RE: What are warning signs of speech delay in 15 month old?

[Guest guest]

In our case it was a " count your kid in screening " that warned us of a speech

delay. was always very quiet, but full of smiles. When I took him in at

15 months for that screening I was shocked that he failed everything. The state

early intervention agency evaluated him and started weekly home based speech

therapy sessions. In our case, it didn't help much. He received speech from

them until he turned 3 and then was phased into the public school system. He

still doesn't speak much and his speech isn't very clear either.

If you have concerns, check with your local schools and preschools about early

screenings and have it done.

Best,

[Guest guest]

I had identical twins that had severe problems with asthma and

respiratory illnesses. I don't remember whether or not they cooed

and did other things verbally. Verbally, I knew there was a problem

at 18 months. They just didn't say much then: mom, dad, bapa

(backpack).

However, there were lots of clues that was having oral

troubles. She didn't kiss like other kids. Her kiss was an open

mouth on someone's cheek. She also had a very difficult time

learning how to drink from a cup. She had a very difficult time

learning to drink from a straw. I was very concerned about all of

that that I was talking to my pediatrician about it. (Of course, he

blew me off.)

Suzi

[Guest guest]

Well is now entering into EI with less than 5 words. I was

told by the SLP she should have 50 words at 18 months.

You also have to look at if your little one understands. Can they

follow simple comands? Can they identify family members?

For Apraxia they also look at motor skills. How they eat, can they

drink from straws, sippy cups? Can they do patty-cake patty-cake &

itsy bitsy spider?

http://www.comeunity.com/disability/speech/milestones.html

http:www.scholastic.com/earlylearner/age2/language/todd_milestones.htm

http://info.chsd.org/1501.cfm

http://www.muschealth.com/pediatrics/speech.htm

http://www.nidcd.nih.gov/health/voice/speechandlanguage.asp#mychild

If you are concerned talk to your ped & EI to get an eval. With a

close relative with a speech delay they normally will want to move on

these things quicker than without.

Take Care,

Heidi-SAHM to 8, 5 (apraxia, DSI) 20 months (VUR,

Torticollis/Plagiocephaly-DOCBand Grad/Late Talker-No Dx yet)

[Guest guest]

Maybe it's different for girls than boys, but my understanding, and

my pediatrician backed me up on this when I was spouting out the

stats, is that at 18 months they should have 5-10 words or

approximations, and by 2 yrs they should have about 50 words. My son

didn't even say his first word, " ma " until he was 19 months old, and

by 2 he had 3 words...having just gotten the 3rd word the month

before his birthday.

I agree with everything else here that Heidi said. Even if there

isn't a relative with a speech delay, by 18 months if they have less

than 5 words, the pediatrician should be recommending that your child

be evaluated for developmental delays, including speech, and from

there you can see a specialist. I know with us, our pediatrician

said that if my son Drew hadn't said anything by 18 months, he was

automatically referring him for evaluation, and we jumped on the

bandwagon immediately, and have been on the road with his speech

delay ever since. Drew seemed to be developing normally for the most

part up until that point-- with the exception of the speech. He was

using a straw, eating fine, etc. He was originally evaluated by EI,

and has been with that program to date. When it seemed like he

wasn't making much speech progress, despite the best efforts of his

sped teacher who was assigned to us to get Drew started, we took him

to a great developmental pediatrician who then diagnosed him with the

apraxia about 9 months after his EI qualification for services for

speech delay. With that diagnosis, we were then better able to

concentrate on how to approach things with Drew, and after reading

G.'s book, it turns out that Drew's sped teacher was right on

target with a multisensory approach, and in the last 3 months he's

made tremendous progress.

So don't wait...just start making the appointments and getting the

evaluations and getting services started...I think you can fine tune

things, as we did, once you fine tune the diagnosis, but at least

start with EI and go from there. (That's my personal recommendation.)

Good luck!

le - mom to Drew, 2.6, apraxia and SI

> Well is now entering into EI with less than 5 words. I was

> told by the SLP she should have 50 words at 18 months.

> You also have to look at if your little one understands. Can they

> follow simple comands? Can they identify family members?

> For Apraxia they also look at motor skills. How they eat, can they

> drink from straws, sippy cups? Can they do patty-cake patty-cake &

> itsy bitsy spider?

