Expert: James Michael Roan - 3/13/2007

Question
My 20 month old daughter seems to have a delay in her speech.  She had been saying some words 'love you','hello','dada' etc, but now doesn't.  She does hve 2 older sisters who spoke early/on time.  She doesn't seem to show any other problems.  She is affectionate,answers to her name,makes eye contact, role plays (feeds baby-doll),walks and runs flatly on her feet,does puzzles, and loves to climb and play with her sisters.  I am concerned with the delay in speech however, she doesn't even seem to try to say what she wants.  Any advice you can give me would be appreciated.

Answer
Hi Diane;

If you live in the U.S. contact your school district's special education department and make a referral for Early Intervention services in the Birth-to-three category. They can take it from there. Express your concerns about autism then. Meanwhile, to settle your fears complete the M-CHAT and score it. If she fails the M-CHAT then contact me again. I think she's probably fine and has an expressive language delay.

Download the M-CHAT at:  http://www.firstsigns.org/downloads/m-chat.PDF

Also download the scoring instructions at http://www.firstsigns.org/downloads/m-chat_scoring.PDF

When experts speak of "regression" in autism, they are speaking about a global regression or loss of skills in terms of language, social development, behavior, motor, etc. This sounds like an expressive language delay due something like low oral motor strength or difficulty with sequencing appropriate motor responses in the mouth and tongue that are necessary for speech production (apraxia).

Kind regards,
James