Expert: James Michael Roan - 9/16/2006

Question
he is very social,loves games, knows his colors  interracts well with other children, loves to be held and likes strangers except his pediatrician. Would his dependence on his favorite pacifier cause language delay? my older son did not start talking until he was almost 2 and when he started -he never stopped! She feels because he has a tantrum when he doesn't get his own way means he can't communicate-(yet so did my older child)how can a speech therapist help him at this age?
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Followup To

Question -
My pediatrician said my 18 month old may have a form of autism because he doesn not say alot of words. He did not fail the checklist..the only problem is he is not talking up a storm..just momma and dada. She wants him to see a speech therapist..what do yo think?

Answer -
Hi Connie;

When autism is a consideration at this age we are looking at low social communication and low social interest or sometimes social aversion. By 18 months, even with a language delay, there should be some minimum gesturing to be picked up, to point for a request, eye contact, desire to be near others their age. They should enjoy peek-a-boo games, want to be picked up, want to be held, and turning around to look at you when you call their name. If the majority of these behaviors are present, you are probably just looking at a communication delay. Yes, see the speech and language pathologist.

If there is any doubt, then have a team of professionals experienced with diagnosing autism in toddlers. You can find an autism team at Children's Hospitals or at a major university near you.

Kind Regards,
James

Kind Regards,
James

Answer
Hi Connie;

I wouldn't worry about autism at all. Tantrums around pacifiers are more common than not. Pacifiers provide psychological and physical comfort and removing it would, of course, promote protest!

Pacifiers can delay speech because they strengthen muscles for sucking and not for speech production. Teach him to blow bubbles with a straw. It's fun and develops some of those muscles. A speech therapist can do an oral motor evaluation and recommend oral motor strengthening activities. Of course, when a child or an adult is unable to express themselves they become frustrated and will use behavior to express themselves. Many gifted children have this problem. They are intellectually ready to express themselves but have not developed the oral motor structures for speech and thus get similarly frustrated.

Have fun with him. They grow up way too fast!

Kind Regards,
James