Speech Delays in Toddlers: When to Seek Help

Speech issues in children

Hello Doctor: The child is currently one year and nine months old (with a four-year-old sister).
During the day, the grandparents take care of him, and the parents only care for him after work in the evening.
He started walking at one year old and is now quite active; he climbs high using objects for support and runs around.
He enjoys playing with his sister and often makes some unusual sounds.
When asked where his hands, feet, hair, and nose are, he points to them.
He understands commands to fetch items and does so correctly, knowing where to put them.
When he doesn't want something, he actively shakes his head and says "no" (in Taiwanese) and avoids it.
However, he currently only says a few words like "dad," "mom," "grandpa," "grandma," "sister," and "thank you," and these are mostly in reduplicated forms.
He only speaks these words when prompted by an adult, such as when he wants to be held or given food.
At other times, he does not verbally express himself.
He uses gestures to indicate desired items and makes sounds or pulls adults to get what he wants, but he is reluctant to verbally communicate his needs.
Adults have tried teaching him to point out who "dad" or "mom" is, as well as new vocabulary, but he mostly ignores these efforts.
However, he seems to mimic his sister's actions or sounds more than he responds to adults.
Is there a problem with this behavior? How should we address or improve this situation? Thank you.

Mr. Zhang, 0~9 year old female. Ask Date: 2017/12/04

Dr. Lin Yishou reply Pediatrics

Hello, parents.
Based on your description, your child is developing well.
If you still have concerns, you can ask the physician to evaluate your child during the routine vaccination visit.

Reply Date: 2017/12/04

More Info

Understanding speech delays in toddlers can be a complex issue, and it's essential to approach it with care and attention. Based on your description, your child is showing some typical developmental milestones, such as walking, climbing, and understanding commands. However, the limited verbal communication and reliance on gestures instead of words may indicate a speech delay that warrants further evaluation.

At 21 months, children typically begin to use more words and may start to combine them into simple phrases. While some variation exists in language development, the fact that your child is only using a few words and primarily relies on gestures could be a sign of a speech or language delay. Here are some points to consider:
1. Understanding Communication: Your child seems to understand verbal commands and can follow simple instructions, which is a positive sign. This indicates that their receptive language skills are developing well. However, expressive language skills, which involve speaking and using words to communicate, appear to be lagging.

2. Social Interaction: The fact that your child enjoys playing with their older sibling and imitates her actions and sounds is encouraging. Social interaction is crucial for language development, and engaging with peers and family members can help stimulate speech.

3. Encouraging Speech: It’s important to create an environment that encourages verbal communication. Here are some strategies you might consider:
- Modeling Language: Regularly talk to your child using simple, clear language. Describe what you are doing, name objects, and ask questions to encourage responses.

- Interactive Play: Engage in play that promotes language use, such as playing with dolls or action figures, where you can narrate the actions and encourage your child to join in.

- Reading Together: Reading books aloud can introduce new vocabulary and concepts. Choose interactive books that encourage participation, such as those with flaps or textures.

- Limit Screen Time: While some educational programs can be beneficial, excessive screen time may limit opportunities for real-life interactions that promote language development.

4. When to Seek Help: If your child does not show significant improvement in their speech and language skills over the next few months, or if you have concerns about their overall development, it may be beneficial to seek an evaluation from a pediatrician or a speech-language pathologist. Early intervention can be crucial in addressing speech delays and can provide your child with the support they need to develop their communication skills effectively.

5. Professional Evaluation: A speech-language pathologist can assess your child's speech and language abilities and determine if there is a delay that requires intervention. They can also provide tailored strategies and activities to support your child's language development.

In conclusion, while your child is demonstrating some positive developmental behaviors, the limited verbal communication is a concern that should be monitored. Encouraging language through interaction, play, and reading can be beneficial. If you continue to have concerns, seeking professional guidance is a proactive step that can lead to effective support for your child's speech and language development. Early intervention can make a significant difference in helping children reach their full communication potential.

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