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Healthy Children

with Steven Parker, MD

This blog is now retired. Dr. P passed away on Monday, April 13, 2009. The WebMD Community will dearly miss his kind, caring, and often humorous manner.

Friday, May 16, 2008

Why isn’t my baby talking?

Q: “My baby is 13 months old and not talking at all. He hears sounds because I’ll tap on a table and he looks, but he won’t say any words, just noises. Should I worry?”

A: Is there anything more thrilling than when a baby first starts talking? It’s a brilliant developmental advance. Think about it. Your baby has learned that a sound — which is, after all, nothing more than waves in the air stimulating the eardrum and the ear nerves — actually means something. She’s learned that this noise actually stands for this person or thing I love so much. The first word marks the beginning of the ability to think symbolically. It marks the beginning of what sets us humans most apart from all other animals on the planet.

The first word is, in short, a miracle!

Of course, that’s also why parents tend to worry so much when their baby may be a little slow in talking. So for all of you whose infant still isn’t saying any meaningful words at 13 months, here’s some reassurance and here’s some advice.

First, the reassurance.

There is tremendous variability in when children say their first meaningful words. (Note the emphasis on meaningful. Just saying “dada” doesn’t count unless the word really represents and refers to that guy who is such a big part of the baby’s life.) Some say their first words at nine months; other perfectly normal kids don’t do so until as late as 18 months. And, by the way, if there’s no problem otherwise, early or slightly later language is not a sign of how smart your infant is going to be.

Now, the advice.

Although it’s too early to worry and your baby’s probably OK, you (and/or your pediatric provider) need to remain alert to the possibility of a potential problem. Here are seven questions to ask yourself:

  • Does he understand the meaning of single words (e.g. “where’s mommy?” “NO!” “give me …”)?
  • Is he making a lot of different sounds with a lot of expression to them?
  • Could there be a hearing problem?
  • Is he developing normally in other areas?
  • Is he being spoken to a lot? Is someone reading to him every day?
  • Is he exposed to any significant family (or other) stress?
  • Is there a family history of slow language?

Reassuring answers to these questions are, well, reassuring. In such a case, a real problem is unlikely and, if I were your pediatrician,I’d say that it would be OK to wait another three to five months before an evaluation would be necessary.

But if you are not reassured, by all means talk to your pediatric provider about how best to keep an eye on yourchild’s language development and whether an evaluation by a speech language therapist or other child development specialist would be helpful.

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Posted by: Steven Parker MD at 3:05 pm

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