Delayed Speech

For the first time Saturday, I had some contact with my great nephew
who just turned 3. My sister (his grandmother) thinks he has delayed
speech. I'm not sure. What he said was pretty intelligible to me,
and I didn't think he was untypical in how he behaved.

hschinske...

He sounds about the way my son did at that age, and I have a pretty
good memory of that stage because it's right when he was in fact
evaluated by a speech language pathologist. He scored fairly high for
receptive language and was borderline low on expressive language -- a
bit too high to qualify for therapy. It sounds to me as though it would
be worth having your great-nephew's speech evaluated, but my bet is on
him not actually needing therapy. I was told that my son would either
catch up, or he'd fall more and more obviously behind. He did seem to
me to catch up. Now (at almost eight) he has speech therapy for an
apparently unrelated stutter, but his articulation and vocabulary have
been very good since, I dunno, four or so.

The evaluation was fun for my son, interesting for me, and insurance
covered it. I don't see any possible down side to having him evaluated.

He would say 'want to go out - play' 'put on shoes' when he wanted to
go outside, and also said that he wanted something to eat when he was
hungry. He didn't melt down, but he insisted on what he wanted over

an588...

I think most kids who have just turned 3 use more advanced
sentence structure than that. That doesn't mean his speech
has to be considered "delayed". Not everyone can be above average.

and over until someone did something. He is still wearing diapers.
My mom had made the comment that he was not talking at all last year
when he was two.

Ericka Kammerer...

I think the tough thing about speech is that there's
such a wide range of normal, especially at this age. There
are certainly 3yos who have much more speech. My just-turned
3yo is speaking in fairly long and complex sentences. (She
just turned three, and just said, "After I get this diaper
on, I'm going to get Colin's glasses and give them to him,
okay Mom?") But, it's also normal at 36 months to have a
lot less complex speech. Perhaps the other grandkids have
been on the more advanced side of normal, which could
understandably make someone worried given the pretty large
gap between the different ends of the spectrum.
I seem to recall that there were some decent websites
on language acquisition that you could perhaps send to your
sister. They might reassure her, or maybe they'll suggest
to her that her grandson *is* behind the normal curve, in
which case she could perhaps forward the websites to the
parents. I would imagine that if he is speech delayed,
with what you describe it isn't a severe delay. Here
are a couple:

Best wishes,
Ericka

When they wanted him to pick up toys and put them back, he did that
relatively cheerfully. My niece says that he is very rough on things,

an588...

...

and has completely broken one of her dining room chairs beyond repair,
but I didn't see that when I was observing.

Somewhere in the house, he picked up a plush stuffed owl (we were in
my mom's house dividing up and packing up the furniture), and he
didn't want to give it up. I didn't require that he interact with me
at all, so when it was time to leave, and they told him to come and
hug me, he did that (after thinking about it for a moment).

He wanted to keep track of his mom, but mostly his dad took care of
him so that my niece (who is pg) could look at various items (like
books and china) to see what she would want. I understand from my
sister that he is mostly taken care of by a nanny and his dad.

My sister says that the only thing that works with him is distraction
- that you can't tell him not to do something and have him not do it,
but I don't think that is untypical - at least for very young
children. But it has been a long time since I have had to deal with

an588...

It's not true that the only thing that works with him is
distraction. Apparently you can ask him to do something
and he will do it -- as with putting away toys as mentioned
above. One thing to try is, when you don't want him to do
something, try wording it positively. For example, if you
don't want him to go in one room, you can say "we stay in
this room," referring to another room.

When you tell someone not to do something, the image of
the thing they're not supposed to do appears in their
mind. There is no such thing as an image for the word "not".
Images are always positive. It's better to get the
person to have an image of what they are supposed to
do -- that tends to lead to them doing it.

that age boy (my latest grandchildren are all girls). Is three too
young for this kind of thing? Should he have more control or more
words?

My sister also said that they spent the weekend with 4 little boys
under 5 (her grandsons - two boys of another niece, one boy of my
nephew and this child), and that none of the parents had the same
parenting style, and none of the parenting styles was what she and my
BIL would regard as effective.

I pointed out that this child was my niece's first and asked whether
her other daughter did not have some of the same issues with her first
child, and she said that daughter and SIL just allowed the kids to do
whatever they wanted.

