The Late Talker

"Based on studies in the literature, 50 to 60 percent of late talkers 'recover' without treatment," noted Camarata. However, late speech can indicate a variety of neurological or developmental problems such as autism, verbal apraxia, deafness and other learning disabilities. If your child is delayed in his speech development, especially if by more than a couple of months, or if he drops a speech skill he'd gained, you should keep a close watch for other risk factors such as:

• Overall developmental delays: in fine motor skills (picking up things, scribbling), gross motor skills (walking), intellectual (recognizes person or object, follows directions)
• Does not gesture or point by a year
• Lack of social interaction: making eye contact, imitating sounds or actions, attempting to communicate nonverbally, demonstrating that she knows the difference between people and objects, playing creatively or symbolically (rocking the baby doll, driving cars to the store, making dinosaurs fight)
• Uses only vowels, or does not use a variety of consonant/vowel combinations (la-da, abunana) by 8 months; has no single words by 16 months
• Stereotypical behavior: spinning objects, flapping hands, or obsessive behaviors like lining up cars or crayons but not playing with them
• Tries to speak, but cannot and is frustrated at his attempts
• Does not seem to understand what you're saying when you do not provide nonverbal cues (asking if he wants more food without showing it to him, for example)
• Does not hear you unless you are in front of him; is scared of loud noises
• Your own instincts tell you something is not right

If your child is showing one or more of these signs, have him or her assessed. "The 'worst' that can happen is that your child doesn't have a problem, and the doctor will tell you," said Dr. Marilyn Agin, a neurodevelopmental pediatrician and co-author of The Late Talker: What to Do if Your Child Isn't Talking Yet. If your child does have a problem, catching it in the years before age three when the brain's plasticity is highest increases the chance of overcoming the problem. Agin said this is especially important for verbal apraxia, a motor planning disorder that hinders a child's ability to put sounds and words together.