Expert: Dr. Sharon A. Mitchell - 2/5/2012

Question
My son is 2 years and 1 month old. He can speak at most 3-4 words. There is no problem with his hearing.

When we visit a house which he is not familiar, he cries a lot.
However, he uses hand gestures to communicate. He understands what we speak.

Have tried to make him speak some words but have not succeeded.
Please advise what i should do.

Regards,
Saju

Answer
Good evening Saju,

I'm glad to hear that your son is using hand gestures. When a child has no communication system, we often see undesirable behaviors due to the child's frustrations over not making his wants and needs known. Is he using gestures he's made up on his own, or have you taught him? If you're interested in more signs and other ways of helping him learn gestures, take a look at these websites:

- http://www.babies-and-sign-language.com/glossary-photos.html
- http://www.babies-and-sign-language.com/

You mention that there are no problems with his hearing. That's good. May I ask how you know, though? If you stand out of his line of sight and quietly call his name, will he turn his head in your direction? When an object is dropped, will he startle? Turn to look at it?

Sometimes children who experience frequent ear infections develop some degree of hearing loss, especially during the times when their ears are infected or plugged. Sometimes a child might have an infection without the parents even knowing. Repeated ear infections can contribute to slow language development as the child has missed some of the experiences of hearing language. If you're in doubt about either the possibility of ear infections or your little guy's hearing, please see your physician. Audiologists can most definitely test the hearing of a baby your son's age.

According the the American Speech-Language-Hearing Association (http://www.asha.org/public/speech/development/12.htm), between the ages of one and two, most children:

■Say more words every month.
■Use some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?").
■Put two words together ("more cookie," "no juice," "mommy book").
■Use many different consonant sounds at the beginning of words.

Between the ages of two and three, most kids develop these expressive language skills:

■Has a word for almost everything.
■Uses two- or three- words to talk about and ask for things.
■Uses k, g, f, t, d, and n sounds.
■Speech is understood by familiar listeners most of the time.
■Often asks for or directs attention to objects by naming them.

See their website for more detail and for suggestions on how your can help your little guy: http://www.asha.org/public/speech/development/23.htm

No two children develop at exactly the same time in exactly the same way. The above language milestones are a guide. But, I do think you are right to have some concerns about the level of expressive language your son is using.

In the meantime, the work you do with him on gestures is helpful. Augmented communication methods, such as using gestures and signing, do NOT discourage a child from speaking. In fact, they often bridge the gap and encourage a child to speak. After all, it's faster and easier to say, "I want a cookie" than to attract attention, gesture or seek out a picture of the desired item, then show the picture to mom.

When he wants something, do you anticipate his needs and get the item for him to prevent him from becoming frustrated? Do you wait and insist that he make some effort to make his needs known to you?

You mention that he cries in unfamiliar homes. Is that also true in other environments? Is he uncomfortable when out of his usual routine? Does he prefer to rigidly stick to what he already knows?

Since you found your way to a site that answers questions about autism, I presume you're wondering if your little boy may be showing signs of an autism spectrum disorder. Although many kids with autism due have a language delay, just because your son speaks only a few words at age two does not mean that he has autism. There are many other characteristics needed for an autism spectrum diagnosis.

If you are worried about the possibility of autism, take a look at these developmental milestones: https://www.firstsigns.org/healthydev/milestones.htm. Then take a look here, read the page, then follow the link to the video glossary: https://www.firstsigns.org/concerns/index.htm. At the video glossary page you will see brief video clips of typically developing children alongside those with autism.

Since you are worried and there does seem to be some evidence of a delay in his language development, I'd suggest that you seek out a Speech/Language therapist for an assessment and advice. If you reside in North America, you can find one through this link: http://www.asha.org/proserv/.

If you are concerned, seek help. If it's nothing, then you will have put your mind at rest. If there is a problem, then you will have gotten on it early and are doing everything you can to help your little boy.

Best wishes,

Dr. Sharon A. Mitchell
www.autismsite.ca