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What causes delayed speech in a child?

Answered by
Dr. Meera Kotecha


Practicing since :2004

Answered : 460 Questions

Posted on Tue, 12 Aug 2014 in Child Health
Question: Hi, I have a 22months old son. He niteven saying 1 single word yet. He did made a sound like ba ba. , ma ma , etc, before but after18 months old he not saying it at all, but he babbling some different sound. He know what he want. If hand me the drink cup if he out of water or hand me the can of food to open if he want to eat , take me to where he wants. Before he waive buybuy. Now he doesnt even care. Before he point out his facial face part when I ask ed him, now he not doing that. I can tell by the way he act. He just doesnt wanna listen . Not like he is not understand me. My family and I usually just hand him what he want. Barely ask him to get something to me so I dont know is it the reason why he doesnt know when I start asking him to hand me stuff. And we speak chinese and cantonese at home. Including english cartoon that made 3 languages. Is that the reason why he still havent talk ?his more likely understand chinesd tho. His dr said he doesnt have any sign of autism . He going back to his 2 year check up soon . But I just cant wait to ask the question. Is itnormal for him not to talk cuz we are bi languages. Is it normal for him not to know what I say when I ask to hand me something since I barelyask him to. Cuz everyone just give him what he wants instead of making him say something

He also know how to pick a learning game he wants on the ipad, and he knows how to play. He know how to switch to a differrnt game if he wants to. Everything is fine except he not saying any words and not paying attention sometime. He pay attention when he not doing anything or playing by himself or when he wants to. Sometimes he just doesnt care.
Answered by Dr. Meera Kotecha 33 minutes later
Brief Answer:
autism needs to be ruled out

Detailed Answer:
Hi, thanks for using health care magic.
I can understand your concerns.
In my opinion you should get him evaluated by a Developmental and behavioural paediatrician who can do formal assessment and rule out autism and other communication disorders in him like expressive and receptive language delay.
Bilingual children are said to be having slightly delayed speech but the receptive language (i.e. following instructions, responding to commands or calling his name) should be present.
And not a single word with meaning at 22 months is not normal and definitely speech delay even for multilingual children.
The points which a pointing towards autism are that he had regression of certain language milestones. He is not responding to calling his name. How is his socialization? Does he do pretend play?
I would put two differential diagnosis for him, autism or expressive and receptive language delay.
Allowing the child to communicate his needs instead of simply understanding it will definitely improve his communication but that can not be cause of so much language delay.
I hope I have helped you.
If you have any further query please feel free to ask.
Thank you.
Dr. Meera Kotecha
Developmental and Behavioural Paediatrician.

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Meera Kotecha 24 minutes later
He does response to me when I calk out for him unless he s watching tv. But 8 out of 10, he will run over to me when I call out for him. Even it is from living room to other room. I play like normal kid do like peekaboo. Hide and seek.etc. nd pretty much all normal play . He share food whenever I ask for. He like to play with other kids at play center. He is all finne and normal except speaking and getting stuff when I askedto. But like I said I barely ask him to do thing. From birth till now. Less than 6,7 times that I asked him to hand me something. He does blabbering when he piss. Or wants something

Everytime he wanna climb up to the sofa. He always look at me first before he starts climbing up. Ifi said no. Then he wont. When we go out . Most of the time he will grab my hand to walk with him instead of running on his own. If the step is too high he will hold my hand other wise he will either not going down or slowly move down. He acted pretty normal . Everyone said he act more mature than a normal 2 years old kids. Cuz he understands things still he doesnt mind doing it

And when he going to nap or sleep. I get the water ready and tell going to sleep and he knows that . He will run to his sleeping area in the living room or his room . He climb up and laying down
Answered by Dr. Meera Kotecha 52 minutes later
Brief Answer:
seems more of language delay

Detailed Answer:
Hi, thanks for your feed back.
From your description it seems more of the language delay than autism. But still I would suggest you get a formal assessment which will be done by the doctor watch him play and respond to commands and watch him communicate.
He will definitely benefit with speech therapy. creating more situations at home for him to talk will also help.
I hope I have helped you.
If you have any further query please feel free to contact.
Dr. Meera Kotecha
Developmental and Behavioural Paediatrician
Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Meera Kotecha 4 hours later
His 2 years appointment is in september. His dr said we will have it done if he still not talking by then. Shouldnt be a problem to wait till then right?
Answered by Dr. Meera Kotecha 24 minutes later
Brief Answer:
no problem to wait till then

Detailed Answer:

Thanks for your feedback.

Its ok to wait till that time for the assessment. is a good site which teaches parents how to build up vocabulary and language skills in non verbal toddlers. You can use those ideas at home.

I hope I have helped you.
Thank you
Dr. Meera kotecha
Above answer was peer-reviewed by : Dr. Ashwin Bhandari

The User accepted the expert's answer

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