Should we see a Speech Development Specialist?

Question

My child is 2.9 years old. He is very active and restless. He understands everything but can't respond with even a word. He can say just 1 or two words, such as water, car, toy, give me, etc. After pushing a lot, he may say something if he wants to. He spends the whole day watching cartoons on TV. In fact, he has stopped saying the the words he used to say as he prefers action language rather than talking. Should we take him to a specialist for speech therapy?

Answer 1

Turn off the TV!

Sorry for shouting, but a toddler should not watch much television, and certainly not "all day" as you state! Our user dave posted this very related answer:

The American Academy of Pediatrics have [warned] "that parents should limit the amount of time their infants and toddlers spend in front of any sort of screen and reaffirmed earlier research showing that there’s really no such thing as educational TV or software for very young children," according to this article.

It's no wonder that he doesn't want to talk - you're training him to be a media consumer rather than an independent individual.

Our user Rory has another great related answer: you should be his entertainment, not the TV. That page has even more good answers you should look at.

By letting him watch TV all day, you are overloading his brain (because small children cannot mentally process so much media). That might also be a reason why he is so restless. By letting him do this instead of playing with toys, you are hindering his creativity and independence. He needs to learn that he can find an outlet for his energy and restlessness by doing things himself — in a sense being a producer (of creative stuff) rather than a consumer (of TV).

If he's been good during the day, you may want to reward it with five minutes of TV as part of his regular bedtime routine, but make sure to show him something that is low-tempo and age-appropriate. For instance, most Disney movies, and shows on TV channels like Cartoon Network, are not age-appropriate to a toddler! An example of good toddler material would be one 5-minute episode of Barbapapa or similar — there's a reason why these episodes are so short and (to an adult) rather boring. That's age-appropriate.

Update: Should you take him to a specialist for speech therapy? Depends.

• I don't think you must because if you turn off the telly and start him playing then he might surprise you will good skills that he just kept hidden because he didn't needed or wanted to use them.
• I think you should go to a specialist after two or three weeks if things haven't improved noticeably.

Answer 2

Yes, you should take him to specialist for speech therapy.

Or, rather, take him to a specialist who can determine what may (or may not) be the issue and if speech therapy is the next step.

Also, maybe lay off the cartoons for a bit. That much TV for a developing mind isn't a good thing.

Answer 3

In addition to turning off the TV, and possibly checking in with a specialist if things don't get better pretty quickly, it will likely make a huge difference if you increase your verbal interactions with him (something TV watching usually stifles). Since turning off the TV is likely to create a situation where all of a sudden he doesn't know what to do with himself, you'll have to start "entertaining" while also getting stuff done. It may not feel like it, but this is a good thing.

Things to do with him that Increase Your Verbal Interactions:

