Expert: Valerie Herskowitz - 2/23/2011

Question
I am a Mom of two older boys.  I watch my 19 month old nephew every day.  I am a little worried about a possible developmental delay or more.  He only has about 10 words and does not combine two words.  He uses a sign language to signal more that I taught him, he does tippy toe walk, he will flap his hands and make a 'aaak aaak aaak' noises and does at times with a toy in one hand bite his other hand to the point where he has marks.  However he will sit and listen to books over and over again, he will bring the book to you, say 'book' and move his hands indicating he wants up in your lap to read.  He will sort blocks and put the shapes in the appropriate holes, he does wooden puzzles, will copy car sounds and push cars along the floor.  He knows his name and will respond, will hold your hand when asked, when he is hungry and you ask him he will go to the highchair, when finished eating he always clicks the belt around the chair.  When the older kids come home however and I don't know if it is an attention thing he will throw toys or his bottle at them, he will hit them, etc., continually he knows what the word 'no' means but uses one word often, 'ball' he knows what a ball is and will bring it to you play with it throw it, etc.  But he will use the word ball with other objects that are not a ball.  Sometimes when he wants out of the high chair he will move his head rapidly from side to side.  He eats very well, smiles and does engage, my older son had a language delay and I got EI involved and he was back on track and caught up with his age in a matter of 6 months, I am just a little concerned, my brother has raised concerns as well, #tippy toe walking, repetitive motions, one word, etc# would a developmental pediatrician be a good starting point?  I did read that you have ideas for helping children with speech development as a result of a language delay...what do you think?  Thank you very much.

Answer
Hi Alicia

I would start with a developmental pediatrician like you said. The behaviors that you are noting:
delayed language, tippy toe walking, flapping, noises, biting himself, sorting blocks and doing puzzles well, throwing things, moving his head weirdly, etc. These combined are all red flags. Singly, maybe not-but together-absolutely.

EI is another option-or do both.

If you want to do a consult with me, I am available via phone. You can email me at:
info@valerieherskowitz.com

Keep me in the loop