WWYD? Nearly two year old not talking, no words, barely any sounds, not understanding speech

[HarumScarum]

Hi there. I am asking this question on behalf of someone else. But they don't know I am asking. I'm worried because they aren't worried, ISWIM.

In brief, my SIL has a baby of very nearly two years old. He has never made many sounds and most of those that I remember from him have been high-pitched squeals or guttural croaking. No vowels, no consonants, no babbling at all. About 6 months ago, he was diagnosed with glue ear and was fitted with grommets around two months ago. There has been no improvement in his speech at all. But I know a lot of children take longer to talk and this on its own wouldn't really concern me that much. The thing that really worries me, apart from the lack of babbling and sound production is that he appears to have very little understanding of what is said to him. He cannot follow any type of instruction, like show me your toy or point to grandma or similar.

I'm really worried about him and have tried to talk to SIL and MIL to suggest that he may need some help but they don't seem to understand what I mean. They insist that he can understand everything that's said to him and interpret the fact that when you ask him where someone is and he looks randomly around and the questioner reacts with delight when he happens to scan the correct person as evidence that he understands what's going on. I really really think there is a problem of some kind. You can ask him anything at all and he looks randomly around the room and waits until approval is shown before fixing on the 'answer', if that makes any sense at all. So he understands social cues (he's very smiley and likes to wave at people) but he doesn't seem to understand speech, not even if he is looking directly at you while you talk to him. I don't think he understands when you say his name.

Can anyone give me any pointers as to how I should handle this and should I just butt out? I am just worried as I feel that he does need some help and the earlier this could happen the better. I have a child of my own and do understand how worrying any idea that your baby may have a problem could be.

Or alternatively, is this normal for this age? It doesn't seem normal in my experience (lots of younger brothers and sisters and cousins as well as my own child) but perhaps my experience is too limited?

Sorry, said I'd be brief but that's a bloody essay!

[Parietal]

Your description sounds like a hearing issue, but if he has grommets, I assume a hearing test was done at he same time. Does he respond to a loud bang noise by looking around?

Otherwise, there may not be much you can do. Just support SIL if he does realise something might be different.

[duchesse]

Golly, that sounds quite significantly delayed. The most important thing to rule out would be hearing loss beyond mere glue ear. It sounds to me like he could have major hearing loss- if he is communicative enough to check the adult questioner for signs that he's got it right then that might rule out things like an ASD. Regardless of what is causing it however, it is severely impacting on him and they MUST address it. Can you casually drop into conversation an innocent little question about whether they've had his hearing checked recently, then sit back and let the question take effect?

[duchesse]

I disagree with you Parietal- if he has severe hearing loss his language development could be affected for ever- SIL has got to deal with it. I think maybe you need to be plainer with them and say you think there is a problem and think they need to take him for a hearing test. As he is your nephew I think it's fair to be at least slightly invested in his well-being. (In fact I think we should all be invested in the wellbeing of all the children we come across, but that a whole other debate). Even if your input is not welcomed by SIL, you might be doing nephew a big favour.

[HarumScarum]

No, he doesn't respond to eg clapping just behind him or similar. I do think he has a hearing issue but thought the grommets would sort this out. The hearing test was done and he was found to have some hearing loss (not sure of exact details as it is hard to discuss it when SIL seems to think there is nothing wrong) but this was put down to glue ear at the time. As I say, he hasn't ever made any vowel or consonant sounds, not even as random baby babbling.

I wondered if any parents whose children have had similar issues might have some advice as to how I could approach this sensitively with SIL? She is lovely and we get on well but my (genuinely) gentle hints don't seem to strike any kind of chord with her. As I say, it's the receptive language issue that seems a bigger concern at this age than being able to produce language himself, especially given his glue ear and grommets. From what I have read, it seems that most children with glue ear do have a reasonable grasp of what is said to them even if delayed a little, particularly if they can see the speaker talking to them and perhaps use supplementary lipreading to help any hearing loss.