My sister was venting to me, and she certainly (knowing her) wouldn't
say anything to her children, so I let her do that. But can anyone
who has dealt with language delay see anything that I ought to suggest
to her that my niece should consider?

Nikki...

I do think it would be worth it to have his speech evaluated. It is easy
and free and if he is behind a little therapy can really help at this age,
the sooner the better too. Hunter had speech delays and I wish I would have
acted sooner. IIRC Hunter was saying similar things (maybe not quite that
much) at 3yo. The other things you describe sound pretty normal to me but
one thing to keep in mind is that receptive language is hard for regular
people to gauge at this age because we don't expect all that much. I was
surprised when, at 3.5yo, Hunter's receptive language scores were so low.
In hindsight it was a marker for some auditory delays he still deals with
but I'd have never guessed it. He was a mellow easy 3yo but a 3yo that
seems to be misbehaving a lot might be getting lost in the language rather
then ignoring instructions.

Rosalie B....

This child will follow directions, and I really don't think he
misbehaves, or at least not while I was observing. Because my mom
(his great grandmother) had concerns about his language level, I tried
to pay attention to him, but I thought he was two, when really he was
3. I'm not sure that I think it is a severe enough problem to try to
get my niece to get him evaluated. My niece is a bit difficult at
times.

Like Erika, we always talked normal language to the kids, and I
probably had a kind of heads up for receptive language when I had to
try to explain to dd#1 why her dad wasn't coming home at night every
night when she was about very small. She was acting up, and since I
felt the same (pretty much) about him being gone, I guessed that she
might be missing him. When I explained it to her, she understood and
calmed down, but this was way before she had enough language to ASK
where her dad was.

At least that was how I interpreted the situation at the time.

So I've assumed that children were kind of like unconscious persons -
they couldn't respond to us or express themselves, but they could
somehow understand a lot. I've found myself that when I was in a
foreign country where I didn't understand the language, that even so I
can have a somewhat restricted conversation with people. I'm
obviously communicating on some kind of subconscious level.

Jeanne...

Your grand nephew sounds almost exactly like my son who also just turned
three. At his 3 year old check-up, the nurse practitioner talked to him
a bit, couldn't really understand him. DS has some clear words and
talks in short sentences much as you described. He patiently repeats
everything until he is understood. But sometimes when he's excited or
angry, he loses his words and is pretty intelligible. The nurse
recommended that we call "Child Find", the preschool component of the
public school system to have him evaluated. She wasn't sure if he
really was speech delayed and if he would qualify for therapy but she
felt it would be a good idea to at least have him evaluated.

Ericka Kammerer...

I think every state is supposed to have an early
intervention program like Child Find that will evaluate kids
for free, and many kids have benefited from evaluation.
On the other hand, I'm wondering whether what
Grandma saw was typical of the child's speech. I know that
at that age, my kids tended to clam up a bit when they were
around people they weren't as familiar with--so much so that
people were amazed to overhear them talking when the child
didn't know they were around, because the difference was
so great. Is it possible that the child talks a lot more

Tori M...

I know I thought Bonnie was fine because she talked more when no one else
was arround.. One of the ladies that insisted she needed speach therapy
sugested it because Bonnie wasnt talking when she had Hand Foot and Mouth
disease! I was like what are you talking about.. she hasnt talked in 2 days
her mouth hurts.. but we ended up testing her anyway to quiet people.. she
was boarder line so we went with the therapy.

when he's just around his immediate family, and perhaps the
impression that Grandma and Great-Aunt had was atypical?

Jeanne...

Well, it MAY be atypical but it's hard to say via the 'net.
What Rosalie described was VERY familiar to me. Being shy and quiet
isn't the same as hard to understand. DD was shy - when she met new
people she became quiet and very soft-spoken but still very articulate.
DS OTOH can be hard to understand. Strangers often can't understand
him although they can certainly hear him.

Ericka Kammerer...

Ahhh, I got the impression Rosalie wasn't particularly
concerned about him being intelligible, but was more concerned
about the variety and complexity of his expressive language.

Rosalie B....

I was with him for most of one morning. His mother, father,
grandmother and grandfather were also there. He didn't talk to me

an588...

