Expressive Language Delay - 18 Month Old

Updated on June 07, 2010
J.C. asks from Naperville, IL
19 answers

Hello,

I would like to get some feedback from anyone who has/had an experience with expressive language speech therapy. My 18 month old son was evaluated and starts speech therapy for one hour a week next Thursday for expressive language only. He understands literally everything but does not say any words consistently other than "Daddy". I am really hoping this will help him but I am not sure what they are going to tell me to do with him that I am not already doing.

Thanks for your feedback!

J.

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So What Happened?

Thanks Moms so much for your advice! I am really looking forward to the sessions and learning what we need to do to help him. I am very hopeful!

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E.C.

answers from Chicago on

It's great you're being proactive with him at such a young age - the in-home therapy is wonderful and yes, they will give you things to do with him between sessions.

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A.C.

answers from Cincinnati on

My brother didn't say anything until he was over 2, and then his first words were, "This is delicious!" ^_^

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M.P.

answers from Portland on

My grandson is 7 and been in speech therapy since he was 2 1/2 because he wasn't learning to talk. Even now his speech is difficult to understand much of the time. They started with pictures pasted to notebook size cards so that he could point to what he wanted. We said the word for him after he pointed to the card before getting what he wanted.

They encouraged us to encourage him to try to say the word but to not push. When he did say the word we were to then say the word correctly. If he wanted to try again, ok, but the idea was to be relaxed.

As the teacher worked on certain sounds she would tell my daughter what the sounds were and show her how to reinforce what she was teaching.

There is a hierarchy of sounds and a planned approach that we were unaware of before he started in therapy.

For my son, he was and still is unable to say certain sounds because messages do not get sent between his brain and his muscles. A part of therapy, as I understand it, is to build nerve pathways. A part of being in speech therapy is to try to discover why he isn't talking. The causes are complex and, as yet, do not have easy cures.

A speech therapist has a lot of specialized training as well as an understanding of anatomy and how speech develops. They are also not mommy or daddy and can get your son to do tings that you may not be able to do. Having a therapist takes some stress off you because he has a deeper understanding of what may be going on and also shares the teaching.

I'm very glad that you're getting started at this young age. He has a better chance of learning to speak in a clear manner than my grandson does. My daughter delayed having her son evaluated because people, including his pediatrician, said some children just learn later. But he wasn't learning later. And he was becoming very frustrated and had begun acting out in anger. Kudos to you for recognizing the need and acting on it in a timely manner.

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B.P.

answers from New York on

You are so good that you are starting speech therapy so early! Boys are often slower to develop than girls and since this is his only issue, you should be very hopeful. They will teach you techniques like letting him fill in the blanks when you talk, using songs, pretending you don't understand what he wants, giving him choices, and encouraging him to look at your face and mouth when you talk. They will only be there once a week so its up to you to do most of the "work". They will also teach you to only say 2- word sentences and always ask your son questions to encourage his speaking. My son has been doing speech therapy for 1 1/2 months now and there is a huge difference in his abilities.

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D.B.

answers from Charlotte on

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S.H.

answers from Honolulu on

My son, had Speech Therapy from 19 months old, until about 2.5-3 years old.
He LOVED it. His was expressive delay as well. BUT, nothing was 'wrong' with him clinically or developmentally. His overall assessment, even determined that he was advanced in several areas for his age.
But, his talking was late... and he was not saying as much as kids his age. He is also bi-lingual, and understood EVERYTHING articulately.

It was very helpful... and fun for my son. I learned a lot too, about development. The Therapist was great.

Also keep in mind, that boys are generally later in talking. Our speech therapist said, that about 80% of her clients, were boys.

Don't expect changes to happen over night. It takes time and as the child gains confidence about talking. My son, was initially 'shy' about talking and self-conscious... but he had fun. He KNEW the therapist was there to help him 'talk.' He liked it.

Sure, it may seem common sense to you to get a kid to talk. But for me... and I have a degree in behavioral sciences... I learned a LOT. The Therapist gave common sense and developmental knowledge to me... as a Parent, to help my son. She also taught me about the way a child learns to talk... ie: at each age a child attains certain sounds... and his mouth/tongue/throat/lips coordination ALSO develops more at certain ages... and thus, the words/sounds that they can say or not. These things, a lay-person does NOT know. It is not common sense. So when my son was having trouble pronouncing a certain sound/word... I knew it was because it was a sound that older children master, not him at 19 months old. So your 'expectations' about the kid talking, has to be in line with development. For example.
I also learned how to encourage him, not make him feel forced about it. And not just making him repeat words/sounds over and over and over again... if he had trouble with a word.
Speech Pathology... is not common sense. These therapists are highly trained... things that we do not know.

