How Much Speech Should a 20 Month Old Have

Hi R. - I'm a pediatric Speech Language Pathologist. There is definitely variability between children and speech/language development. Just to clarify (pediatrician's make this mistake all the time) - it sounds like your pediatrician is talking about language concerns (the actual words) vs. speech concerns (HOW the words are produced and pronounced) - but maybe both, I'm not sure since you mentioned that people don't understand him. Not to worry - but I think EI is a great option to help give him the boost he needs. Try not to be paranoid - it sounds like he has a decent base of words - and a variety of types (people, objects, adjectives, possessives, action, etc.). Generally we'd like to see children have approximately 50 words by 18 months. Of COURSE there is variability with this - some children blast past this (as your first did??) and some have much less - more like 20 or so, which sounds like your youngest...

However, I would at least get the Early Intervention evaluation. If they are so short staffed that you don't get anywhere with them, you can also seek out a private speech and language evaluation if you are referred by your pediatrician, at a rehabilitation center / clinic SLP. Also, another option is to check into your local public elementary school for an evaluation and possible itinerant services. I've provided it all - and I recommend the clinic setting as the best option if your insurance covers it - but EI is a great first step if they can get you the services/eval in a decent amount of time. I think the biggest complaint I've heard regarding EI is that parents and their children had to wait too long. EI is only provided up until age 3, and then you have to seek out the other two options if necessary. So it's best not to waste too much time - but ....
try not to panic through the holidays - and you can wait a couple weeks for your appointment. A couple or few weeks won't hurt him - honestly! Waiting months or a year could though.

In the meantime, just enjoy him for who he is - and don't worry about there being a problem. Sounds like a typical case from what you describe - and you felt yourself that he doesn't talk enough. BUT you also mention that he understands what you say, and has a great foundation of words.

Try to relax and enjoy the holidays!! Let me know if you have any questions. : )

You sound like you just had my doctor visit. My son is also 20 months and does not talk much either. I was also giving an early intervention # but I have not called. I have been through something similar to this before with my two other sons so I may have been a little more prepared for this than you. I think that boys do definitely learn to talk later than girls. I feel that my son makes his wants known and that is what is the most important thing. He has only a few sounds but changes the tones for what he wants. I feel that as his mom it not just his job to learn how to talk but also my job to learn how to understand him. I hope your son begins to talk soon but I would definitely not panic yet.

I am a mom to 3 boys and 4 girls

B. O

Hi Rachel,
How wonderful to have two sons! I'm hoping that I can encourage you to have a wonderful, family, holiday season, and see Early Intervention in January, as planned.
Children vary in their development, but I think you have indicated very important aspects of his communication. Your son is frustrated with his communication and he chooses to be quiet in public, as he probably doesn't want to risk being misunderstood. So a visit to EI is a great idea, and your timing is perfect, as a 20 month old is a good candidate for speech/language therapy. And about "something being wrong with your baby", please remember he's exactly the same wonderful child you have always loved. It's just that your investigating what his current developmental levels are, and what education may boost his learning. This is a positive adventure, honestly. One more thing. Please do not allow your anxiety or anyone else's comments to "take over" this situation. One step at a time is really a good approach, and you have taken that step by contacting EI.
Take care, Rose

I wouldn't worry too much. My son is almost 17 months, and barely says anything. Da_da, dat, no, all done...and that's about it. His pedi says not to worry as long as he knows at least 3 words by 18 months, and it seems your son is quite past that. Maybe call EI and see if they think he should be there before you worry too much :-)

I can totally understand your concern, but you have to remember a speech issue is fixable.

I have a 8yr old that had hardly any words at that age, then when he did talk more stammered, he did go through speech therepy and did fine.

I now have a 2 1/2 yr old that for at least 10 months now could carry on a full conversation. So they are total opposites.

Every child is differnt, it does sound like your son has a lot of words. I wouldnt be too concerned. If I were you I'd sit back and enjoy your holidays and try not to stress. Make some calls after the holidays and perhaps start with talking to his own DR first.

Speech therepy is nothing bad to put him into. Sometimes they will start with a hearing test just to make sure the hearing is okay cause it is all connected with the speech. If his evaluation suggests speech therepy..... then just do it. He will be fine. I know I have always worried about every little thing wrong with my kids..... but if there is a problem with them, just make the calls, get the help and get it fixed!!!
Take care