• Let him help you in the kitchen. If you separate the knives out before hand, he can help wash dishes that are lightweight and easy to maneuver. While you wash together, talk about what you are washing, the soap bubbles, what the water feels like, the motions used in washing and drying. . . what you will do next, what he had fun doing earlier . . . You can also have him help with cooking and baking. He can help you measure ingredients by scooping numbers of Tbs, or Cups into your measuring utensils (or SI units), he can use a butterknife to slice bananas, he can do the stirring, mixing or folding. Talk to him about what he is doing while you do it. "Teach" him the steps and honor his contribution. Kneading dough (if you occasionally make your own) can keep kids busy for long periods of time, it supplies them with a surprising amount of sensory stimulation. While he kneads the dough, you can slice and dice, fry and saute and talk to him about everything you are doing. Most occasions, you may not be baking bread, but play dough works too.
• Have him help with household chores. Just give him a duster and let him "dust" while you clean up a room. Talk about each item you pick up to put away, talk about what he is watching out for and being careful about while he dusts, ask him if he thinks he missed any spots. . . You can do the same with washing mirrors and windows and he can even imitate you vacuuming with a toy if you encourage it (though vacuuming isn't as great an opportunity for the verbal stuff).
• Engage in touch sensory activities. Touch Sensory activities are really about scooping and pouring, playing and molding, and generally experiencing substances and their interactions on a macro scale. Playing with dough is actually one. Here is an article with ideas for "wet sensory" activities, ideas for dry sensory activities (both from my website), and another article with ideas for using sensory activities to encourage using description (though it is aimed at older kids). There are a lot of great "wet" activities too and you can find recipes for making Gak, Ooblek, and all sorts of fun things, but these tend to be messy so they often only get used occasionally. Finger painting falls into this category as well. These activities seem pretty lame to us adults, but are soothing for kids and encourage discussion about sensations. Talk about sounds the particles make as they move, how the sounds change if poured from a higher point as compared to close to the bin, how it feels for the sensory item to move across skin, temperature of the particles, rough or smooth. . .
• Go on walks together. Even if it is a short walk around the block, there are lots of opportunity for verbal interaction. "Oooh do you see the line of ants?" "Wow look at all the different leaves" (you can look at color in the fall, but don't forget about shape all year round). You can go on a "number hunt" and learn about the addresses on your house, your neighbor's houses, the mailboxes, streets. . . The weather is a great thing to discuss. "Hmm. Its a bit chilly today, good thing we put on our jackets. Oh the weather seems to be getting warmer as spring sets in."
• The obvious: Play games (particularly rhyming and alliteration games), sing songs, read books together (and then read them again and again) etc.
• Finally, include "quiet time". This one is probably counter-intuitive, but at some point in the day, insist on a short "quiet period of time." You can still be in the same room together, and he can still be playing - but playing quietly. Even rolling cars around on the floor can constitute quiet time. Sensory activities are also good for this, but encouraging him to look through some of his favorite picture books can also be an option. Quiet time is exactly as it sounds. Time when there are not other noises. You don't say anything, no stereo, no TV, just quiet. Since is small, he will make noises - as long as it is coming from him and is not yelling, its fine. He can make them. Having such time allows the child's brain a chance to process all the information it has taken in so it is ready for more later. A good time for this is right after lunch and just before nap (if he still takes one - which I also recommend). If he isn't used to quiet time, you'll want to start very small (five minutes) and slowly make quiet time last longer.

While these activities will increase your verbal interaction with him, there is still one more piece of advice I have for you. He's old enough, and it sounds like you know he is both physically and mentally capable of more than he is doing now. Because of that fact, don't accept "half speak."

If he says, "Give me!"
You say, "Oh, what did you want me to give you?"
When he then responds with, "Ball!"
You say, "Oh, so you meant, 'give me the ball please?'"

Then, after about a week of this kind of exchange has occurred, require him to say the entire statement (or at least attempt it) before he gets the ball.
"Give Me!"
"I don't understand. Give you what?" (even if its obvious what he wants).
"Ball"
"Oh. Yes. I see. How do you ask nicely?"
"Give Ball Please?" Then, hand over the ball.

I wouldn't recommend this part normally, but it sounds as though there is some back-sliding that is needing remedy and this kind of an attitude about it will help. Of course, this part may not apply if there really is some sort of physical or developmental delay in addition to the TV problem - that is what a specialist is for determining.

On the rare occasion that you do watch TV with your child. Treat it more like a book. Sit together and watch something "age appropriate" and designed for toddlers. Pause the video frequently and speak with your child about what just happened or what you are seeing. Ask him to describe what he sees, likes or doesn't like about what he just saw. As he gets older (and the shows become more complex) you can also ask for "predictions" "What will Pokoyo do next?" - "Will the butterfly go away if he makes noise?". . . (Pokoyo may be a good one for you to check out now as a TV option for your child actually). In the linked example, a good question might be, "How does the narrator know Pato wants to be the postman?" Just before he takes off to take Ellie the post. (He could also predict when the narrator asks questions (that is the whole point of having those bits in the program). It is translated in many languages by the way. Even interactions like this should be limited, but occasional TV viewing is okay if it is an interactive experience for your child - that means you have to be there and talking about it together while you watch.