Pam and Todd W. admit to being slightly anxious: Their son, Christopher, is 17 months old and not yet talking. Oh, sure, he babbles a lot. But his noises are little more than vocal exercises, certainly not sounds you could confuse for words.
All around them, toddlers Chris' age have multiword vocabularies, some of them even two-word sentences: "Go out," "Go home," "Get cookie." All around them, there's hushed talk and the long faces of their worried friends and family.Pam and Todd aren't rushing out for evaluations, though. Chris is a happy, animated baby, the pediatrician reassures them his hearing is fine and his comprehension is good. Ask Chris where his nose is and he points accurately; ask him where your nose is and he grabs it with a grin. Tell him Mommy's coming home, and he toddles to the front door, babbling excitedly as he goes.
At this age, professionals commend a wait-and-see attitude.
"I tell parents not to wring their hands until 24 months," says speech language pathologist Nan Bernstein Ratner, an associate professor at the University of Maryland who studies children's language development and whose son, Adam, now 9, didn't speak any words until he was 2 1/2.
If your child is not babbling by 8 months, an evaluation for deafness is in order, says Naomi Baron, a professor at American University, in Washington, D.C., who studies language development. Beyond that, as long as you eliminate the serious things that might be wrong - mental retardation, for instance - and as long as there is comprehension and sociability, not talking at 17 months or even at 20 months is not as big a deal as parents often fear.
By 2, however, if your child doesn't have a vocabulary of about 50 words and doesn't put them into simple sentences, it's reasonable to begin to ask why.
Answers may not be easy to come by.
"There's a Catch 22," says Baron. "If there is a serious problem in language delay, you should begin intervention early. Given the variability among children at 2, however, it's hard to know if there really is a problem."
There are a number of reasons why an otherwise normally developing child might not talk, from extreme shyness to slow physiological development that makes articulation difficult. Ruling out these possibilities requires an evaluation, optional at age 2 but mandatory, say Baron and Ratner, if a child isn't talking by 3. They recommend a licensed speech language therapist, and they advise getting several opinions.
There's no guarantee therapy will help, but as long as it doesn't seem to be harmful - your child doesn't throw a tantrum when it's time to go, doesn't withdraw as soon as she's there and isn't sick afterward - it may do some good, says Ratner.
Indeed, the benefit may be secondary. "If it makes you feel you are doing all you can for the child's well-being, you'll be more relaxed, the child will be under less subliminal stress and thus freer to develop at his own rate," says Baron.
Sometimes time is the best antidote. "When everything has been ruled out, just wait. It will happen," says psychologist Ann McCabe of Windsor University, in Ontario. McCabe studies differences in children's language acquisition, including developmental delays.
As Pam and Todd W. are discovering, waiting is hard. "Some parents' biggest frustrations don't come from the child," says McCabe. "You need to put at bay the demands and questions of the people around you."
Patience begins to wear thin when a child still isn't talking at 3. Of the 10 percent of young children with language difficulty, for 3 percent of them, there is no obvious reason why. Economist and social critic Thomas Sowell's son was one of these late-talkers.
John Sowell, now a 32-year-old computer programmer, spoke his first words at about age 3. They were few and far between. "Wah-ee" was for a body of a water, a lake or a pond, but he had no word for a glass of water, or bath water. When the weather forecaster on the "Today" show talked about weather west of the Rockies, John would cry out, "rocky!"
About nine months later, he put three words together: "Down the drain."
Sowell had already determined his son's intelligence. When John was 3, he scattered the pieces of his father's chess set on the floor. When Sowell told him to put them back, John put all 32 pieces back exactly where they belonged on the board.
Years later, Sowell came to interview 44 other families with 46 children who talked as late or later than John (the average age at which they talked was 4), and wrote a book as a result, "Late-Talking Children" (Basic Books). This small subset of children for whom deafness and medical issues have been ruled out share unusual characteristics: They are above average in intelligence; have a high level of comprehension; are musically inclined and/or have family members who are; have some close family relative in an analytic profession, such as engineering, math or science; and are late to toilet train. Eighty-seven percent of them are boys.
Based on his interviews with these parents, Sowell advises staying away from evaluations performed by the public school systems. "They have a conflict of interest," he says. "They have all these special ed programs in place, and they need the bodies to keep them going. Once a child gets labeled and placed in a program, it's hard to retrieve him."
He also tells parents not to "teach" a child to talk. "I used to sit my son down and say, `John, say this, say that.' He couldn't care less, but I would get very upset." It wasn't until Sowell backed off and simply spent enjoyable time with his son that John finally began to produce words.
Indeed, talking to your child is one of the most important things you can do. "If your child isn't talking to you, it's very tempting not to talk to him," says Baron. "Whatever you do, don't stop the stream of language."
McCabe encourages parents to establish alternative means of communication, including gesturing, sign language and a trial-and-error technique: "Is it the juice you want? No? How about the apple?" Support and sympathy are helpful, too, especially when a child gets frustrated: "I can see you're having a hard time trying to tell me something; I'm trying to help you."
"A loving tone goes a long way," says McCabe.
The older a non-talker gets, the more important it is to not pressure him. "You encourage when you ask a question and give time to respond; these kids may need more time than we realize to organize a response," says McCabe. "You pressure when you repeat, repeat the question, then get annoyed or stomp away."
When a child isn't talking by 4 and intervention hasn't helped, Sowell worries about the psychological impact on a child. "At this age, kids are very social creatures. Not talking can be a social deficit. Don't stay with a situation that's a disaster," he says, whether it's a classroom with an impatient teacher and kids who tease or a therapist whose waiting room is full of kids who are worse off than your child. "That alone can overwhelm," Sowell says.
Keeping your concern from your child is important, too. Baron says if a child knows he's a source of disappointment, it can become a self-fulfilling prophecy. "He thinks he can't talk well, that he'll only disappoint, so doesn't try."
Sowell says, "Let your child know you think he is the most wonderful boy in the whole world."
- Boys are more likely to talk late than girls.
- Signs of a good speech language therapist: She lets the child set the pace; she doesn't expect him to sit still for three hours at a time; she doesn't insist on separating him from you; she doesn't insist on knowing someone else's diagnosis.
- Don't panic if doctors suggest an evaluation for autism or cognitive impairment. Part of what they need to do is rule things out.
- Once a child is talking a little, repeat his thought and expand on it. If he says, "We go," you might say: "That's right! You're going to the store with me. We will go together."
- Research shows that late- or early-talking does not predict future academic or professional success. Indeed, late talkers are often very successful; Einstein didn't talk until he was 6.
- Encourage siblings not to do a child's talking for him.
- Late-talking is often genetic.