My 14 month old granddaughter doesn't talk, and she doesn't seem to understand.

Question

But she babbles a lot. She only seems interested in actions. She can wave bye-bye, but does not understand what it means. If you say "yay!" she will clap her hands and say "yay". So far, she does not recognize words as labels. Not even "mommy" or "daddy". She seems to hear fine. She will turn her head at the sound of her own name, if you are persistent enough. She does not raise her arms to be picked up. She will "dance" when she hears music. She does not ask for things, she does not point. She crawls fine, she takes steps holding on to furniture or toys. She screams and cries when she is hurt. Cries when she is tired or cranky.

I have no idea if it's related, but she has lots of teeth, like 12 teeth. And she chews on every thing. Her mother thinks she's teething, but she already has a mouth full of teeth (but not molars).

Is she behind developmentally?

Answer 1

First, I need to prerequisite my answer by saying that you should have your grandchild evaluated by a licensed Speech Language Pathologist. You can also discuss your concerns with your pediatrician and you may want to do that first because many insurance companies will not pay for a speech-language evaluation without a referral from the child's pediatrician.

Now to my opinion... I have two children, a 2 yo and a 4 yo and my wife is a Speech Pathologist. While she is really the best person to answer your question, from observing children in my wife's clinic and having recited several different development charts, 14 months is really too early to gauge a speech or language delay based on your characterization of her behavior.

As many people will tell you, children develop at vastly different rates. Our daughter developed language very quickly because her mom (the Speech Pathologist) was staying home with her. Our son, on the other hand, developed language much later because our attention was split between him and his sister. So, again, I would discuss your concerns with the child's pediatrician and / or consult with a Speech Language Pathologist. Insurance will typically cover an evaluation that will determine if your granddaughter has a significant delay when compared to a normal population her age. If the assessment does determine a significant delay then she may qualify for Speech Therapy covered by insurance.

You should also have her hearing checked by an Audiologist or Speech Pathologist. Either can perform a simple hearing test if they have the right equipment. Again, everything is smoother sailing with your insurance if you have a referral.

If you do not have insurance, I would check with your grandchild's preschool / daycare to see whether they offer free screenings. If you are in California you could also check with your local state funded early intervention center. They provide free screenings and therapy services for families without insurance or who's insurance has denied coverage.

I hope some of this was helpful.

Sincerely, John

Answer 2

This is a PDF that is widely used to screen babies for developmental delay. It is based on social behavior, fine motor skills, language, and gross motor skills. Open the chart, and put a sheet of paper at the 14 month notch from top to bottom. That way, if there are behaviors she does that you didn't mention which she ought to be able to do, you can identify them.**

Based only on what you've said (there is more to consider), I would say that she is not where she should be. Part of it could be explained by a hearing problem, but not all of it.

She should have a 15 month well-child visit scheduled (in the US, babies are seen at: 1 week, 1-, 2-, 4-, 6-, 9-, 12-, 15-, 18- and 24-months. If she doesn't have a visit scheduled, please encourage the parents to make an appointment with her primary care provider (PCP) within a month for an evaluation of her development. In the meantime, if the parents have not taken videos of her on a semi-regular basis, video-recording her eating, playing, babbling, listening to music, walking, etc., might come in handy.

If her PCP is unconcerned, ask for a second opinion.

In terms of development of communication (which includes pointing to things she wants, indicating that she's hungry, that she doesn't want something, etc.), a mother's feeling that something is not right is the most reliable source of information; the maternal grandmother's concerns are the second most reliable source. (Sorry, all you dads out there!) In other words, a doctor takes such concerns seriously, and unless their exam completely contradicts the source's concerns, tests are ordered, because if something is found, early intervention in delays is more beneficial than later intervention.

**_{Average is the white part of the rectangle. Behind but still within normal limits is the blue part of the rectangle. For example, you'll see that she should be standing alone for more than several seconds - not holding on to anything - by now.}

Answer 3

Every child has his or her own developmental pattern. My first, at 14 months, was exactly as you describe (except for the number of teeth). He's a junior in college now. My second started interacting with language and meaningful pointing around 12 months. My mother said I only spoke three words (no, Mommy, mine) until I turned two -- and I ended up quite talkative!

In my state, at least, you can contact the health department and ask for an early intervention evaluation. The child's doctor needs to sign off so it can take place. It is free.

Chewing on everything is fine.

Try reading simple picture books with her. I remember the amazing moment my slow-to-talk baby first pointed at something in a book we were reading, and I saw his little gears turning. What a thrill.

Your granddaughter is lucky to have such a devoted grandmother.