[Guest guest]

Hi Shilo. My daughter is 7 months old and already is exhibiting oral

motor issues which will affect speech. She is not mouthing anything and

hates the area around her mouth being rubbed or touched. The OT noticed

this and now we are doing lots of work on her face and in her mouth. My

son who is now 5 also had oral motor issues and had trouble eating when

he was young due to the same issues my daughter is now experiencing. I

suggest having an OT assessment. Good luck!

Co-founder CHERAB of OHIO

kmartin@...

For more information visit our web site

www.cherabofohio.org

or e-mail info@...

[ ] What are warning signs of speech delay in

15 month old?

I've heard some of you say your children have been in speech therapy as

early as 15 Months, and I was wondering what are some of the signs of

speech delay that early.

My son Preston is about 14 months now, and my older son 4 years

old has (CAS), and he seemed to develope pretty normal to me up until

about 18 months, or maybe he didn't maybe I just missed the first signs.

Thanks everyone,

Shilo

[Guest guest]

I noticed my son was not even trying to talk at 15 mos. He babbled

for a while, but it wasn't progressing to common English sounds.

--Sange

[Guest guest]

Hi Shilo!

There are a number of warning signs of a disorder vs. a delay of

speech. We have so many covered in The Late Talker book that I

couldn't sum them all up here -so here is just a quick one page

handout from the CHERAB website below. Thing is -they are all just

warnings -and if you notice warning signs then acting early is a

good thing. Contacting EI for an evaluation won't hurt if not

needed -and could help big time if needed. Since you have another

child with apraxia however -you do want to consider taking the late

talking serious as a precaution just in case.

The good news is that since you have an older child with apraxia you

do know many of the warning signs for down the road even though you

may not have been aware of the early signs of apraxia. (please

don't call it childhood apraxia of speech which is what CAS stands

for -it's a cool name for a 3 or 5 year old child -but you are

pushing it using the name even with a 7 year old like my son Tanner

http://www.cherab.org/information/familiesrelate/letter.html -and

forget it by the time they are 9...and insult for anyone in the

tweenie years -10-12, and not at all appropriate for those in their

teens...so just call it what it is -apraxia -or you end up with kids

that grew up like http://www.cherab.org/news/.html and

Khalid http://www.cherab.org/information/familiesrelate/success.html

and http://www.cherab.org/news/.html and they are

stuck saying that they as teens and adults have " developmental "

or " childhood " apraxia of speech. If your child has apraxia you

know right now there is not cure -so it's a lame and mean thing to

call it something that makes it sound like our kids are mentally

retarded to childhood age in some way. OK I'm off on a tangent -

smak to me!)

Is Your Child A Late Talker?

· Are they quiet? · Seem shy? · Not talking like their peers?

· Allow you or siblings to speak for them? · Do you wonder why?

Your baby's babbling and toddlers first words can be music to your

ears. When faced with a child who doesn't speak or seems to have

difficulty with words parents are often told that their child

is " just a late-talker. " Unfortunately, all too often, that is not

the case. The American Speech and Hearing Association (ASHA)

estimates that 16 million Americans under the age of eighteen have a

chronic speech-language disorder and that some 45 million Americans

are affected by communication disorders of one kind or another which

was announded by Congresswoman Carolyn McCarthy during the kick-off

of the Better Hearing and Speech Month Health Fair in Washington, DC

on May 8, 2002 .

Most parents, and even most pediatricians, are not concerned when

faced with a two-year-old who passes all of his developmental

milestones on time - except speech and language. However, they

should be. It is vitally important to identify and treat speech and

language challenges as early as possible in a child's life, with a

strong emphasis on the early intervention years of birth to three.

At this age the brain is undergoing the most rapid development. No

harm will come from therapeutic services. " Early intervention

services are benign in their delivery but can be extremely

beneficial. Don't wait. Six months for a 2 year old is equivalent to

a quarter of their lifetime developmentally " as Dr. Judy Flax says,

who is a Research Coordinator of the Tallal Lab and a Senior

Research Speech Pathologist for the Infancy Studies Laboratory at

the Center for Molecular and Behavioral Neuroscience (CMBN) of

Rutgers University, Newark, NJ

To find out about your nearest Early Intervention program you should

call your local school district, they will be able to refer you to

the program appropriate for your child's age. Waiting to refer is a

loss of precious time that may impact on the child's learning

ability and social-emotional well being in later years.

