “mummy help”)

• comment more on what he’s doing instead of asking lots of questions

• pause and give him time to respond

• keep encouraging communication through signs, pointing and gestures

At the appointment she suggested we try these strategies for a couple of months and then review, since he’s still young. In a follow-up email she also mentioned that AAC (like picture boards or possibly a device) could be introduced sooner to help expand his communication, although she also said she’d be happy to review in a few months if we’d prefer to try the strategies first.

So at the moment I’m feeling a bit unsure about the best route.

A couple of other things we do at home that I’m wondering about:

• When he wants something, we often ask him to sign “please” before giving it to him. I’m now wondering if it might be better to focus on signing the actual word he wants (like banana, drink etc.) rather than please.

• I’ve also read about a strategy where you hold the item near your face and clearly say the word so they can watch your mouth (for example holding a banana and saying “banana”), then pausing to give them a chance to respond.

I’d love to hear from anyone whose child had good understanding and lots of gestures/signs but delayed speech.

A few things I’m curious about:

• Did your child eventually start talking, and around what age?

• Did anyone try AAC at this stage, and did it help?

• Were there any strategies that seemed to really help speech start to come through?

Thanks so much in advance — I’d really appreciate hearing other people’s experiences.

Is he making sounds or is he totally quiet? Has he had his hearing tested?

Have you consistently used words alongside signs? This is drummed in when you do training for Signalong etc
Please and thank you are not functional words. Nice to be polite and use/ learn the signs but when there is little or no language they shouldn’t be a priority. Respond to requests and just name the item. You can always expand e.g. car, blue car, balloon, big balloon.
I’d follow the Speech Therapist’s advice for now. Try to take the pressure off your child and yourself. Processing time is important.
Repetitive and rhyming text books are good and anticipation rhymes. Pause to see if he will sign or try to say a work. Keep it fun.
Will he copy or attempt animal or car noises? Bbbrum bbbrumm, baaaa, mooo etc?
Good luck and have fun.

I'm surprised you didn't mention this OP. If a DC is late talking usually the first thing you do is get their hearing tested. One of my DC was a late talker and he had glue ear, so he couldn't hear well. He needed to have grommets fitted and following that and intensive SALT he caught up. My DC was also communicating well via non-verbal means.

Is he making any sounds at all? Two of my children had really unclear speech, one because of glue ear, one not, so we used more signing with them but their speech did catch up. Words weren't always even close to what they were trying to say at this sort of age (e.g. 'ma' for open) but they got there. They are both autistic though. I wouldn't personally use an AAC so young but I'm not sure what's considered best practice.

I'd be having his hearing assessed.
And be seeing an ENT.

Does he make any sounds or babbles at all? If not, get his hearing tested.

My daughter babbled and grunted, but no words- then randomly put three words together one day at about 23 months.

He does babble and grunt a lotX!

Are you being advised to encourage him to speak? Surely he needs to be practising his speech sounds and words instead of relying on signing and AAC, if he is capable of speech. Has he had a hearing test? Any history of ear infections?

My DD has speech issues. I don’t remember when she managed to speak recognisable words. Later than usual. She was a noisy, chatty, babbling baby toddler but barely any actual words. We constantly spoke to her and narrated what we did. She had speech therapy from toddler to end of primary school.

We had to stop responding to her grunts and pointing and get her to attempt words. We’d say the word and get her to copy, and repeat this a few times each time. It was annoying for us and frustrating for her but it really helped to get her saying words that were more recognisable. Communication had to all be verbal instead of DH and I responding to her non-verbal communication. It felt mean at times but the speech therapist reassured us that we needed to do this.

We also had to practise just the basic speech sounds with her, so she could practise those mouth movements. We would do it face to face with her or in front of a mirror side by side so she could watch her mouth and tongue. Things like mmm, b b b, lll, t t t, sounds like that.

She still has some issues at 16yo but generally she can be understood by strangers. She has other conditions including ASD and low muscle tone, so I’m sure they contribute to her speech issues.

And has he had his hearing checked? @Wickedin

We’ve have always said and emphasized the word alongside the sign consistently but he only attempts to imitate the signs and therefore can communicate quite well with them. He naturally says please with a sign when he wants something. It’s a way he can communicate a ‘what’ without having to whinge or get frustrated. He points and signs ‘please’. He does it naturally now but we always sign the object alongside it as well as saying the word.

he has attempted animal noises since about 12 months old but very rarely and then never again. He has a sound animal book he sits with and has a go but this is rare. If we do it with him he’s less likely to do it but when he’s on his own, he does it more!

it must look like we’ve put pressure on him but aslife from the usual excitement and responsiveness to your child’s first attempts to talk, we’ve never put pressure… so it’s really confusing he doesn’t seem to want to talk around us.

If he cant hear 100% then he is going to really struggle to talk. Unless you have eliminated this as an issue then it will be impossible to work out how to help him because support for a hearing impaired child is very different from support for a learning delayed child.

