2 year old with speech delay--how to help?

Hello there,

One of of our children had a severe speech delay, with only a few sounds available to him at 2 1/2 years of age.  We had him tested, and under our insurance were able to get him speech therapy.  We continued with that at three times a week for three or four years through Alta Bates.  It made an enormous difference.  We then tapered off to twice a week until he was eight.  At that point our insurance wouldn't cover the cost and though it was recommended that he continue, we chose not to.  I wish I had.  Today, he is 15 and speaks with a slight impediment, making him a little difficult to understand, and when he is tired, his speech is even more impacted.  Still, he is an A student, very popular and has his eyes set on a top college.  For all of our children we have found that early intervention is the key to bridging the gaps, and that it is critical to do so at an early stage.  Don't worry about your child being labeled.  None of that occurred with any of our children and they are all doing well.  I don't think that would have been the case had we waited things out.  Advocate for your child --- they can't do it themselves.  Good luck to all.

Not sure I can offer advice, but just wanted to say that our boy didn't speak at all until around 21-22 months, and didn't have many words at age 2. All other milestones were met on time, so our doctor wasn't concerned.  Now at 2 1/2, he's having a language explosion! One thing that I noticed: whenever we had family visiting from out of town, or did new experiences or visit new places (we just moved, so there have been a lot of those!), there was a noticeable increase in his language within a few days. Made me wonder if he just gets into a habit of communicating with us and needs the stimulus of new experiences or new audiences to trigger more speech.  Instead of games or TV, I'd just try outings to new places. Even a month ago, my mom also happened to be home when we had a babysitter, and reported to me he spoke to her in almost full sentences (which he NEVER did with us), so I do think it could be situational. I'm no expert, but wanted you to know you're not the only one!

I would recommend you to immediately contact your son's primary doctor and insists to be referred to Regional Center to get tested.  My son was tested at 2.5 and received private speech therapy one on home at our house before 3 years old.  After 3 yrs old, he was transfered local public school with an IEP for service.  I hope this is helpful as I went through a lot with my older son and had to spent great amount on private services (didn't want to deal with crappy one with local public school).  It is best to get it before 3 years old.  Good luck and let me know if you have further questions.

My grandson was speech delayed and I thought this was perhaps due to part of his family speaking Spanish.  It is not uncommon for bilingual children to begin speaking later.  However, when he turned three and still didn't have the 100 words that people outside the family could understand, I suggested that my daughter-in-law have him evaluated by the school district.  The district qualified him for intervention with a speech therapist who worked with him and the family.  I wish that we had started even earlier.  He does have language processing difficulties and requires ongoing support resources. 

I have been a infant development specialist for many, many years. Some children just develop words later, some need support. I have a few questions, if you don't mind. Does he understand everything you say? Can he follow simple directions? Does he get frustrated when not understood? Personally, I go with getting an evaluation and possibly speech therapy "just in case". It won't hurt him and it really might help. A good speech therapist would tell you if therapy is needed now or if things can wait. It sounds like you are already concerned. I think as parents we often look for 'reasons' (a vocal sibling, anticipating his needs, etc) but if underneath you are worried, get the evaluation. Then you'll know you've done what you can in the moment. If he doesn't need therapy, great! In the meantime, I stay away from audio games. There is nothing better than communicating with an engaged person. Read --lots-- ask questions--"what is this? It's a dog! What does the dg say?" Label things in your house." I"m getting you a fork! Here it is. Here's a fork!" 

Good luck-

Here's what I learned when I studied language acquisition as part of a linguistics degree.  Learning  language is a complex process.  Producing speech is just part of it.  Anything up to age 3 is considered in the normal range for beginning to produce regular speech.  Children learn language from other humans.  Video's, tv, audio tapes, etc are pretty useless for primary language acquisition.  It is very difficult for someone without training to help a child overcome obstacles to speaking and attempts to do so often cause anxiety and may create a bigger problem than the one you are trying to solve.  

At the time I was studying linguistics I got to see this in action. I had a niece who did not speak more that a couple of words until she was nearly three.  She did seem to understand when others spoke to her.  She did  communicate through gestures.  She did participate in "conversations"  but babbled where she would have spoken.    Her parents decided to wait and see.  All of a sudden shortly before her 3rd birthday she began to speak more words.  Within a few weeks she was speaking full sentences.  Within a couple of months no one would have know she was a late talker.  

If you are not concerned that the lack of speech is part of a bigger problem then probably the most helpful thing you can do is relax.  Play with him, sing to him, read to him.  But don't push.  He'll speak when he's ready.  If not it will become clear that professional help is needed and you can pursue an evaluation then.  Good luck.

 I am a grandma with lots of experience-- and a retired speech and language pathologist.   I worked as the primary speech pathologist at the West LA Kaiser and did a lot of parent training with language delayed kids.  First of all, boys are often slower at talking than girls, and just turned two-year-old boys do not necessarily have anything close to 100 words in their speaking vocabulary!  Is this person talking about receptive or expressive vocabulary?  You might consider speaking with a speech/language specialist to get tips on how to stimulate language appropriate to his age level.  There are ways to do this successfully that do not create stress.   

I'm not sure what you mean when you say you are "actively encouraging him to make words..."  Its' a good idea to do this mainly through praise , repetition and expanding on what he just said.  For example, when he says "ball,"  repeat and reinforce the word enthusiastically that he has said and then add to it.  "Yes BALL!  That's a BALL.   A BIG ball." or "yes, ball!   Let's roll the ball! (and roll the ball to him)  Repeat and expand using the target word again.  Children that age learn by repetition of words and short phrases that are within their grasp.    When they generate new speech/language, praise and repeat what they just said.  Then expand it.   Also, when reading or looking at pictures, use this as an opportunity to stimulate language.  Rather than read the words, talk to the child about the pictures, using words or short phrases to describe the picture.  If he tries to generate any kind of speech, reinforce enthusiastically!!  Sometimes anxious parents ask questions a lot when looking at books with a young child.  "What's this?"  "What's that?"  This is not a good way to stimulate language. At his age you can encourage speaking by repetition and praise. 

