Expert: Valerie Herskowitz - 6/9/2010

Question
Hi Valerie,

My name is Kurt, and I live in the Philippines. I have a son who is 2 years and 5 months this end of May. My concern is that up to now he is not speaking words which me and my wife will understand. He says "nanana", "dadada", "colcol" and other repeating syllables but never a clear word. I am worried since I see some delays on his other areas of development particularly in speech and language. Following are my observations:
1. He is not delayed on gross motors skills- he loves to run, climd, and exhaust himself physically.
2. I believe he is on time on fine motor skills- he now loves to scribble on walls and almost everywhere. he tries to do circles and when he gives us his crayons he says "colcol". He has started trying to use utensils.
3. I do not know if he understands the words, or just the routine but he removes his shoes when i tell him to "remove shoes" just after shower, just before entering the house, and before climbing up the chairs. When we are on a restaurant eating, he removes his shoes without me telling him to do so before he climbs the seat. He makes wee wee when we are in the bathroom and I tell him "weewee", he sits down when I tell him "sit down" as well. He knocks on the door when we approach and I say "knock knock". He lifts his arms and flaps his hand when we say "bye bye" close to the window.
4. Compared to other kids I see, he has somewhat poor eye contact, but when his mom sings to him he is very intent on looking at his mom. He is very interested also when he watches TV that he can maintain his focus for about 15 minutes (like bumblebee kids, montesorry way, and backyardigans)-these CDs he has watched since he was a few months old. He can also focus and look at me longer when we are playing outside running around chasing each other.
5. To communicate his needs, he grabs us, pushes us to where he wants to go, grabs our hands and tries to direct on the things he want such as turning on the TV, getting his oreo cookie on top of the ref, directs our hands to the light switch when its dark on the room, directs our hands on his wet diaper/shorts so we can remove it. I did notice that on the table when eating he will raise his hand towards the direction of his cup and flap it up and down (its like pointing, but except that the pointing finger is not pointing- he was just grabbing the cup before and spilled all the water that's why we told him "mommy only" or "daddy only" and we will get the cup and give it to him, that is why he raises his hand instead of grabbing the cup when he is thirsty). If he is able to do it himself, he wont bother us and just do it himself, like he will open the fridge, get a coke bottle, and then give it to us to open (he can't open it alone)
6. In terms of playing with his toys, he loves cars and have lots of them at home, he also loves ride-ons and will try to ride them as fast as he can. I sometimes see him just looking at the wheels while playing, but sometimes he will try to push the cars and let go, and will sometimes guide the cars on some narrow ledge (maybe he is thinking its a road?). I notice he has short patience, he tries to stack bricks but when it will not hold, he smashes the whole arrangement. He plays with balls and throws them to me, he also loves looking at me using my tools, and when he gets a chance he will try to use them himself, like trying the screwdriver on the screw.
7. In terms of social, my wife and I usually take him to a playroom for kids, I notice he doesn't mind playing alongside kids, he doesn't mind them going out and about, he does get rattled though when some kid runs fast past him. Sometimes, he has a 3 year old playmate at home, and he tries to hug her and kiss her, he doesn't mind playing close to her either. He loves to cuddle with me and my wife, he does not like seeing me and my wife hugging or cuddling, he will insert himself between so he stays on the middle. Everyday my son and my wife cuddle as part of their daily routine and he loves it (my wife stays with him full time attending to all his needs and whims while I work). He loves it when I carry him, and when other people are passing by while he is playing, he usually likes to chase and look at them (depending on his mood), when he was less than 2 years, he was chasing girls who are in miniskirts and tried to hug their legs. He also wanted to kiss a teenage girl at the park one time- the teenage girl was with her boyfriend. He likes to put his face near the monitor just so he can disturb his mom.
8. In terms of behavior, he throws a tantrum when he doesn't get what he wants, he usually throws anything he is holding (like his toy car, or plastic toy spoon) but not directly to anybody, then he will grab one of his toys and throw it again, then he will cry loudly, I usually come near him during this time and tell him "no cry, no cry" and he will try to control his crying. When he is excited (he knows when we are going out the house for a stroll) he will flap his arms, and have a good mood, smiles a lot, excited and upbeat, and jumps around. He doesn't like it when we leave him alone in the room. I have not noticed any unusual symptoms like stacking his toys over and over again, crying too much for hours, banging his head on walls intentionally repeatedly, etc.
He will be turning 2 years and 6 months at the end of June. The set-up on the house is that he has been with his mother since birth, he started watching his DVDs around 4 months old. My wife and my son usually stay in the house during the weekdays and we go out on weekends. We usually don't have relatives in the city so usually it is just us three talking to each other most of the time. When he is playing the house is a mess, he is very very active that when we are done playing and I am exhausted, he still has a lot of energy ot burn. He seems not capable of settling down and listening to us read a book to him, or point him body parts (he cannot identify a body part yet), he settles down only when he is eating his oreo, and when he is watching his DVD's and just before sleeping. I also noticed he is drooling up until now, though I have seen his teeth have not fully grown to the desired size yet. My wife who stays with him at all times is not worried about our son's situation. my wife says our son understands her and maybe it is jut a delay on the speech. I do not spend so much time with my son that is why I worry.
I am praying it is just a developmental/ maturation delay and that he will catch up. I pray it is not autism or some form of mental retardation. Regardless, I have made a vow that I will love him no matter what.
Thank you for taking time to read this. It is hard for us to obtain help from the Philippines that is why I try hard to look for help online. We have seen a pedia about November/December (5/6 months ago)and all she said was that boys usually have delayed speech. We will be seeking a secong opinion within the month.
I am very appreciative of you taking time to read this. I hope it is not too much of your time to respond with your comments.

Thank you very much to you and God Bless your Family!

Sincerely,

Kurt

Answer
Hi Kurt
Thank you for your very informative letter.

You should be commended for being so astute as to your child's development.

I am very glad that you are going for a second opinion in the month as I feel that your pediatrician is not very skilled at identifying developmental delays. To tell you that boys usually have delayed speech is quite incorrect information. A child who is two and a half should be talking up a storm-boy or girl.

You didn't mention what type of professional that you were seeing for a second opinion.

Right now, I want you to do me a BIG favor. This will be very hard, but I want you to promise to do it! I want you to NOT focus on what the issue is with your son, but what you can do to get him to start progressing in a forward fashion. In other words-don't concentrate on a diagnosis. Concentrate on figuring out what to do to get him on track.

Once you do that, you will need to begin an INTENSIVE language stimulation program. You son MUST learn how to communicate or else many things will happen that won't be good. He will become very frustrated and probably start to develop more tantrums than he already has. He will also be quite delayed in other areas as language development is a necessary prerequisite for other developmental skills like socialization and eventually pre-reading.

So let's get going on working on his communication development.

You have come to the right person to help you with this. I would love to work with you in a professional capacity if you like. I work on Skype or on the phone and help you to develop a home-based language development program that you can do in your home with your son. If that is something you would like to do, you can email me directly at
info@valerieherskowitz.com

Meanwhile, keep me in the loop and try not to concentrate on a diagnosis but on what he needs!