Why do parents introduce signing to a baby that isn’t hearing impaired? If a baby/toddler can sign then that’s going to take away the motivation to learn to talk.

@Wickedin Does DS have any other delays like sitting up, crawling, walking? How’s his eating, drinking and utensil/tool use?

@FeralWoman research ahows the opposite. Children who have a range of options of waya to communicate learn to speak more quickly. I dont know why. Maybe its to do with them understanding how useful communication is.

Its not that uncommon. At 2 my daughter didnt use words. Shes just turning 3 and still has a small vocabulary but it is growing. Health visitor and nursery staff have all gone on line of its normal, she is bright and following instructions and will get there in her own time. I was similar and just came out in sentences one day. It didnt hold me back.

Tbf Feral woman that's bollocks.

However, I agree that this may be something more developmental. He doesn't have many signs for his age so I'd be asking the GP for referral to the neurodevelopment clinic just to check if there's anything underlying going on.

Really? Weird. I wonder if that’s true for all children. Signing wasn’t an option for my DD anyway because she lacked the necessary coordination and fine motor skills that would have been needed.

Our eldest was a late talker , had about 8 words until he was almost 3 and then when he did start talking he spoke in sentences almost as if he had waited until he had something worthwhile to say . As it panned out he failed a hearing test at 6 and has moderate to severe hearing loss but had taught himself to lip read very effectively ( 95% accuracy on the tests they did ) . So it is likely that his hearing loss was what caused his late speech however he had passed all the hearing tests that they gave them as a baby 30+ years ago . As it is he is extremely academic ( HFA) , has a photographic memory and still relies on lip reading to a great extent as he refuses to wear hearing aids .

My DS didn’t try speaking until he was about 2.5, and then couldn’t speak properly, it was more noise but mimicking back in the tone that I used. He did use signs, had excellent understanding of instructions and was quite skilled at making himself understood despite lack of speech. He’s a twin, so he could make himself perfectly understood with his sister as they had their own secret babbling language and she was an excellent early talker which possibly might not have helped.

He eventually started to be able to form words but always spoke incredibly nasally and you had to tune into his radio station to understand. Words became clearer, then he’d have what I’d call a language explosion and the process would start again.

After a looooong fight with the NHS ENT I ended up seeing another private ENT who finally diagnosed the problem as seriously enlarged adenoids, the poor lad never stood a chance of ‘normal’ speech. He had an adenotonsillectomy privately 18 months ago and he’s been on fire ever since after some speech therapy to help him on his way. He’s now 8, and since his op has virtually caught up to where he should be academically after making zero progress at school for 2 years.

It’s a challenging road, could be something or could be nothing for your DS. 21 months is still very young, so I’d follow the speech and language therapists advice for now and wait and see what progress if any is made for a while and reassess later. I’d absolutely recommend if it’s affordable to you to access private services if possible because ENT round my way was (and still is!) an absolute shit show.

The speech therapist said he definitely didn’t have a hearing issue. Is that enough?

Because every child development expert recommends signing as a pathway to speech. But perhaps you are right.

he smiled at about 12 weeks, he rolled at 3 months, sat up at 5 months, commando crawled at 6 months, properly crawled at 11 months, walked at 18 months.

he had always been good with hand / eye coordination and feeds himself , can use an open cup.

Ok. In which case, we paid for a private salt and did about 6 sessions of video therepy with them. This involved us playing with our son and the salt videoing it and then we would watch it back and the salt would show us ways to improve out interactions. By the end of it we were basically doing speech therepy all the time with our son without having to think about it. If you are worried and want to give him a boost i would highly recommend it.

I Would still keep a watchful eye out for hearing issues though because they can fluctuate massively. So glue ear can cause huge hearing issues but onky when the child has a cold and then can totally clear up at other times.

What are the signs he could have this issue so I can try to get a GP referral? Thanks

Is it a bilingual household? That can cause a temporary speech delay.

One thing that worked for us was communicating with each other in simple babyish sentences too.

Daddy do you want MORE pasta?
Yes Mummy I want MORE pasta! Thank you!
Do you LIKE the sauce?
Yes! I LIKE it!

We probably overdid this with dc1 but she picked up stringing sentences really well when we did

Please OP, have his hearing tested. No, a speech therapist cannot rule out hearing problems. It would be irresponsible of them to imply that they can. You need a full audiological test AND pressure test to rule out glue ear.

You asked what are the signs of hearing problems. Number one is speech delay.

If he does have hearing loss, the sooner you know the better- for his speech and general development.

I had two children late to talk. One was autistic but very high functioning and a teen now, hugely eloquent. The other had glue ear, had grommets in and speech grew very quickly after that. 12 weeks is on the later side for smiling so may be some neurodivergence? Not wishing to jump straight to that but I experienced that with my ASD one so just putting it on the table for consideration.