Q&A: 5 Year Old with Childhood Apraxia of Speech
November 4, 2013Q&A: 3 Month Old Not Cooing – Should Hearing be Tested?
November 4, 2013My son is 33 months and I have noticed he isn’t speaking as much as children his age and younger. He still babbles a lot. He says around 60 words and 7 2-3 word phrases. Most words he will only say once, maybe twice and then doesn’t say them again and you can’t get him to repeat words that you are saying. He will only answer questions if his answer is no. If you ask him to identify something such as a body part he doesn’t want to do it. He is very active and doesn’t want to stop long enough for you to explain anything to him, like “I want you to …”.
In the past week he has began to sit down and let you read to him but mostly he just wants to play with the book. When he wants something he will just stand there and babble talk until you get up to see what he wants. I’m taking him to the pediatrician tomorrow but would also like to know your thoughts and let me know things I should talk to the pediatrician about.
Thanks for your question. From what you have told me I would recommend that you ask your pediatrician for referral information to the early intervention provider in your area so that your son can receive a speech therapy evaluation by a licensed speech pathologist. It sounds like your son has a lot of single words in his vocabulary which is a good start, but you aren’t hearing them consistently and he is not attempting to repeat new words for you. I am glad he has a few 2-3 word phrases already, but by 33 months he should be using primarily two and three word phrases (for example “me want milk”, “daddy go work”, etc) more so than single words and his babbling/jargon should be minimal.
By age 2 1/2 we generally like to see a vocabulary of at least 50 words, and that list should increase weekly, so that by age three a child has 100 or more words. Saying “no” to most questions is fairly typical for children at your son’s age, even if he really means yes. He should also have begun to ask you some “wh” questions such as “where go?”, “what that?” etc. It sounds like your son is extremely active and since speech is also a motor task involving complex movements of the tongue, lips and jaw, sometimes children who are putting all their energy into gross motor activities (running, jumping, climbing) are quieter during play or talk less or later because all their motor energy is going to one place-physical activity.
You can start offering him choices during meals and playtime to encourage him to use words instead of just babbling or pointing to get wants and needs met. For example, at dinner ask “Do you want juice or milk to drink?” If he is not yet saying either juice or milk, you can accept him pointing to one or the other and then put it back into a sentence for him “You want milk to drink for dinner tonight”. Whenever your son says a single word, always expand on that word for him so he can hear it in a simple sentence. For example if he says “ball”, you say “You threw your red ball”. Being a good speech role model is always helpful.
If there are words your son cannot yet say, and you see him pointing or gesturing for things, you may want to think about building in a few simple sign language signs into his vocabulary, especially if he gets frustrated by not being able to tell you what he wants. Using signs paired with a word helps young children learn new vocabulary words before they can physically say them. Once children have mastered the spoken word the sign typically fades away. A speech therapist can teach you a few simple signs if this would be helpful to your son. If he is not yet pointing to body parts or following through with simple directions such as “Bring me your shoes” or “get the book and put it on the table” then your son may also be having some difficulty with receptive language-either understanding it or processing what is said to him. We do not start to look at articulation (clarity of speech) until a child turns 3, but by age 3 we like to see children be understandable by adults and other children at least 80% of the time.
Since your son is already nearing preschool age, I would definitely try to get an early intervention speech evaluation or a private speech evaluation set up for your son as soon as possible to assess his expressive and receptive language skills and determine if he is eligible for therapy.