Pediatricians and parents should insist on a speech and hearing

evaluation as soon as there is a real concern about a child's early

language development. Early referral is endorsed by the American

Academy of Pediatrics, and the American Academy of Neurology. In

addition, " any child with a severe speech/language delay should have

a comprehensive health and neurologic assessment to look for medical

conditions that may be causing or contributing to the delay " as

Dr.Marilyn Agin says, a developmental pediatrician who is the

Medical Director for Early Intervention for NYC.

CHERAB is a non-profit foundation that focuses on raising awareness

of Apraxia and other speech and language delays, and the importance

of early intervention. Working with developmental pediatricians,

speech pathologists, neuroscientists and major hospitals the CHERAB

Foundation is working towards research on therapies which may help

late talkers with Apraxia, Dysarthria, delayed language development,

Autism and other speech and language impairments. A list-serv

overseen by pediatricians, speech-language pathologists, and

educational consultants is run by CHERAB and can be found at their

web-site. Through the list you can connect to many other parents who

have children who have speech or language delays, and find out what

they have been able to do to help their child.

Some speech disorders can overlap, or be misdiagnosed. For

example, " Verbal apraxia, a disorder of central nervous system (CNS)

processing, and dysarthria, a disorder of output, are commonly

confused " , says Dr. , chief of child development at the

Chicago College of Medicine. " Experts are able to differentiate

between these two disorders by listening carefully to a child's

speech and by identifying certain physical clues " , says Dr. ,

but adds, " These disorders are poorly understood by physicians and

by a lot of speech therapists as well. " It is possible for

phonological disorders, apraxia and dysarthria to all occur together

in the same child. Speech Language Impairments, which is connected

to language based learning difficulties may also be present. And the

severity of each may vary.

Apraxia is perhaps the most misunderstood of all the speech

disorders. So, what is apraxia? Verbal Apraxia is a neurological

motor speech impairment that involves a breakdown in the

transmission of messages from the brain to the muscles in the jaw,

cheeks, lips, tongue and palate that facilitate speech. There is no

obvious weakness in these muscles and the child may well be able to

move them quite happily when not trying to speak. Apraxic children,

who are usually seen as " just late talkers " when young, are able to

comprehend language at an age appropriate level, however have

difficulty expressing themselves using speech. With apraxia, a child

knows what he wants to say but there is a road block obstructing the

signal from the brain to the mouth. For any child with a speech

disorder, but especially with apraxia, the earlier therapy is begun,

the better the results for your child and their social-emotional

development.

Your Child's Language Development

So how do you know when your child is having problems with speaking?

When is a good time to seek out help? Being aware of average speech

milestones can also help you decide whether or not to speak to your

doctor. Some guidelines are provided here for your information, but

if you have concerns about your child's speech or language

development, or any other developmental issue, make an appointment

with your pediatrician so you can discuss these issues. While the

average milestones are a good way to measure development, every

child develops at their own pace, and this overview should not be

used to diagnose a specific problem.

Normal Language Milestones - Clues of a Possible Problem

Typically seen in first 6 months

· Responds to name by looking for voice · Can regularly find speaker

or source of sound · Cooing, gurgling, chuckling, laughing ·Imitates

sounds and actions · Enjoys social games (peek-a-boo, pat-a-cake) ·

Babbling (bababa, mamama)

Cause for concern in first 6 months

· Cannot focus, easily over-stimulated · Seems unaware of sound,

Cannot find source of sound · Seems unaware of people and objects in

environment · Does not seem to understand or enjoy imitating · Lack

of connection (eye contact, vocal turn-taking)

· No babbling, or babbling with few consonants

Typically seen in first 9-12 months

· Attracts attention by vocalizing · Waves bye · Vocalizations that

sound like first words (mama,dada) · Clearly indicates desire for

objects · Imitates new sounds and actions

Cause for concern in first 9-12 months

· Easily upset by sounds that would not upset others · Lack of

response indicating comprehension of words · Lack of consistent

patterns of babbling · Does not clearly indicate desire for objects

Typically seen in first 12-18 months

· Single word production begins · Requests objects: points,

vocalizes, word approximations · Gets attention vocally or

physically (mommy) · Knows adult can do things for them (wind up a

toy) · Uses " ritual " words (bye, hi, please, thank-you)