My son's services were free... through our local Early Intervention program.... so I took advantage of that and because I believe in early intervention.

all the best,
Susan

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A.S.

answers from Dallas on

That's great you're are starting therapy this young. Lots of communication, reading books, word games and tasks the therapist give you can help, such as games like I spy, asking him choices like for colors and objects, fill in the blanks...

Neither of my boys spoke until after they were two years old. They knew a few words, but rarely spoke them, not even the word "mommy".

But once they hit about 2 1/2, they started talking in sentences out of nowhere. Just keep in mind some kids bloom late, but they are learning all the while and turn out fine.

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K.M.

answers from Chicago on

Hi J. - my son (who is now 5) also had the same problem; however, we didn't catch it until he was almost 3. My pediatrician kept telling me to wait and I/he wouldn't qualify for services. When I talked to a speech therapist for my older son, she suggested I get him evaluated. We had a speech therapist through Early Intervention come in once a week until he was 3 years old (at which time they transitioned him into our school district's early childhood education program). Within 3 weeks, he was saying a lot more words. She gave us homework to work on between sessions--just fun things to do while we were playing, having dinner, etc.--nothing hard or that was "additional" time. He transitioned smoothly to the ECC walk in speech therapy (2x a week at first and quickly went down to 1x week). He just "graduated" from walk in speech therapy and will be picking up speech therapy the first few months of Kindergarten. He now talks up a storm and doesn't stop at times-just keeps going and going like an energizer bunny.

Any kind of help is worth it and starting early is a good thing. It doesn't hurt and should not carry any stigmas with it. (My 20 year old nephew also went through speech therapy and is now studying to be an actuary accountant--top of his class!!).

Good luck!!!

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M.K.

answers from Chicago on

Hi J.. I have not read all the responses, but I'll bet you've gotten some great advice. I don't know if this is possible (if he is getting services at home or at day care), but I strongly recommend you "hang out" during his therapy sessions to observe and learn. Ask questions at the end of his session and ask for ideas on how to keep helping your son on a day-to-day basis. I think you'll find it really interesting how your Speech Therapist will, basically, play with your son...however, she will be sneaking in "instruction" at the same time! Once you learn some of these techniques (based upon your son's individual needs), you can do it yourself at home. You will be amazed how much she will help your young toddler!

If you have any specific questions, feel free to send me a message. My son started ST at 17 months old. My very best wishes!

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M.D.

answers from Chicago on

Hi J.
My son had an expressive speech delay and started receiving early intervention at home 1 day a week when he was just shy of 2.They incorporated play into his therapy and he seemed to enjoy it.He is in preschool now...and talking up a storm. Because he was in early intervention they transitioned him into the school district and he is receiveing speech 1 day a week through the school. I took a lot of heat from my family cause everyone thought he was fine...and he's a boy. As a mom you know your child best. I'm a nurse so I talked over his lack of speech with some speech therapists and pediatricians too.I'm so glad I had him evaluated. You're doing the right thing,best of luck to you!

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L.D.

answers from Las Vegas on

There is a whole science and system for speech development. If your son is delayed with his pre-verbal communication skills such as pointing or joint attention skills, then they will work on that at the very beginning because that it is very important step in your son's communication process.

If your son has oral motor planning issues or apraxia, then they will give him specific exercizes to do to help with either of those two issues and you will be given homework to work on with him through the week. It's a whole systematic approach and there are certain sounds that come in first before others so your ST will really help guide the process so that therapy that your son is receiving is not scattered or overwhelming (and maybe unreasonable) for him.

What I have learned is that sometimes you need an outsider who has that special training to work with our kids when needed. Children often will do more and be more responsive when they are working with someone other than mommy. You're not going to be completely off the hook with helping your child with his homework but it is so much better when you can have the ST being the leader in the speech development department and you can be the leader in the mommy department, as you should be.

I have also found that ST's are a great resource for ideas on how to really facilitate communication through play. Take advantage of this by asking a lot of questions and watch what she does with your child. Your son will be so much better off in the long run if your really open yourself up to this opportunity and provide your son with the specialized support that he needs at this time.

I hope I answered some, if not all, of your questions. Blessings to you and your son.

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M.R.

answers from Columbus on

The speech therapist should give you homework that will be different than the things you are allready doing. It will be targeted in both technique and in area to enhance what they are working on. If you are getting public services, also get a private evaluation and therapy too, and viceversa. You can't get too much.

M.

