speech delay in 22 month old

[amberl10]

My adopted son is 22 months old.  He was born at 39 weeks gestation.  The birthmother used meth the last 4 weeks of her pregnancy.  My son has done remarkably.  His apgar scores were 8 and 9.  He never showed any signs of withdrawal.  He was always a well behaved good natured baby.  At his 9 month well check we noticed his head circumference had not grown so we have been monitoring it.  It still has not grown at all.  He is a petite little guy and his birthmother is petite at 5'0 and 110 lbs.  His head is in proportion with his body so does not look unusually small.  He walked at 10 months of age and has always met all of his developmental milestons until 12 months.  At 12 months we noticed a speech delay.  He was only saying 3 words at that point.  At 18 months he was up to about 10 words.  Now at 22 months he is saying around 35-40 words.  A lot of the words he says he will say on his own with no prompting, but most of the words he only says if I say it first.  He understands basic commands, can point to all body parts, knows most animal sounds, he has put basic 2 words together like "lets go, see ya, hi daddy".  He understands everything I ask him to do or show me but he does not use the words like we want him to.  At this point there is no other delays or symptoms.  He's never had seizures, he's never had a head injury, he's just a small boy.  He has seen a neurologist at 18 months who wanted to wait and see how his speech improves and we may be doing an MRI, but I'm just wondering if this is a significant delay, what could be the causes of his head growth issues???  I'm worried to say the least.

[specialmom]

I just wanted to say with regards to small head size----  I am sure that your doctor is monitering this as you are.  Okay, here I go with honesty.  My head is really small.  I can wear a small boy's size baseball cap and I'm in my 40's.  (please no pea brain jokes--ha ha).  I have a Phd from a well known university and a lengthy career behind me-----  so even a little head goes a long way.  So try not to worry and stay aware.  You sound like you are doing a fantastic job mothering this little child you saved!!  Great job!

[amberl10]

Thank you so much, that really helps me a lot.  We are involved in Early Intervention but at this point the speech therapist is not involved.  I think I will talk to them about bringing the therapist in to help him further.  I think the head size concerns me more than the speech delay.  It's so frustrating when you don't know what's wrong.  My son's birth weight was 6 lbs 2 oz.  His birthmom also smoked cigarettes during her pregnancy so that's what we accounted his small size to.  She's so small herself that we know he's going to be a petite child, we just wish the head would grow.  It grew consistantly and then at 9 months it stopped.  He's obviously progressing though so I know that's a big plus.  Thanks again for your support.

[specialmom]

Hi,  congratulations on adopting a child!!  That's awesome.

As far as gestation, you probably know that 39 weeks is considered full term.  More important would be his birth weight.  What was that?  Being an infant born to a drug addicted mother makes delays more common and you are smart to watch for these.  Early intervention can solve lots of problems.

Your child also sounds like he is doing pretty well.  While his speech sounds delayed to what extent, I don't know, but his receptive and expressive language skills sound pretty good.  (this is his ability to understand you and his ability to get his point across to you (through whatever means))>  It sounds like you work hard with him and that is good.  But try to relax and enjoy it all too.

I have a son who is now 5 who has a delay of sensory integration disorder which involves his nervous system.  We didn't know until 3.5 years of age.  He met all developmental milestones and really only showed the delay fully at school (back then, anyway.)  He was my firstborn, so in retrospect there were signs before this at home. For example, he gagged super easy as a baby.  Going to solid food was difficult for him as chewing and swallowing involves muscle/motor control.  He would also avoid certain activities that he found distastful or hard.  But it is hard to see when they are such little toddlers and not too  many things are expected of them yet.  He walked at 10 months too and talked on time.  But he had articulation problems at first.  That is what his preschool first told me they saw as a potential problem.  Anyway, I'm here to tell you----  we did do occupational therapy and many activities at home to address his nervous system needs and he is doing terrific.  You wouldn't know he has a delay at all most of the time.

So, that is just my story.  With little ones your son's age----  it is a good thing that nothing is glaringly obvious.  That means if a delay turns up, it will probably be mild.  I'd maybe start speech therapy with him.  Your local children's hospital or your pediatrician can put you in touch with early intervention programs (which the US provides by law to our kids age 0 to 3).  With the fact that your son's birth mother was activily using toxic drugs during gestation, you'd probably meet the criteria to be evaluated.  Then perhaps, you could get some speech therapy for him at no cost.  

And remember, lots of kids are slow with speech and have NO DELAYS AT ALL!!!!  So just keep the physical activity high, talk to him all the time, read and play with him whenever possible!!  Social interaction is good too  as some of other kids skills his age in terms of communicating with peers will rub off on him.  Set up a playdate or join a play group.  Good luck!!