[HarumScarum]

Sorry cross posts. Thanks, duchesse, I think you feel the same as I do about his potential issues.

if he has severe hearing loss his language development could be affected for ever

This is my worry! I am so worried that he may be falling further and further behind while they do nothing. I realise that some people just are deaf and, you know, I wouldn't mind learning sign language if that's what it takes. But if you don't get language input as a young child, I think it could severely affect your later language capability whether spoken or not.

[HarumScarum]

OK, I need to be brave and say something very plain about it, then. Gulp. Thanks. I think that's what I needed to hear. It is what I thought I would have to do. DH tried to talk to her about it at my instigation but she just kind of brushed him off.

[BoulevardOfBrokenSleep]

Ds' speech was 'severely delayed' - he had basically no words at all aged 2. But the 2yo health check is where they pick up on these things and the system starts to flag up problems... if they still have a 2 year health check in your area?

We were referred on for hearing tests and speech therapy; there is nothing specifically wrong with DS AFAIK, and he is now catching up with speech. Slowly.

But really, this does sound like a hearing issue doesn't it? Hmm. I am not very head-in-the-sand about these things and was very keen to pursue all avenues so not really the point of view you're looking for...

...however, we did get referred for the hearing tests through a drop-in speech therapy service at the local children's centre. Definitely worth checking if yours has such a thing, do you think your SIL could be persuaded to talk to a speech therapist?
Even if you just phrased it as 'getting ahead of the queue in case he has problems later' maybe? Because I think a professional will pick up on the hearing issues pretty quickly, if you can get her into contact with one.

[HarumScarum]

Thanks very much. We're not in the same area, but maybe I could find out if there is something like that in her area and point her at it quite strongly.

May I ask if your son had any consonant or vowel sounds at this age? Could he actually make normal speech sounds even if not as part of words? And could he understand what was said to him?

[HarumScarum]

I am not very head-in-the-sand about these things and was very keen to pursue all avenues

See, this is what I'd be like. So I find it hard to understand why she won't do anything about it. Honestly, I'd be beating down the doors of whatever healthcare was available to find something to help if it was my child. I suppose I just need to be really forthright and say 'this is really worrying and you need to do something and would you like me to help you find out what to do' or similar.

[starfishmummy]

Sounds like a hearing thing to me. Has there been a follow up since the grommets? Ds had checks/hearing tests for a couple of years afterwards
Also grommets don't always work or can fall out very quickly (ds's was out by his 6 week check).

[HarumScarum]

No, I don't think there has been a follow up. I will ask when I see her next. Thank you. I really appreciate the input from anyone who has had any kind of similar issues.

[Want2bSupermum]

You need to have a speech assessment. Here in the US our state has an early intervention program if the paediatrician recognizes a problem in speech delay.

I have just been through this and was very lucky that my Aunt is a speech therapist and recognised a hearing problem with DD. We had tubes put in when she was 18 months and now at 26 months she is 'talking' in a babble. I got her talking based on exercises given to me by my speech therapist aunt and the therapist assigned to us through the early intervention program here in NJ.

I will add that I was quite ambivalent about my DD's lack of speech progression until my Aunt told me to get on it because the effects can take much longer than you think for the child to get over.

[HarumScarum]

Thanks. How significantly delayed was your daughter's speech and was she able to understand any of what was said to her before the grommets or shortly afterwards?

[HarumScarum]

Bumping for the morning lot, just in case.

[CoteDAzur]

Does he point? Ex: when he wants something or when he wants to draw someone's attention to a toy.

[HarumScarum]

Yes, he points.

[HarumScarum]

He also gestures to be picked up etc and smiles at positive attention and waves hello and goodbye.

[GerardButlersSecretLover]

I have experience of a child with a hearing loss and this sounds very similar. I am assuming the child's hearing was tested at birth? You must say something or this child is going to be even more delayed if the parents bury their head in the sand!

