The Late Talker
When is late talking simply a matter of temperament and not a symptom of a neurological or learning disorder?
Milestones and Influences
Talk shows. Radios. Cell phones. Everywhere we go, we see evidence of the value we place on the spoken word. We equate verbal eloquence with intelligence or success. Little wonder, then, that we parents are so eager to have our children achieve—or exceed—the standard milestones for speaking. Missing those milestones has become a signal for worry and an indicator of other more fundamental problems.
Yet Einstein was a late talker, and so were many notable scientists, engineers, economists, columnists—and possibly even the person who helped you the last time your computer wouldn’t go online. When is late talking simply a matter of temperament and not a symptom of a neurological or learning disorder?
In general, most children follow this path to speech:
- Cooing and babbling socially (in response to your vocalizations) around age two months
- Some “syllables” (la-la, abu, nanana) around age six months
- One word utterances (mama, dada) by age one
- Two word sentences by age two: “Cookie allgone!” (bye-bye, allgone are considered one-word utterances in this case)
- Three or more word sentences by age three
- Adult style speech by age four, with some allowance for grammar and pronunciation. “Wascally wabbit!” or “Him and me played.”
As with all developmental milestones, children reach them at varied rate. Some talk at 10 months, others may wait another six. Likewise, genetic and environmental factors may come into play. A history of “naturally” late talkers in the family who “grew out of it” is one example. Children growing up in bilingual homes may need more time to process the different vocabularies and grammars—but when they do, what an advantage!
Some parents of late talkers say their children were simply less motivated toward early speech; they had older siblings ready to anticipate their needs and speak for them. However, these children are most likely inclined towards waiting; otherwise the youngest child would always be the late talker.
Sometimes, learning style plays a part. Stephen Camarata, a speech-language pathologist with over 20 years’ experience working with late talkers, said that he’s seen children who are more prone to perfectionism wait until they can enunciate and speak at an adult level—something they simply cannot do in the toddler years. Others may put speech aside while learning something new.
Laila Bernhartsen’s son suddenly stopped babbling at eight months; neurological tests showed he was doing fine except in the area of speech. He did “o.k.” at therapy, but months later, surprised his mom by correctly identifying every letter in the alphabet, even flipping M to make W. “It became apparent that he also was able to read. His therapist later told me it is not really unusual for boys (especially) to learn one thing at a time, and when they discover that they can move, manipulate their environment, or any new skill, they put others (esp. speech) aside,” she said.
Red Flags: When Speech Indicates a Problem
“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.
The first step in assessment is to see your pediatrician and rule out physical problems like deafness. Next, you may need to take your child to be assessed by someone qualified in language disorders. Camarata cautions parents to be sure they find someone very skilled at assessment. Such a person should be familiar with the different disorders associated with late talking and differentiate between them. Camarata specifically urges parents to beware the assessor who gives each patient the same diagnosis. A specialist should also be able to discern when a certain behavior is a coping mechanism or a sign of frustration by a child unable or unwilling to communicate with a stranger, and when it’s the symptom of bona-fide autism, for example, or when language intervention may be needed before a more accurate diagnosis can be made.
Parents should take an active part in the process. You know your children best; you see things in day-to-day activity in many environments and situations that an assessor will not in a few hours, often in an unfamiliar environment. Bring your observations and concerns to your doctor. Ask questions; voice objections. If you do not agree with a diagnosis, and if the doctor or therapist cannot explain herself to your satisfaction, get a second or even third opinion. Do some research yourself, contact other families of late talkers, and meet families with kids who may share the same problems as your child.
The most important thing you can do for your late-talking child, be he autistic or the next Albert Einstein, is to simply love him and appreciate his uniqueness, beauty—and brains. Late talkers often have average or higher intelligence; they just express it differently.
“Remember, too, that you did not cause (late talking). Do not feel guilty or so nervous that you forget to enjoy your child,” said Camarata, who is also the father of seven, one of whom was a late talker. “Don’t get caught up in a label or a diagnosis. Children are full of wonder. Play with them. Talk with them. Be sure to have fun.”
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