Dear David Coleman: My 19-month-old son has never said any words at all. Is something wrong with him?
Clinical psychologist David Coleman offers parenting advice in his weekly column.
Q. My 19-month-old son is a bright and happy little boy but he has never said any words at all. I wonder if I should get him checked out? He seems to generally understand us if we talk to him, and if you ask him to point at something, occasionally he will point at the right thing, but not all the time. He loves having books read to him and is happy to concentrate on them, and in other respects seems fine - he walked very early and is very physically mobile; climbing up on things, etc. But why isn't he speaking? Is something wrong with him?
David replies: There is a wide spectrum of what is "normal" in terms of children's development, so, no, there may not be anything wrong with him. That said, most children will have some words by the age of 19 months. A lot of children will have at least 10 words, some might have more (maybe even up to 50 words). Some of those words will be clearly articulated and understandable to anyone that meets the child. Other words may be only understood by the child's parents or with some awareness of the context.
Some children may even be able to put two words together in a simple sentence, often combining a verb with a noun. For those children that do put two words together, the order of the words will be meaningful and appropriate to what the child is trying to express.
So, for example, "Go car?" might mean "Are we going driving in the car?" or "will I get into the car?" The context might help to know which your child is trying to express. "Car go?" on the other hand might mean "has the car gone?" or "where has the car gone?".
As you have noticed with your son, receptive language (the ability to understand words and language) develops ahead of expressive language (the ability to make yourself known to others). So, your son is able to understand a lot of what you say to him and can respond accurately to requests or commands that you give him.
These are all good indications that the precursors for expressive language are becoming set in place for your son. The fact that your son doesn't have any words by which he will try to express himself isn't necessarily a cause for worry. That said, it is still probably worth getting it checked out.
Your son is probably due a developmental check with the Public Health Nurse (PHN) at some stage between the age of 18 and 24 months. Given that you have a concern that he doesn't have any words yet, then it makes good sense to contact her and ask can his developmental check be brought forward if it hasn't yet been scheduled.
That developmental check will already include some assessment of language ability and so the PHN should be able to determine, with you, whether your son's language development warrants assessment with a Speech and Language Therapist (SLT). The SLT is the expert and will be able to both identify if there is a problem and give you guidance and direction to help your son's language development.
The fact that you read books to your son is a good thing. Picture books, where you can label objects for him are great for helping with language development. So, as you point to a picture of a truck, for example, you will say "this is a truck". You might then choose to add in some extra phrases like "trucks have wheels, trucks are big".
Similarly, talking to your son, a lot, naming what you see him doing, describing the objects and actions he is experiencing will also help him to both understand the words, and in time be able to use the words.
So, even though your son may have no words yet, don't panic. Look for his developmental check to be brought forward and continue to read to him, speak to him and include him in your daily activities, talking all the time to him.
What we often find with toddlers is that even if they seem slow to achieve certain developmental milestones, they often get a sudden surge, when the time is right for them, and by the time they are in preschool, a lot of the development has evened out. Perhaps he just needs more time.
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