Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Only Speaking Ten Words at Two Years | | | QUESTION | | | Dear Dr. Needlman,
My grandson is 27 months old. He only has a vocabulary of 10 to 12 words. He understands instructions and other things you tell him to do. So I do not believe he has a hearing problem.
Is there anything to be concerned about? His mother was on an anxiety/panic medication when she was pregnant with him. Would that possibly have an impact on his not talking much?
Any other suggestions that I can provide to mom and dad to help him start talking?— Concerned Grandma | | | ANSWER |
May 9, 2001 | | | Dear Concerned Grandma,
Anytime a child isn't developing along the expected timeline, it's a cause for worry. You can be reassured that most children who are slow to begin saying words and sentences, but who seem to understand well, do learn to speak eventually. Even so, some (but not all) of these children have some minor speech problems that only a speech pathologist would normally detect, and (more importantly) some (but not all) have difficulty learning to read in school.
As a rule, I recommend that any two-year-old child who is not speaking "on schedule" should have a thorough developmental assessment, including formal hearing examination. Some children with significant hearing impairment become very skilled at reading an adult's body language, and appearing to understand what's being said to them. The only way to know for sure is hearing testing by an audiologist who has experience examining children. Any children's hospital will have at least one of these professionals on staff. Your grandchild's doctor can make a referral. You really want to know if your grandson has a hearing problem, because hearing aids can make a world of difference.
What else can you--or the parents--do? A developmental examination can help rule out problems in cognitive or social development that sometimes cause delayed speaking. In some cases, evaluation and therapy by a speech-language pathologist can help, both in supporting a child's learning to talk, and giving his parents coaching about how they can best stimulate language development. In other cases, a speech pathologist will decide to wait and monitor a child's development; many do catch up on their own without intervention.
Finally, I don't think you need to worry that medication taken during pregnancy would have caused this problem. The medications most often used to treat depression and anxiety have not been found to cause significant birth defects or language delays. You can also reassure your daughter (or daughter-in-law) that her parenting style is not likely to be the cause of the speech delay. Very often, one child in a family shows a delay like the one you are describing, but the other children (who are raised very similarly) don't. Genetics seems to play a role, and in some cases you can find a family history of late talking, if you look for it.— by Robert Needlman, M.D., F.A.A.P. |
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