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.

@Wickedin Sorry wasn’t accusing you of putting him under pressure just trying to help.
Signing does of course encourage and support communication. It’s especially helpful if speech isn’t clear.
Did the Speech Therapist notice he used please to request alongside pointing? It does sound like he is using it as a generic sign such as help or more which would be introduced early on.
At home you obviously know what he wants. Good you are naming the item. I’d start to offer a choice so if he points to toys on a shelf and you know he wants a drum, offer the drum and a teddy sign/ say which one and or offer both with outstretched arms, naming. You’d say “ DS wants…. Pause” when he indicates say/ sign drum and hand it over.
Same with food. If he signs please and indicates the fruit bowl and you know he wants a banana offer a choice of banana or apple. Or next stage sabotage and just offer a non preferred item.
This is good prep for Nursery where staff wouldn’t understand please as you do. Should help him to learn that the word/ sign please isn’t the automatic word for getting what he wants.
Sounds like he’s doing well developmentally.

We’ve considered this but HV won’t refer for an assessment as he points, signs, shares attention and bring objects to us to play with … he’s also now extremely smiley and social. But yeah I do wonder about this too. A lot,

We do do this choose thing and he tends to point and nod and sign please so it’s hard to not give it to him until
he signs item if that makes sense?

thanks for your advice

I’d say no and if you can get him in with an audiologist for a test it will at least put your mind at rest . As I said we had literally no clue that our eldest was partially deaf as aside from being a late talker he did everything else normally and when he did finally speak it was clear and with no impediments .

Glue ear is often intermittent. DS was prem so was regularly screened from birth. Clear speech was delayed but he was stringing words together from very early on which often sounded like gobbledygook. One in particular sounded like bouillabaisse, he used it whenever he saw a lorry or bus, we eventually realised he was trying to say wheels on the bus.
We read to him from very early on so by the time he was 3 he had a huge vocabulary and comprehension. He was a dinosaur fan so I was constantly pronouncing dinosaur names for him to learn. Reading regularly is invaluable.
Until his glue ear was treated he did have some speech oddities. He pronounced Y as L and some more complex words were entertaining. The improvement in his hearing rapidly corrected his speech. But like me, I too had glue ear, he often struggles with processing and often needs to see someone’s face when they are speaking to fully understand.
I would get his hearing tested first. You can do a quick check by standing behind him while someone distracts him visually the talk quietly to him to see if he responds. If he doesn’t respond keep talking, increasing volume until he does. We noticed that DS was often surprised when someone approached him from behind. We also had to get his visual attention before talking to him.

My son had no words until 2 and a half so I taught him signing. I used BSL signs but with English grammar/ sentence structure so Sign Supported English really. It worked really well, he had over 400 hundred signs at 2 and a half and could communicate easily.

Tbh, im not sure why your SaLT is recommending AAC over just teaching g more signs? He has shown he can learn them and use them and you always have your hands with you so why change to a different method?

And please ignore any posters who imply signing is the reason for your son’s speech delay. It has been proven that signing actually helps with speech development, not delays it!

Has he had an eye test? Ds struggled with speech development but had good understanding. He had an eye test at 2 (as both myself and dh suffered with lazy eyes) it turned out his eye sight was really poor. We had no clue as he never bumped into anything. Once he had his glasses his speech cae really quickly, his speech therapist said it was because he could now see mouth shapes which were making the words, which before he couldn't.

I’m going through this right now OP. 21 month old, my 3rd DC, hasn’t said a single recognisable word yet. My other two DC hit all their milestones with speech, so this is a new one for me as a mum.

We had his hearing tested 2 weeks ago - all is fine.

He’s started trying to say some words e.g. water is ‘worrr’, and he says mama and dada. But yes, I’m concerned.

We live in a non-English speaking country and he attends French-speaking creche, so apparently it’s normal for kids in a bilingual environment to speak later. This doesn’t stop me being concerned though!

Im moving back to my home country in September, and if he’s still behind then I’ll book him into speech and language therapy.

My daughter did this. Hardly any words. Went away on holiday with her aged 26 months.
First morning there my husband was doing the dishes. "Look at the bubbles" then when my husband used the pink cup instead of the blue she said "that's mummy's cup' and off the went and at 33 she's never stopped 😂

I’m a SLT and always advise a hearing test as the starting point. I’m really surprised your SLT didn’t recommend this.

All the other advice sounds really appropriate to me. You’re right to move away from “please” as a general request communication. It’s much more useful to encourage functional words/signs like help, open, again, more and nouns/verbs.

Definitely lean into the signing. Decades of research indicates it only supports the development of communication (including spoken words).

No. He needs a proper hearing test.

Adenoid issues can present as snoring.

We still do functional signs but he always signs please after. He’s been doing it since he was 11-12 months.

She just noticed him hear a plane outside and said ‘his heating is definitely fine’

we sing constantly to him ♥️

Good idea!

Being able to hear a noise isn’t the same as being able to hear a range of noises at the various different frequencies needed for speech to develop.

I have my.child a running commentary on everything in simple language. Also read lots of lots of books to them in simple language every evening. Ask questions, what colour is the car? Blue!
It was exhausting, but worked.

Do you do this kind of thing OP?

The advice you've had so far is great, the only thing you've not mentioned that we would encourage is mimicking the child's 'speach'. You said that your child babbles/makes noises, if this is still the case, make sure to repeat his noises and babbles as if holding a normal conversation. This helps to promote verbal communication, as they learn that you are responding to their voice (even if it is incoherent) instead of just their gestures/signs.
#typo

I do - but now I’ve been told to only do two word phrases with long pauses in between … and definitely ask a lot of questions when reading which he always responds to. We read at least three books a day

Again we e been doing this since he was a few months old and will continue to

No, it's not. You need a referral to audiology. I thought my DS's hearing was fine, he actually had moderate hearing loss.