Expert: Valerie Herskowitz - 6/25/2011

Question
QUESTION: Hi.  I'm writing out of concern for my 16 month old son.  He is healthy, very mobile, and very 'vocal' in terms of verbalizing his wishes to us.  However, he had consistently been using about 5-6 words, like mama, dada, hot, whoa, hi, and pop.  Within the last two weeks, he has not been saying any words much, instead he points to things and yells, or makes noise.  If he wants something, he will point to it and say "ahhhhhhhhhhh".  He is very alert, and interested in exploring and learning.  He can understand many, many words, and that increases every day.  He can identify body parts, objects in our home, and people by either looking at them or pointing to them.  He just seems to have slowed down on saying actual words.  Should I be concerned?  Should I call his pediatrician, or give him some time?  We don't see his pediatrician again until Sept.  I just don't want him to lose vocabulary when he should be gaining it.  Thanks for any advice.

ANSWER: Hi Kelly
I would be concerned. Not so much about autism as he seems to have good understanding of language but the regression in expressive language. A child of sixteen months should be saying quite a few words.  

I would wait another few weeks and see if the words return. If they do not, then schedule an appointment with a developmental pediatrician.

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

QUESTION: Valerie,
Thank you so much for the prompt response and advice.  With MUCH prompting, I was able to get him to say WHOA! today.  But he is just not using words like he used to.  He only uses them when he absolutely NEEDS to.  For instance, I was on the phone before, and he wanted his milk, which was out of reach while he was in his highchair.  I was at the kitchen sink, and he said "mama", because he really needed me.  Could this regression be almost like a laziness?  Or, do you think he has learned that he gets a response, even if he doesn't speak?  He's got a lot going on right now, he's learning to climb, like a monkey ;) LOL, and getting quite a few teeth at one time.  What else could cause this type of regression?  I will definitely follow your advice, to give it some time, then seek professional help.  Thanks again for your response.  ~Kelly

Answer
Hi Kelly

Usually we do associate regression in language with autism or seizure disorders like Landau Kleffner which is rare. But in your son's case, his receptive language seems really good and kids with autism usually have issues in receptive language as well.  

Try not to worry too much. Don't try and get him to speak by prompting right now. Too frustrating for you and him.  Let's see what happens in a few weeks-like 3 or so. If you don't see an improvement or his receptive language regresses or you see other behaviors and he stops coming when called or appears a little out of it, then I would highly suggest seeing a developmental pediatrician.

Meanwhile, try not to worry. Let's wait. Get in touch with me in about 3 weeks and give me an update and we will go from there