[girliefriend]

My dd had quite severe glue ear at that age but could still make some sounds, her speech was delayed and she still struggles with some sounds now age 7yo. If he has had grommits he will be under the care of an ent consultant so should be getting regular hearing tests.

It sounds positive that he is otherwise sociable.

Your sil just needs to take him to g.p and mention that he still doesn't seem to be hearing all that well, he can then be seen by the ent team asap.

[DeWe]

Grommets can come out very quickly. I know one person whose child woke up the next morning to find one on the pillow.
Ds has had grommets (both ears) twice. The first time they stayed nearly 18 months, the second time one came out after 5-6 months (we could see it sitting in the ear canal) and the other was about a year.

When he's had grommets we've noticed an improvement very quickly though.
Did they do a 6 week follow up appointment to check his hearing with grommets in? If they didn't then request a hearing test now. It could be he has hearing problems which have been masked by assuming it was glue ear.

But it could be other things here. In some ways I'd wonder about there being more of a processing disorder. Because with Ds he'd actually taught himself to lip read, and ENT said that children are very adaptable to hide hearing issues and find ways round it.
It could be that he is able to make himself understood so well without speaking, he doesn't need to (I had a cousin like that, and the parents had to spend a month pretending they didn't understand his gestures to get him to speak. At the end of a month he'd caught up with all his peers in language-he was nearly 4yo)

But if your sil is not worried, then I don't think there's anything you can/should be doing. It may be that he is shy and just won't perform round others-so she knows that he obeys instructions. She may also have him on a waiting list for checks and doesn't want to discuss it with you (or others). I don't think you saying you're worried will do anything other than get them to dig their heels in.

[HarumScarum]

Thank you. Yes, I am going to say something. I haven't said nothing so far, honestly. I did ask SIL and MIL if they thought he could hear all right (this was before diagnosis of glue ear) and they thought he could but were obviously proved wrong later. Have also mentioned since the operation that I am worried about his hearing and understanding but all I get back is 'oh, X is all right, he's just taking a bit longer' and it's very hard to persist when people are trying not to listen or genuinely unconcerned. DH also pointed out that our nephew is not at all the same as babies we have known at this age, in terms of attempts to speak etc and asked if they're going to see anyone about it with absolutely no result. We are trying. I am going to say something MUCH stronger next time I see SIL, who I think will be more receptive than MIL who thinks I am criticising her perfect grandchild, I think.

I suppose he must have had a hearing test done at birth but I presume that was all right or something would have been put in place much earlier.

[HarumScarum]

I don't think you saying you're worried will do anything other than get them to dig their heels in.

This is exactly what my previous comments to them have done. Hence asking for a sensitive way to approach it.

In some ways I'd wonder about there being more of a processing disorder.

I wondered about something like that because when I was looking on the internet for stuff about children with speech delays it did mention that even children with quite severe glue ear had often quite reasonable receptive language.

I don't think he's shy. He is v independent and eager to socialise, comes to other adults quite readily (even ones he doesn't know well).

[HarumScarum]

Anyway, thanks to everyone. I am going to speak to SIL about the checkup and whether they've had one next time I see her and possibly also ask if they have a two year check in their area as at least then I could be confident that someone would pick this up in the near future.

[BoulevardOfBrokenSleep]

You asked about my DS just before I went to bed...!

He could definitely understand what was said to him, but he didn't babble as a baby and only had a few vowel sounds at 2.

I didn't really have any concerns about his hearing, but the speech therapist said to do the tests anyway in case he had hearing loss at particular frequencies. But he didn't.

Mind you, now he's nearly 3 and has lots of vowels but only a few consonants; DD and I are the only ones who can understand him. He has another speech therapist app't next week, will see what she says.

You have my sympathies, it seems like it's a really tricky situation.

[HarumScarum]

Thanks so much. It's really useful to get an idea of what kind of ways speech or hearing problems can present in others - really to gauge how bad this is because I have no prior experience of either hearing loss or speech delay so it's hard to tell if I am being alarmist or not.

I am sure my nephew understands very very little of what is said to him.