When teaching new vocabulary to a new talker, say one word or two words at a time.  Name things and see if he repeats the name.  Praise, repeat again, and maybe expand to two words or a short phrase.   As his language expands, expand your responses.   I am not suggesting you always speak with him one or two words at a time!  I am just saying that when you are in teaching mode, that is the best way to stimulate language. 

If your child continues to show what you feel are signs of a delay in his speech, consider a professional assessment, including a hearing exam.  If he has had numerous ear infections, this can slow down speech development.  It's important to know if he has a mild temporary hearing loss.   Meanwhile use good language stimulation techniques at his level and make talking fun.  Most kids are just fine and learn to talk.   

I understand not wanting to label your child but would you be against sending him to speech therapy? I went in kindergarten for my ST sounds and never felt pathologized. I think at 2 any labels that might be assigned to him will affect you more than him but not getting an early intervention could affect him deeply. My sister put off having my nephew tested and didn't pursue speech therapy for a while and he is now 4 and is not very verbal and has a LOT of behavioral issues that stem from it (he is not ASD either) but speech therapy has been helping him since he has started.

-In the better safe than sorry camp

Hi,

Our daughter also didn't say enough words at two nor did she string any words together to make sentences, but was meeting most of her other milestones. We got her some speech therapy through the regional center. It is free until age 3 when the local school district has to start providing services. Altogether she did about 1-1/2 years of therapy. It seemed to do the trick. She is now almost 10 with no problems. I would look into it. Better not to wait in case there is a problem. I don't think my daughter remembers much about it.

Hi,

My daughter started speaking early (9 months) and what I did was to read to her all the time. If you are already doing this, great. But if not, sitting and reading to your child, and pointing out and labeling the items in the pictures is more effective than letting the child listen to an audio program by himself. That being said, you can always make audio recordings of the books you read together and let him listen to those while falling asleep, in addition to reading them together.

My son was slightly delayed in speech when he was 2, and I also never got him checked out because my pediatrician wasn't worried. My mommy gut told me something was wrong, but I was afraid to make a mountain out of a molehill. Fast forward my son turned 5 and was about to enter Kindergarten and his speech was still behind that of his peers. I finally took him to private speech therapy and he improved SO FAST, even with a few sessions. I couldn't help but think if I had put him in speech therapy when he was 2, he would be totally caught up by now. All this to say, don't wait for your son to be so delayed that insurance will kick in for his services. Ask your pediatrician for some sort of evaluation--many will just mail you a questionnaire for screening, but get him tested. If you have the funds, go to a private speech therapist and get him tested there. I will tell you that it is a LOT more work to get these services for free, and you will get it faster if you are willing to pay. But trust your mommy gut. Don't worry about labels or "pathologizing" him (I'm not even sure what you mean by that). Different kids just need support in different areas, and you are helping your son to get the help that he needs. Good luck!

Engage him in communication in a natural way without pressuring him to verbalize what he wants to tell you.  Talk to him - describing what you/he are doing, what you/he see, what you observe.  Use short, simple sentences, and when he says something to you, repeat it and expand.  "Ball" - "oh here's your ball - it's got red stripes, doesn't it?"  If he is talking more at daycare, you may want to spend some time there to see what is happening there that promotes more initiative in communicating.  Whatever you do, be fun and light about it.  You may also want to start using signs because your main goal at this point is communication - pediatricians counting the number of words a child knows is only a way to estimate that.  There are plenty of books out there about using signs with little ones.  There is also parent info on www.hanen.org.  I disagree with holding off on requesting an evaluation - it may take another 6 months for it to actually happen anyway.  Nobody will pathologize your child, it's called "early intervention" - call the Regional Center of the East Bay and request it.  

At two, my son had only one word. He clearly was not on the spectrum and we were easily able to understand all his communications even though he couldn't talk.  But we were concerned. I am not sure that encouraging your son to find his words will work if he "clearly can't." We brought our son to a speech language pathologist for evaluation and therapy. It was not remotely stigmatizing or pathologizing. My son thought it was tremendous fun - all the exercises were taught as games & I was with him the entire time. I think earlier rather than later helped him learn more quickly once the therapy started. Good luck to you and your son!

I understand your concerns,  but as someone who has addressed the same issue, I highly encourage you to go to a speech pathologist now rather than wait any longer. The sooner your son gets support, the easier it will be for him to progress and to do so more quickly. The speech pathologists who work with children work in a very fun and playful way. They can also provide you with recommendations on games and tools that can help at home.

My son didn't have many recognizable words in preschool.  We had him evaluated for speech delay and our insurance paid for therapy.  When he entered elementary school in Berkeley Unified, he did not qualify for speech services because he tested too high. I met with the Speech Therapist at the elementary school and explained my son's history and she agreed to add him to her list of students who receive therapy. When school began, my son had difficulty reading. The school was required to give him assistance which was ineffective to say the least. After years of watching my son struggle to read, we demanded he be evaluated for a learning difference. The result was no surprise (to me) - my son has dyslexia. I am told that his speech delay and the dyslexia were linked. I wish someone had told me about this link - it would have saved my son from so much. My son is now in 8th grade, he speaks clearly and widely. His speech delay had no detrimental effect, it is the way that Berkeley Public handles his dyslexia that continues to cause him to suffer.