...

much but I didn't expect him to. He talked to his father and mother,
and it was fairly easy for me to understand once I had tuned in and
listened. He talked quite a bit actually, and he spoke quite loud
enough for me to hear. He wasn't shy OR quiet with his family. It
was just that he repeated everything a lot, and it wasn't anything
except short declarative sentences.

Jeanne...

Did he have to repeat things because nobody was listening to him? Or did
he have to repeat things because nobody understood him? Sometimes, I
ask DS to repeat two or three times before I can decipher what he's
saying. I'm listening as closely as I can and searching his face for
visual cues.

DS uses pretty simple sentence structures with imprecise grammar; no
complex or compound sentences yet. He still says "carry you" instead of
"carry me". I would have thought this would have corrected itself by
now. Especially because I tell him to say "Pick me up please".

an588...

Maybe he's not mixing up "me" and "you". Maybe when you
say "Would you like me to carry you?" he hears it as
"Would you like me to carriou?" In other words, maybe
he thinks the verb is "to carriou".

I don't think it works very well to say things like
"please say pick me up please". Children tend to learn
words by hearing them used in context, not be being
told to say them. Also, since he already knows "carriou", he
may not be motivated much to learn a new word for the
same thing at this time.

When you're about to pick up an object (for some other
purpose, or just for this game), you can first animate
the object and pretend to have it say in a high little
voice, "Carry me! Carry me!" or "Pick me up please!"
You can talk back and forth a few times, asking it
"Would you like me to pick you up?" and having it
repeat its request. Or, you can have a doll act as
the one being asked to pick something or someone up.
This way you can demonstrate the verbs and the
usage of "me" and "you" in context.

DD never mixed up "you" and "me" although I remember my eldest niece
doing that for a while but I don't remember when she stopped.

Clisby...

I don't think this is terribly uncommon - my daughter did it, but my son
didn't. I don't remember exactly when Emma stopped - maybe 2, 2.5? I
didn't do anything about it - she just figured it out eventually.

Clisby

He obviously understood more than what he was saying. I do wonder
whether anyone actually talks to him without dumbing it down but I
have no way of knowing that.

dragonlady...

If a child is speaking loudly and repeating himself a lot, I'd wonder
more how well people listen to him when HE talks....

Rosalie B....

Absolutely!!!

Over and above the lack of vocabulary the adults weren't really
listening to him at all. It is true that they had a limited amount of
time to move out and pack up, but they didn't seem to consider him as
anything but a nuisance. I've found the same true of my own children
with my grandchildren BTW. It isn't just my sister's children.
Although I tend to think that the children (mine) who have been
responsible for training animals do better than those that have been
restricted from having them.

L....

That's not necessarily a concern. DS as well as many of his peers in
our playgroup (at 2.5) tend to repeat things over and over even if
someone is attending to their needs. For example, I can tell DS I am
getting his juice after he asks for it, and he will repeat "juice
peeze" until I hand him the sippy cup. Or he will ask for something I
don't have over and over even when I tell him it's "all gone" or that
we don't have any. Our playgroup moms were just talking about how
annoying this can be! Maybe this behavior improves or ceases after age
3, but at 2.5 it seems normal, at least for us.

Jeanne...

Guilty here. For some reason, we (DH, DD and I) seem to underestimate
DS's abilities including listening comprehension. So we tend to use
simple sentences. I'm working on "attending", describing DS' actions to
him. I find that when I do that, DS' vocabulary increases and he begins
to use bigger words.

an588...

You can also talk about what you guess his feelings and
thoughts to be. For example, if he looks at something
and you think he's interested in it, you can talk about that thing.

It's fine to use big words to express his emotions.
Generally the child will understand right away that
you're naming their feelings, even if they've never
heard the word before, and will feel some relief at
having a name for the feeling or just from knowing
you're trying to understand their feelings. It's part of
the important process of teaching them to name their
own feelings. Even many adults don't tend to use
many words to describe their own feelings. Naming
your child's emotions can also be good practice for
the parent.

Ericka Kammerer...