L.C.

answers from Kansas City on

i actually just talked with my sons pediatrician about this. my son is 20 months old and does not talk as much as i would like. he CAN say a good 25 words or so, but he choses to only say about 10 consistently. His pediatrician asked me if he understands things. YES, he understands everything! he follows directions and he communicates great in terms of just answering yes or no questions. Generally he brings you things and says, "here" or "talk" and waits for you to say the word to the item. if you are guessing wrong he says, "uh-uh" of your right, then "uh-uh" and he shakes or nods his head along with it. She said that receptive language is the most important in terms of boys since they tend to talk later then girls anyway. She said if he was seeming like he did not understand things or couldnt follow direction then she would be concerned, but as long as the receptive language is good, then we should not be too concerned until he reaches 2. if at 24 months he still has not progressed, then they will jump into speech therapy. In the mean time, just talk to him all i can. Even if it is just walking around narrating what i am doing, and also to read to him often.

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A.S.

answers from Chicago on

My youngest is 27 months and we just started ST about a month ago. He only says about 5 -10 words, not real consistently....he understands everything, knows how to point and grunt , shake his head and say Yes, but other than that it's mostly just grunting and jibberish. We went through early intervention to get services. Our ST mostly just plays with him...encouraging him/repeating the same few words trying to encourage him. We are working on some sign language in the sessions and at home although he is very resistant to it cause he knows that I know what he wants without him doing the sign. He has oral motor issues so she also gave me a list of foods to try that will exercise those muscles more. There has been little progress with us so far other than him just being a little more noisy. I know they say it is not a magic wand but I am very anxious to hear what goes on in his head. My other son was talking non stop by this point so this is really odd for me.
I hope it works out well for you.

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J.P.

answers from Chicago on

J., My son went to speech starting at 18 months also. Aside from mama and dada, he really didn't say a WORD until after his 2nd birthday. He is now 3 1/2 and he talks up a storm - SERIOUSLY!! His issue was also expressive language. I did sign language with him as a baby and that helped a lot - though some people (my mom, aunts, etc) thought that would cause a language delay.

I'm not sure if therapy helped him or if he would have grown out of it - but the way I looked at it, it couldn't hurt. The things the therapist did with him are things I could and did do with him on our own - but it was good to have this other person/professional working with him. The other added benefit from speech therapy is he actually learned his letters and their sounds - because as he worked with her they worked on different sounds. His take-home work would be to practice "F" and "V" sounds, for example - and he had an "F" folder filled with little pictures of "f" words... etc. for all the letters he had trouble with (quite a few!!). Best of luck and please don't worry - I am sure your son is going to be fine!

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E.C.

answers from Chicago on

Hi J.-

My son is also 18 months old, and has the exact same issue as your son. Daddy is his favorite word, but other than that, he doesn't have any words. He also understands everything, in English and Spanish.

Sam has been in speech therapy through Early Intervention since 16 months. One of the best things the speech therapist has done for us is teach him sign language. He now has over a dozen signs and it makes a huge difference. He doesn't get frustrated when he wants something because he knows how to ask. Now that his frustration level has dropped, the ST is working on the words.

Anyway, for us, so far, ST has been a great experience. I'd love to hear more about how your son is doing. We can compare notes. Feel free to write me back at any time.

E.

G.R.

answers from Dallas on

my boy is 17 months and the only 3 words he says is mama and papa and water and thats it.i think they will start talking about 2 1/2 yeari tried not to worry about him.

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S.H.

answers from Chicago on

My son (now 10 years old) went to speech therapy at fifteen months for just about 6 months. We won't ever know for sure if speech therapy was the reason he started talking or if he was "just ready" to start talking but I am so glad we had him in speech therapy. It was fun for him (looked like playtime) and painless for me and he began saying words and then really talking in those few months of therapy. It wax totally worth it. Good luck to you and your son. All will work out.

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V.G.

answers from Chicago on

My 2 yo has the same problem and is getting services through Early Intervention. One thing I highly suggest is getting your child's hearing checked through an ENT doctor. Our Early Intervention coordinator suggested a hearing test to us and it turned out my son had fluid in his ears, which caused some hearing impairment. He couldn't fully hear the sound of our words to talk back.

He had tubes put in his ears (a temporary thing that lasts about 6 months). Literally, the next day, he started saying more words because he could hear better. I felt so bad because I had no idea he couldn't hear well or that there was even a possibility of fluid (he had numerous ear infections when he was 1 yo, but nothing in the last year).

The tubes are basically a small ring (like a donut) that they insert into the membrane that acts as a small hole to drain the ear. The surgery took 10 minutes, and the tubes will fall out on their own some day and the ear will close the hole.

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