Expert: Dr. Sharon A. Mitchell - 5/17/2011

Question
Hi Sharon,

My nephew will be turning 21 months next week. I see him quite often, at least once a week and I have some concerns about him. Overall, he is a very active little boy, hardly ever sits in one place and quite physically strong for his age. He has good eye contact, will smile, laugh, point at objects. My concern is about his speech. If he wants something he will just say 'ah..ah' and point at it. I have heard only 4-5 distinct words including dada and mama, sometimes he will repeat words but not always, never combines 2 words. Of course, I do not interact with him on a daily basis but at least from my observation, he does seem to be a little behind with his speech. Especially when he's with other kids his age and they seem to say lot of words compared to him. I know that boys tend to be a little behind with speech but is there any cause for concern? I would like to have your opinion before I bring it up with his mother.
Thanks for your help.

Answer
I see why you are concerned about your nephew's speech and language development. According to the American Speech-Language-Hearing Association, children between ages one and two typically increase their spoken vocabulary monthly, ask simple questions using a couple words together, etc. You can read what they say about these milestones at the following website, along with suggestions for encouraging a child's development: http://www.asha.org/public/speech/development/12.htm

It's great that your nephew is an active, strong boy who responds socially to others. Although kids with autism may have language delays there are many conditions unrelated to autism where children also have language delays.

I would suggest that an appointment with a speech therapist would be in order. The best outcome from this is that the therapists assessments would show that this little guy is on par in his development. If there is a delay or difficulty, then he could begin receiving assistance soon and the therapist would also guide his family in how they can help their son at home.

Best wishes,

Dr. Sharon A. Mitchell