However…after doing another evaluation the other day…followed by a recommendation from a pediatrician whom often refers to early intervention….I thought that I really needed to write a blog post…specific to children between the ages of 12-18 months. Often times in this age range…parents bring their little one for their well visit and the pediatrician of course asks about the child’s overall development…and the question then is asked: how many words does she have?…..and when the parent replies: none…or one…or maybe just two….the pediatrician often states:….well…around 15 months your little one should have at least 10 to 15 words. And for children closer to the 18 month mark…the pediatrician is expecting closer to 20-25 words in your little one’s vocabulary……and although there are some little ones with a vocabulary of 20-25 words at the age of 18 months….what is more important to me is your little one’s receptive language development (her understanding of language)…overlooking the receptive component in speech and language development does not look at the child’s overall communicative competence.
For me as a speech and language pathologist…between the one and two-year mark when I am evaluating children…I am more concerned with her receptive language development….this is your little one’s understanding of language….and if I see a little one that is having a difficult time in her understanding of language..then I am more concerned than with regard to how many words she has. Pediatricians often miss that piece of language development (in my experience). As speech and language pathologists…when we evaluate children under three years of age…..and more specific to children between the ages of one and two years of age…and even more specific between 12-18 months…what I want to know is the following (all specific to receptive language development):
Does she understand COME HERE…with your hand extended as you say the words come here.
Does she respond to her name when her name is called?
Does your little one look at objects or people the caregiver points to and names: When the mommy points to an object or family member and say: Look at daddy. Does your little one then look to daddy? Did she understand that simple direction given both your language and also your non-verbal cue (pointing to daddy).
Does your little one respond to the word: NO….does she stop and pause what she was doing..showing you that she understands what you are saying….she may go back and do it again…but she is showing you that she UNDERSTANDS.
Does she understand a specific word or phrase without a gestural cue…such as: give me a kiss.
Does she play appropriately with her toys?
Does she use two objects during play together?
Does she use self-directed play….does she pretend to comb her hair…does she pretend to feed herself….maybe she does this with the mommy…combing mommy’s hair.
Is she beginning to follow a routine, familiar directive with cues…if you say to your little one: give me the keys (if she was holding your keys)…and your hand is extended…giving her the visual cue….does she follow this directive. If she was holding a ball…and you asked her to throw the ball as you modeled throwing the ball…does she follow this directive?
So….it is really important…when testing a little one under 24 months of age…more specific to the 12-18 month mark…it is important that I look to see if theses skills are mastered…does your little one understand the world around her…is she related and connected….does she respond to her name..is she recognizing family members and is she starting to understand simple routine directions…with cues…and then without cues as you get closer to 24 months of age.
If this is the case: your 15 month old is babbling and producing a variety of consonant sounds and vowels…maybe making some attempts to say a word with meaning…maybe she has one word in her vocabulary….or your 18 month old has maybe 2 words in her vocabulary…and is babbling and producing a variety of consonants and vowels…..and as stated above…she presents with all of the receptive language skills….well in my experiences…your little one will talk..she will acquire language typically…..she will learn that words work to get her what she wants…she will learn language on an incidental level.
I plan to post more receptive language skills…that are mastered closer to the 24 month level and beyond. For me…receptive language is like the foundation on a house…you need the foundation to build the house…it is the same thing for language development. If you have not yet acquired the receptive language skills..then it will be more challenging to acquire words…if you are not sure what the words mean…and how to use them on a functional level.
Hope this was helpful!