Speech “Delays” and Way-Too-Early Intervention

Dear Amy,

I am reading and memorizing your blogs, and I am very grateful for the information! You don’t imply that other children ARE for sure delayed, just because you have experienced this with your son. So thank you!

My boy is 11.5 months old. He doesn’t have words yet, and he started to babble late. At 9.5-10 months old, he said Gaga and Bababa for a week or two, and stopped with 4 weeks down time. He picked up again with Dadadada, Tata and Didididi at 11 months. He still can’t point, can’t clap his hands (although he is clapping mine), and he only occasionally waves to greet people. He doesn’t really imitate gestures, and he sometimes imitates sounds, like Dada, or Yay. If I say a word like Bingo, he would try to say it back, but he comes up with Bghghg, a raspberry, and scream, or Dadada.

I can’t trust my own judgement, because I usually assume there is a problem and then doctors very often tell me I am wrong. I evaluated my son at a private and well-respected speech therapy practice at 11 months of age, and he scored at 8 months for expressive language, and 16 months for understanding. The speech therapist seemed very confident he is not on the autism spectrum because he is very social. I was told that at this age, they are not overly worried about the delay yet, and we should wait-and-see.

My family thinks I am crazy, and I have no support for my worries and evaluations. Even my mother thinks my son is absolutely fine, and she is the prime caregiver of my son. But I am really upset, because he is supposed to do complicated babbling by now, combining various consonants, and he is nowhere near to even mama or dada with meaning.

So here are my questions: at what age do I start worrying about speech-delay? Can we say anything about late babbling, or babbling patterns and connect with speech issues? If the problem is only isolated speech delay, do most children pick up later, or do they need to go to special schools? In other words, what are the possible outcomes?

I would be very grateful for your response.

Gurl, please picture me very gently stroking your hair right now, and perhaps handing you a slightly-oversized glass of wine, because you need to CHILL. OUT. And I mean that in the most understanding and loving way possible.

I actually kept jumping back up to the beginning of your letter just to make sure I hadn’t misread your son’s age. He is not even a year old.  I’m honestly more worried about you than him, because you have worked yourself into quite a fearful state here. For both of your sakes, please step away from the milestone charts and developmental books and all of these “but he’s supposed to be” generalizations. Please stop trying to label him as anything right now and making yourself sick over ridiculously premature worst-case scenarios. (Special schools? What? No. Nononono.)

My son was first POSSIBLY, MAYBE, LET’S STILL WAIT AND SEE identified as slightly speech delayed around 18 months. The doctor was still not really concerned — language in young toddlers often comes in waves and “explosions,” and kids can seriously go from almost non-verbal to talking in sentences within a span of a couple days.

At 20 months, when things hadn’t really improved, we were referred to Early Intervention for an evaluation. By this point, we saw toe-walking and other sensory problems, so while I probably made the biggest deal over his speech, I’m guessing that actually wasn’t our doctor’s primary concern but simply the gentlest way to nudge us into getting him seen by someone. We started speech therapy just after his second birthday in September, and by June (or so — God, it’s all getting fuzzy), he was adequately “caught up,” speech wise.

All along the way, every therapist and evaluator was shocked (in a good way) that our pediatrician referred us as early as he did (again, at 20 months). Most doctors wait until after the second birthday, and lots of kids aren’t identified until preschool. And while earlier is better, I gotta admit that by kindergarten, the kids who had speech therapy were mostly indistinguishable from the kids who hadn’t. And no, not every speech-delayed kid has Other Issues.

Because I’m guessing my oldest’s story is the one that probably brings out a bunch of “YES, BUT…” worries for you, because yeah. He had a speech delay, and then went on to have Other Issues (SPD, PDD-NOS, ADHD, ASD, ACRONYM SOUP). Therefore: HOLY CRAP MY KID ISN’T BABBLING ENOUGH DOOM DOOM DOOM. Dude, I couldn’t tell you the exact babbling patterns of my “typical” kids, either, or what they were or were not doing at 11.5 months. My second son had words on the “early” side — maybe 12/13 months? (But horrible articulation, by the way, his vocabulary was too much for his mouth. I acted as his interpreter at lot.) My third was a very late talker, but caught up on his own by 28 months, after we enrolled him in a toddler program and around kids his age. Gestures and mimicking and sound acquisition were all over the damn map. There was no One Way It Happened; there was no Supposed To Be, By Now.

Because there’s “earlier is better” and then there’s…11 months. That’s  just….too early. I would personally be REALLY REALLY suspicious of anyone who tried to “officially” peg your son as delayed this young, or told you he needed expensive therapies and interventions. He’s a baby. He’s got his own pace. There’s a really, really wide range of “normal” and I implore you to please, stop worrying about this.

You’ve taken him multiple places. You’ve had him evaluated. (8 months expressive at 11 months is not really a “delay.” That is well within an expected range because it’s not an exact statistical science when you’re evaluating a BABY. You could probably evaluate him a dozen times and get a slightly different month result each time, depending on the therapist and your kid’s mood.) You admit you’re alone in your worries and suspicions AND that you have a history of diagnosing non-existent problems, only to be told by doctors that you’re wrong.

And yet you still can’t let this go. You are still clearly convinced he’s delayed despite no external support for your theory, you’re worrying about outcomes and special schools, and are basically asking me to tell you the “right” age at which you’re allowed to officially freak out over this thing you’ve diagnosed that — honestly — stems from some pretty odd expectations of what he “should” be doing. I mean…you’re worried that he’s not repeating “bingo” accurately enough? (What baby says “bingo”? What’s really so unusual about “Bghghg”? Raspberries are great! They work the oral motor skills he’ll need for later language! They are also very funny! Maybe he’s making up a game, or maybe he’s just annoyed at you constantly in his face trying to get him to say “bingo.” Blow a raspberry back at him and see if he repeats it. Look! He’s communicating! Raspberries count, I swear.)

And by the way, none of my boys said “mama” or “dada” with any purpose or frequency before their first birthday. NONE of them. Mama was probably one of the last words, and dadadadada was a stand-in for all kinds of things that were not actually Dada. They made sounds, and it was cute, and now I have three kids who never, ever shut the hell up.

Some kids babble early but talk late. Some kids babble late and then skip right to sentences. Some kids babble and talk late, and on and on the scenarios go. Boys often talk later than girls, and birth order can factor in as well. (A firstborn who isn’t around other peers his age a lot might talk later, especially if he’s the sole focus of his caregivers’ attention and doesn’t need to communicate needs to get them met. On the other hand, a child with older, verbal siblings might let them do all the talking…or might talk earlier in order to assert themselves and stand out from the pack.)

And yeah, some kids are speech delayed and need some speech therapy to catch up. IT’S STILL NOT A BIG DEAL. It can feel like it, of course, but…it’s not. There is nothing in your letter that — to me, who admittedly doesn’t know your son, but I assume you’re documenting your concerns accurately and not holding anything back — remotely suggests that you have any reason to worry about a speech delay right now. And even if there was something beyond him babbling kind of late and still simplistically (like a premature birth or illness or marked motor skill delays), I would still tell you to chill out for now, he’s so young and has so much time, just give the kid some time to develop at his own unique pace. There’s nothing he’s “supposed” to be doing right now other than growing up.  Enjoy him. And those funny little raspberries.