Expert: Dr. Sharon A. Mitchell - 1/20/2007

Question
my son will be turning 2 next month. He is only saying mama and dada, he is not pointing to anything specific, he does love to play peek a boo and he loves to play with adults. He is a twin and he always plays with his brother.i have started to notice he is in his own little world, he won't turn his head if you call his name all the time, i was just wondering if you had any ideas on what i should do.

Answer
It's encouraging that he loves peek a boo and to interact with adults as well as his brother.

Not looking when his name is called is not necessarily indicative that your son may be showing autistic tendencies. There may be other things going on.

Is his brother pointing to get what he wants? Does he speak more than his twin? No two children develop at exactly the same pace so comparisons are often difficult.

But there are guidelines as to what you might expect in the way of communication skills from children at various ages. You can find useful developmental information at websites such as http://www.asha.org/public/speech/development/child_hear_talk.htm There is an easy-to-read fact sheet here http://www.caslpa.ca/PDF/fact%20sheets/preschool%20speech%20and%20language.pdf

There are things you can do to encourage your son's language development. Most of them you are likely doing instinctively but you may get some more ideas from The American Speech Language Hearing Association http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm

Some people feel that their child's language skills have been enhanced when taught sign language. These are simple signs a baby or toddler can learn to make in order to get what he wants. It's a ways of teaching him that he can use communication to control his world. Using sign language, picture cards or other types of facilitated language will not discourage your son from speaking. Rather, it reinforces his learning that communicating gets you what you want. You'll find information on how baby signing here: http://www.signingbaby.com/main/

Do you think your son is at the stage where he can relate to pictures or photographs of objects? If you show him a picture of your car and tell him to get his coat, will he understand that you are going somewhere? There are a couple books I like that show ways of using visuals to support communication - Visual Strategies for Improving Communication (http://www.amazon.com/dp/0961678615?tag=autismhelpf0e-20&camp=14573&creative=327...) and Making Visual Supports Work in the Home and Community (http://www.amazon.com/dp/096725146X?tag=autismhelpf0e-20&camp=14573&creative=327...).

Do you think that your son is able to hear well? Does he look or startle in response to loud, unexpected noises?

Does he become so focused in his play that other things in the environment do not register with him at that time? Does he never respond to his name if he is not watching you? Has he had a history of recurring ear infections? Many colds? Does he have respiratory allergies or food sensitivities? Such things may have an effect on the ability to hear. Children with varying degrees of hearing loss, even when that loss is temporary may show delays in acquiring language skills.

If you continue to be concerned and feel that your son is not using intentional communication, talk to your public health nurse, physician or a Speech/Language Pathologist. If you are unsure how to find one near you, here are the listings for registered SLP's in the United States: http://www.asha.org/findpro/ If you live in Canada, try here: http://www.caslpa.ca/english/profession/find.asp

I know it's a worry, but you may feel better if you check out some of these resources.

Sharon A. Mitchell