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I have a 17-month-old who isn't talking yet. Our pediatrician says that if he isn't talking by 18 months then they'll do a hearing test. But that can't possibly be the problem since we know he understands us, in fact a month ago we went through the words that we absolutely know that he understands and we stopped counting at a hundred. We know he can hear and we know that he understands a lot. But he's not calling us mommy and daddy. He vocalizes a lot and can repeat what we say pretty well, so if we say "mommy" he'll do a pretty good job of that, and things that start with "d" he can create a pretty creative vocalization of a word that starts with a "d", sometimes accidentally getting the exact word right. But, that's not "talking", right?

My wife and I have been assuming that to talk means to use the words to communicate instead of pointing, grunting, or using the his small subset of sign language. What do the books mean when they say "can say a few words"? What do doctors mean? And how did you define this milestone?

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4 Answers

According to this article, by the time your child is 18 months old, he/she should have a vocabulary of about 20 words, and a vocabulary of 50 words by the time he/she is 2.

However....

THIS article from the Mayo Clinic says that, really, by the end of 18 months (so closer to 19 months, really) your child may only say 8-10 words and that this is considered normal as well.

It's also possible that your son is starting to use words, but you just don't understand them yet. It can take awhile for a child's speech to really catch up and be clear enough for even his parents to understand. Some letters are just classically difficult for children to pronounce so your son might be attempting to speak but is merely misunderstood because of his perfectly natural inability to make the "L" sound or the "th" sound.

This article on the what to expect website points out that children who are from bilingual homes tend to be late-talkers, but quickly catch up once they begin and become fluent in both languages. This same article seems to suggest that if your child can understand what is being spoken and respond to it, then expressive language is probably right around the corner.

Having said that, I can tell you that one of my nephews was a child who understood perfectly, but didn't speak. His parents got him involved with a specialist and his language skills progressed dramatically! He's 5 now and you would never guess that he'd ever needed to see a specialist.

I think, for now, I'd focus on what they tell all parents to focus on:

  1. No baby talk.
  2. Talk to your child all the time. Narrate your day, talk about what you're doing, etc.
  3. Encourage your child to say words and applaud attempts to say words even if there's a gross mispronunciation.
  4. Read to your child.
  5. Ask your child questions that require more than a yes or no answer. Like, "Henry, do you want the blue car or the red car?".
  6. Stretch the truth (from the What to Expect website): Repeat your child’s words and expand on them. If he replies “App-uh!” to your remark about slicing one, answer “Yes, this is an apple! We’re going to eat this shiny red apple for lunch.” Add those adjectives!

For the record, it sounds like your son is right on the cusp of talking, but the precursor to using words for communication is repeating those words. There's a lot that's involved in talking...muscles that have to coordinate to make the right sound, the understanding that objects have names, and the realization that using the right word can get you something. If he's still only repeating words by his next doctor's appointment, I would simply explicitly tell the doctor: He will repeat words that we say, but he isn't using words for the purpose of communication yet, then see what the doctor says.

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+1 Very informational. –  Mechaflash Oct 5 '12 at 17:24
    
All babies/toddlers are different - it's understandable to be concerned, but if your child is making talking 'noises' and then they are on their way. My son is almost two and he speaks in sentences - (he makes his own grammar up sometimes, like 'Make it, the milk daddy, please'!), but we also have a daughter who at that age wasn't really saying much at all. I wouldn't worry too much until it becomes clear that your child isn't communicating properly - which doesn't sound like it's the case –  Charleh Oct 12 '12 at 22:04
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We though our son could hear perfectly too. We could communicate effectively with him, he seemed to hear us from across the room and seemed to have no problems. When he started childcare, we found that he did not learn as much as we'd expected from the group environment and would often ignore the kindergarten teachers.

By chance, a doctor mentioned to us that his breathing sounds strained. Upon inspection, she said his tonsils were over sized and referred us to a specialist. When the tonsils of over sized, the adenoids are often large as well. This can cut off access to the Eustachian tube. Over time, the ears fill with liquid. Our son was found to be essentially deaf below 30db. One-on-one he was fine but he had troubles in a group environment.

We had his tonsils and adenoids removed, his ears drained and had gromits inserted into his eardrums. Since then, his vocabulary, learning and cooperation has improved enormously.

Based on my experience, it is worth a hearing test. Find a place that deals with infants as it is a specialised skill.

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We have twins. They are bilingual/trilingual. One verbal and one much less verbal.

The verbal twin could say lots of words at 13 months (including vocalizing animal sounds) and at 17 months could do 2-3 word sentences. The non-verbal twin at around 17 months could probably manage mamma and pappa, and vocalized something in what we used to call "martian" language. They are about to turn 24 months, and the non-verbal kid can do a small number of separate words, and sometimes 2 word combinations ("åka bil" which is Swedish for "ride car"). He only does it for things he really cares about (i.e. riding a car).

As with your kids, he seems to understand as much as the other twin, but can't be bothered to talk most of the time (would nod instead of talking, say). At the same time, he's better in fine motor function and seems to be better at self-play and concentrating on one thing at a time. It was indicated to us by just about everyone (including doctors) that this is still within natural variation.

That said, if I were you, I'd do a hearing test anyway, because it can't hurt, and you can rest easy that's not an issue then.

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Cognitively speaking, a word is an utterance that a child connects to a concept or a situation. What's important is that the child uses this utterance only for the one object/situation (so, if everybody is 'mama', as well as all the toys and one of the pets, it's not yet a word), and that the utterance is consistently uttered in said situation (mama can't be called other names some of the time). The utterance doesn't have to conform to what other people would say for the same thing (i.e. the word doesn't have to be real).

That being said, the medical standards on how many words a child can say are based on what the parents claim, meaning that the definition is much more loose :) I would expect that parents usually consider something to be a word if it's an utterance that's used correctly some of the time (so, 'mama' is a word even if she sometimes gets called 'papa), or even if it's an utterance that the child never uses spontaneously in a situation, but will repeat correctly upon hearing.

Correct signs and gestures are really very close to spoken language, cognitively speaking. They require that a concept is connected to a symbol, which is a big cognitive feat. If it's a gesture, the symbol is motoric, if it's a word, the symbol is spoken. From your description, it looks like your kid is just about to begin speaking.

My own son is 18 months old and he shows a whole range of verbal abilities that might or might not be words, from only repeating a thing once he hears us saying it (with no real understanding), to pointing to the fridge and shouting 'yogurt!', with a clear intention in mind and the desired object out of view. He said his first few words about a month ago. Before that, he had a clear gesture for 'no' for several months, as well as sounds that went with 'I want' and a few more like 'pick me up'. Now, he seems to pick up a new word every two days on average.

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