My son seems to have a speech delay. Can I get a recommendation on a specialist for evaluation?

[Brenda]

My 22 month old son isn't really talking yet. Just very recently he started to finally respond to his name and will randomly say a word here or there, but not much. He is a happy-go-lucky kid who is very affectionate but seems not to be able to communicate his needs. It is weird because even though he seems to be delayed with verbal communication he seems very advanced in other areas. I'm not sure what to make of this and it is starting to worry me. I have an appointment with the pediatrician, but it is not until six weeks away. I can't wait that long and want to start looking into his peculiar development as soon as possible.

Where do I start with this? Are there any specialists I can contact to get him evaluated? Thank you in advance.

[S.PhillyNative]

You really need a pediatrician to lead you in the right direction after he examines your son. I've never heard of taking 6 weeks to see a pediatrician. You need to call his office and explain your concern and ask for a sooner appointment, or you need to find a new doctor for him. It is not acceptable that it would take that long for a problem situation. I, too, would be somewhat concerned at his lack of communication skills, but it may also be quite natural for a laid-back personality. If all else fails, contact CHOP (Children's Hospital of Philadelphia) to lead you in a direction.

[Marc]

What was your pediatricians take on this at his 18mo checkup?

[Brenda]

His last appointment was at 16 months. I didn’t get to see the doctor at that check up, but the nurse practitioner. The nurse practitioner said that all kids develop differently. She also said that it is not uncommon for some kids to be late talkers and then all of a sudden speaks in sentences later. She was not interest in exploring it further at that stage.

In 7 weeks he will be 2 years old and he hasn’t made much progress with his speech at all and does not attempt to verbally communicate except for the words eat, no and come. That’s pretty much it.

However, over the last six months he has developed a weird ritualistic obsession with letters and numbers. He wakes up in the morning reciting the alphabet and numbers, he pretty much does this ALL day nonstop. Wherever we go he is constantly seeking out letters and numbers from everything around him. At home I sometimes hide all things with alphabet/numbers to encourage him to play with his regular toys but he doesn’t show much interest in playing with them, instead he takes his toys one by one and starts naming the letter each toy begins with. By the way, I never taught him letters or numbers, he picked it up on his own from watching certain children shows and such.

This is so weird to me because he seems delayed in verbal communication, but yet advanced in certain aspects. It concerns me even further because I’ve googled his behavior and a lot of his behavior traits come up with searches to a condition within the spectrum of autism. Sorry to spit this all out, but I’m just perplexed by his behavior and don’t know what to make of it.

[Marc]

Concerns appreciated, certainly no need for apologies. I'd echo S.PhillyNative and add if your ped is too [busy, disinterested, whatever] to see you, find someone more attentive, poste haste! My expectation is that all questions get answered and concerns addressed.

All the best to your son & family; I can't comprehend what you must be going through. Kids do develop differently and in their own time. That's not to say you shouldn't seek out the best, most attentive care you can find.

[It'sJessMe]

I wouldn't be concerned about the NP's reaction at 16 months, lots of kids aren't talking by then, but I do echo the concern about not getting an appointment for another 6 weeks. If that's typical, I'd find another ped asap.

My son didn't really talk until 22 months, but he was very responsive and communicative until then, and then one day started speaking (and hasn't stopped). But I'd definitely get it checked out and if necessary start intervention. Call for a new appointment.

[Queen Villager]

Maybe these people provide screening services, or can tell you where to get them.

Early Intervention

Also, if he's in preschool, I think the school can refer him for screening.

Best of luck and hope all's well with your little guy!

[OldMama]

A good first step may be a developmental pediatrician. Call CHOP and St. Christophers.

A good developmental pediatrician will look at your child's overall development, including speech. It's important to know whether the speech issues are part of a spectrum of needs or the only need. That makes a difference in terms of remediation.

[wissahorse]

Brenda,

If you can afford to pay out of pocket (she does not take insurance), by reputation the best speech therapist in Phila is Ellen Schwartz (215) 629-4911. Her office is in QV. She trained a huge proportion of the younger STs that you will find in the hospitals, Early Intervention, etc. A speech therapist can't diagnose, and Ellen is very respectful of that, but she knows as much as anyone in the City about the autism spectrum and other causes of speech delays.

I would also call ChildLink, the 0-3 Early Intervention provider, and schedule an evaluation. You do not need a referral. 215-731-2110 for intake/registration.

I agree with the suggestion of a full evaluation by a developmental ped, but you will wait 6 months (easily) to get one at CHOP. St. Chris may have a shorter waiting list.

General peds are notorious for taking a "wait and see" approach to speech delays and the implications. Don't be mollified. I give you lots of kudos for being proactive about this. Early intervention can make a huge difference -- it did for my son. PM me if you want more info.

Lisa

[OldMama]

I agree with most of the above post but I suggest getting that developmental pediatrician ASAP. As wissahorse said the speech therapist won't- and shouldn't- diagnose beyond a speech/language delay. For that you need a developmental pediatrician. Calling St.Chris is an excellent suggestion but also call CHOP anyway and say that you can be available on short notice if a cancellation occurs.

[ahbinpa]

I'll echo the above an reiterate the Child Link suggestion. They did regular evaluations on my daughter and connected us to early speech therapy. Check to see if Pennsylvania Hospital has anything too... They used to, but it's been over 15 years since we started down this road.

[rojnish]

While I do think you should have your child checked, I wanted to tell you a story to put your mind a bit at ease. Our son was the youngest child of three - two older sisters who did a lot his bidding.. I think the term we used to use is spoiled. Anyway, he never talked in comprehensible words and could only communicate with his older sister. When it came time for school he was still 95 percent unintelligible. The public school said they could not take him (yeah, they used to be able to do that). We contracted a speech therapist who came twice - once to meet him, and once to begin work. At that second visit he said "he can speak fine, just never felt the need." Apparently the speech therapist tried to encourage our son to speak by offering him a quarter, and our son said "how about we make it a dollar?" Our son began speaking in full sentences, went on to kindergarten, got recommended for advanced standing, and eventujally graduated from Duke with an Engineering degree. Lots of reasons kids don't talk. Not all of them qol threatening. I'm very glad your child has a parent that cares. Best of luck to you.

[Naveen]

Six weeks? Get a new pediatrician. I'm not being flip. That's just unacceptable IMO.

[Brenda]

Thank you so much for all the awesome recommendations. I already started making phone calls and now I'm just waiting to hear back from a few different places. Thanks again.

[NJbound]

good luck... I am all too familiar with what you are going thru...