All three of our kids have been relatively precocious
verbally. We have never limited our vocabulary or sentence
structure with them (except with dealing with discipline
issues, where we use very short, very clear sentences even
when they're much older). I have always wondered if those
things were related, but of course you can't know very much
from a sample size of three, all from the same family ;-)
I think it's amazing what kids can understand. They get
some very complicated things very early, and I always think
that's fun. In the early years, even those with great
language skills still think and feel far ahead of their
ability to express their thoughts and feelings, and I
always feel like I want them to have the tools to express
themselves as early as possible because I'm curious what's
going on in there. They say the most entertaining things,
and have such an interesting perspective on things! ;-)

Best wishes,
Ericka

an588...

Well, if you were there most of the morning and you still
don't know, then I would conclude that if they do talk to
him without dumbing it down, they don't seem to do it much!

Some people have been saying that people should talk to
kids with adult-style speech, not baby talk. I don't agree
with that. I think it's more complicated than that.
It's a mistake to always use simple baby talk and never
expose the child to more advanced vocabulary or sentence
structure. But IMO it's also a mistake to just talk to
the child in complex, adult-style sentences all the time.
Baby talk has advantages: it can signal love; it can
catch the child's interest; it can be more easily understood
by the child. Playing with words -- nonsense, rhymes etc. --
is also good IMO. A mixture of types of speech may be
ideal. People can understand speech more advanced than
what they use, and hearing even more advanced speech than
that can stimulate the learning process.

Best wishes,
Ericka

Best wishes,
Ericka

dragonlady...

I'm pretty sure Ericka is right, and all states have the free screening
starting at age 3. (The age has to do with the fact that at age 3, the
public schools become responsible for providing educational needs --
before that, it's a different department.) So anyone can call the
school system wherever they live (in the USA) and arrange for a
screening, which might indicate a need for a full evalutaion -- which
they will then also provide.

I did that with all three of mine, though I had no serious concerns. I
just figured an early evaluation would pick up anything I'd missed, or
that the doctor didn't see in our very fast visits -- that's what
they're for, to catch problems early.

It was an interesting process, and my kids seemed to enjoy it. I do
know some folks who ended up getting short-term speech therapy or
occupational therapy as a result of relatively minor problems identified
for their kids when they took them in for this screening.

With my own, the screener thought it was pretty funny that I had some
minor concerns about my son's speech. It turned out that he was on the
high end -- its just that both of his sisters (including his twin
sister) were SO beyond what was "normal" at that age that my
expectations were unrealistic. Mom insists that his sisters never gave

Ericka Kammerer...

I think this happens for a lot of people. There's
such a wide range of normal, plus those that are outside
normal on the high end, that if you have a child who's on
the low end of normal, it can really *seem* abnormal just
because it's so far from other examples you're familiar
with. That's not to minimize the concerns anyone might
have--there are certainly children who benefit from
screening and intervention, so if there seems to be any
question, it's probably worth it to get the child
screened, or at least ask the child's regular doctor
whether screening would be appropriate. I think it's
just also good to keep in mind that normal development
encompasses quite a wide range of behavior at this
point and not get too worried about things, especially
since even if there is a bit of a delay, speech therapy
seems to be very successful.

Best wishes,
Ericka

the poor boy a chance to talk... So, if nothing else, the screeners are
a good source of reality testing for anyone, whether or not you have
concerns.

DS didn't really talk until he was close to 2 years old. He was always
on the slightly delayed side with his verbal skills; always borderline
"normal" but not obviously delayed. In contrast, my nephew didn't talk
until he was closer to 3 years old, so it was obvious that he needed
therapy (actually he started speech therapy at 2 1/2). DD started
talking at 12 months and was talking sentences by 18 months, so our
experience with her was on the other end of the spectrum.

I talked with DS' daycare provider and she was also ambivalent about the
evaluation because again her experiences were with children either
obviously delayed or obviously precocious. But she encouraged the
evaluation.

I called "Child Find" last week and am waiting a callback.

FWIW, DS has hit a stage where he doesn't want to share or hand back
things to its rightful owner although he will after a while. Previously
he was very good at sharing and taking turns. He is also not
potty-trained. And right now, DS is going through a Mommy stage; when
he was 2, he wanted Daddy.

Jeanne

Just as an aside - my oldest niece is the oldest of 3 as is her
husband. My nephew is a middle child married to a middle child, and
my youngest niece is married to a youngest child of 3.