Protests: Says no, shakes head, moves away etc) · Comments: Points

and vocalizes or uses word approximations) · Acknowledges: Eye

contact, vocal response, repetition of word

Cause for concern in first 12-18 months

· Lack of communicative gestures · Does not attempt to imitate or

produce single words

· Does not persist in communication (may hold hand up for help, but

gives up if adult does not respond immediately) · Limited

comprehension (understands less than 50 words) · Limited vocabulary

(speaks less than 10 words) · Lack of new words between the age of

12-18 months

Typically seen in first 18-24 months

· Uses mostly words to communicate · Begins to use two word

combinations (more cookie etc) · By 24 months has more than 50

words, or word approximations

Cause for concern in first 18-24 months

· Relies on gestures to communicate · Limited vocabulary (speaks

less than 50 words)

· Does not use any two word combinations · Limited consonant

production · Mostly unintelligible speech · Regresses in language

development: Stops talking, repeats phrases inappropriately

Typically seen in first 24-36 months

· Engages in short dialogues · Expresses emotions · Begins using

language in imaginative ways · Begins providing descriptive details

when speaking · Begins to use articles and word endings (a, the,

ing,) uses plurals (cats)

Cause for concern in first 24-36 months

· Words limited to single syllable and no final consonants · Few or

no multiword utterances · Does not demand a response from a listener

· Asks no questions · Speech difficult to understand · Tantrums when

frustrated · Echoing of speech without communicative intent

Adapted from Clinical Practice Guidelines Communication Disorders

III 22-25

In addition, the policy statement from the neurology journal

Neurology, (August, 2000), states that Absolute Indications for

Immediate Evaluation include,

· No babbling or pointing or other gestures by twelve months · No

single words by sixteen months · No two-word spontaneous phrases by

twenty-four months · Any loss of any language or social skills at

any age.

Oral-Motor Problems

Early feeding problems could be a sign of later speech challenges.

The same muscles that are used for eating are used for speaking. A

baby that has trouble nursing could be a early sign that the baby

has muscle weakness in the oral motor area for example. If oral-

motor difficulties are present your child should have an evaluation

by a pediatric medical and oral motor speech expert to determine the

cause and best therapy to possibly prevent some future speech

problems. A few possible signs of oral-motor problems are outlined

next.

Does your child have difficulties with any of the following?

· Blowing (unable to blow out birthday candles, or blow bubbles by

one year) · Kissing or making a kiss face · Licking his lips ·

Imitating facial expressions such as smiling · Chewing or

transitioning to solid foods · Excessive drooling

When trying to speak does your child?

· Display groping behaviors, searching for proper mouth position,

silent posturing, dysfluencies · Show expressive language

disturbances: limited vocabulary, grammatical

errors, disordered syntax · Make up sign language, or show

frustrations when not understood?

It is important to note that some children have no difficulty with

oral-motor movements, and may also pronounce speech clearly, but

still may have difficulty learning language. There are many

different types of speech and language problems, which together

represent the number one learning disabiltiy in schools today. That

is why again it is important to seek an assessment if a child is not

attaining the language milestones at the expected age. Early

intervention is key to your child's development. If you have any

concerns about your child's speech or language development be sure

to express them to your child's doctor. If you want to find out more

about early speech and language development and CHERAB's efforts to

help children with speech and language delays you can contact the

group or visit the web-site at:

CHERAB Foundation, Inc., Communication Help, Education, Research,

Apraxia Base

Web: http://www.cherab.org

Grouplist:

PO Box 8524

PSL, Florida 34952

772-335-5135

Speechville

Web: http://www.speechville.com

To find a Speech Language Pathologist near you:

American Speech-Language-Hearing Association (ASHA)

10801 Rockville Pike

Rockville, MD 20852

Phone: 1-900-638-8255

301-897-8682 (Voice or TTY)

Web: www.asha.org

Acknowledgements:

Marilyn Agin MD

Medical Director NYC Early Intervention, Advisor CHERAB Foundation