Expert: Valerie Herskowitz - 4/12/2010

Question
QUESTION: Hello there:
I am somewhat concerned regarding my 26 month old. Some background information: A pretty social baby, first smile @ 5 weeks, cooed very early, like 1.5 months, babbled around 6 months. Said Mama at 11 months old and couple of times there after but really didn't start using it again until about 23 months olds ( which was so heart wrenching). First word was ball around first birthday,  subsequent words however were slow to emerge, he called everything apple until about 18 months old, began pointing at a year, engages in joint attention, shares toys and interests with me and others, seems to have exceptional receptive language skills as well as great eye contact. He now uses two word sentences like more juice and go outside. He can ask for what he wants for the most part (i.e. play trucks?) and can follow directions pretty good. He can count to ten and seems to understand concepts of numbers (i.e. he will pick up two balls and say one two, two balls). He knows all colors as well. He excitedly shows me stuff,by pointing and looking at me to see if I see what he is referring to.  When one asks his name, he can respond appropiately same with his age too.
Okay my concerns, he has some quirky behaviors that concern me. He engages in this hand clapping thing and has so since he was about 16 month old. He claps and says "hubba hubba" he does it for about 1 minute maybe one to two times a day( although he hasn't done it once today). He is completely fascinated by wheels; he used to spin the wheels on some of his toys but not so much anymore. He's not much of a talker but he is always making sounds, kind of like sing-songy over and over again. I can redirect this by engaging him in conversation. He does engage in pretend play but not often ( once in awhile he will pick up my phone and say hi and then say bye and put it down).  On occasion he has spun in a circle with his eyes in strange position but that was only was or twice.  He does talk as described above but also makes a lot of sounds like babble. He seems to enjoy the company of other children, especially older children and wants to do whatever they do.  He's not scared of loud noise and for the most part is an easy going little guy.
I just wanted some guidance.
Thanks.

ANSWER: Hi Kami

You do bring up some concerns that I would probably recommend that you have someone who is a specialist in children with developmental delays take a look at. Basically, how many words would you say he is using spontaneously. Write them all down and send them to me or at least just how many. If you can send the actual words, that would be better at helping me to determine whether I feel he has a language delay.

Does he come when you call him?

The sounds and the sing-songy thing plus the fascination with wheels is a concern.

Does he seem remote at all? Like not really engaged and into himself?

I'm not overly worried, but he may need a little intervention to keep things on track. Send me the list of words and answers to the above questions.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much. He says about 50 to 75 words on his own, he knows the name of everything and often he will surprise me. Such words include truck, car, big, blue water chon cho (for train) duck, grass, more, dog cat and a ton more. He uses phrases such as go bye bye, more juice, Mama's purse, I see it, all done, go outside, ball is stuck etc.  ( I could go on and on) In fact, as I typed this he walked in and asked me for "more puffs?" which is a snack he was eating earlier.

He's pretty engaged for the most part but yes sometimes he does seem remote. However, I never ever have a free second because he always wants me to play with him or at least just be with him. If I am on the phone, he points to the phone and says "all done!", meaning for me to end my conversation.

Just an FYI, I developed  OCD(Obsessive Compulsive Disorder) subsequent to his birth and one of my obsessive fears was concerning him developing Autism ( when he was 8 days old he watched an interview of Jenny McCarthney which promoted a obsessive fear. Do you think some of this could be related to my anxiety negative impacting him?  

Thank you so much!

Answer
Hi Kami

You may be a little over anxious, but he is a little language delayed.  Most 2 years olds have more vocabulary (200-250 words), but it's good that he is putting words together. He may catch up on his own, but if you want to work with him, then I can set up a phone evaluation with you, and we can have you do some things at home. Or you can wait and then, if by 30 months, he is not really chattering away, then you can get a speech evaluation. Or if you don't see a lot of new words coming in each week, you can do that.

I can't really comment on the remote issue as he does seem to be engaged with you.

I wonder if he has inherited some of the OCDs from you? I have some also-not formally diagnosed though, but both my kids got some it.