Yesterday was Kara's 18-month well-baby visit, and for the most part, things are great. She continues to top the charts with her height, measuring an even three feet tall, and clocked in at 30 lb 3 ½ oz for weight. The doctor was happy with her comprehension skills, eye contact, and ability to imitate and pretend. There was talk of dental visits and potty training. Overall, it was uneventful, except for one small thing: her lack of speech.
Kara is sharp. She knows her animals and is working on letters and numbers. She can identify characters in books and family members in pictures. If you need her to fetch Nathan's pacifier or turn off his travel swing, she can do it. If you ask her if she's finished with dinner, she'll either throw out her arms in an "All done!" shrug or shake her head no. It's obvious she can hear and understand us, and aside from typical toddlerese, Luke and I usually understand whatever it is she's trying to tell us.
The thing is, though, that she communicates her needs in every way but words. Babbling, grunting, screeching, laughing, shouting, pointing—this is how Kara gets her point across. She knows that Luke and I are Daddy and Mommy but normally doesn't ask for us by name (her babble includes "mama" and "dada" though). Sometimes she'll say what sounds like "eye" or "up," occasionally throws in a "go, go!" when she's pushing her shopping cart, and one time Luke swears she said "h i j k" when he was singing the alphabet, but generally speaking, if there's a way to communicate non-verbally, she will do it.
The doctor said that at this age, most kids are using at least a few words on a regular basis, and the fact that Kara isn't is something to pay attention to. He agreed when I pointed out that it's not uncommon for toddlers to refrain from talking much before their second birthday. He also admitted that he falls on the conservative side in the area of speech because he would hate to see a child lose out on an extra few months of help if the issue is addressed later rather than sooner. His recommendation was to informally follow up with Kara's progress at Nathan's six-month well-baby visit, and if things are still the same, we could talk about possibly having her evaluated by a speech therapist.
I really like and respect our pediatrician. He always spends a good chunk of each visit asking questions about the kids, really listens to what we say, and defers to our wishes in areas of potential conflict. I don't think he says anything without carefully weighing the necessity. And I even agree with him that Kara's practically non-existent vocabulary is something worth noting.
That said, I've already told Luke that we are not sending Kara to a speech therapist before the age of two.
It's not that I think speech therapy is bad or that kids who need it are bad. It's just that she's so damn young, you know? I think we have to give her a longer window to express herself than just another month before we start labeling quirks as problems. This issue was already on Luke's and my radar, and we do our best to encourage speech by talking with her, reading to her, and keeping her away from TV (though I admit to occasionally watching my stories when she's in the room). We ask her questions that require more than "yes" or "no" answers and sometimes refrain from giving her the answers she wants when we know she's capable of supplying them herself (a good way to piss her off, by the way, let me tell you). We know she needs more interaction with other children, so we've been dropping her off at the church nursery during Sunday services so she can get that. (I like to think of it as the poor man's Gymboree.) We are also looking into other (free) programs that expose her to other kids. Maybe if she hears them talking, it'll encourage her to as well.
And maybe, just maybe, she's a slow learner in this area and will need outside help from a qualified professional. I'm OK with that. What I'm not OK with is making that call today or even 30 days from now.
You know, you think parenting is hard when your kid gets up every hour of the night for two weeks or refuses to nap or fights you on every diaper change, but this? Having to make judgment calls on your children's development? Preparing to (politely) buck authority on their behalf? This is hard. And I know, I know, it's just the beginning.
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Excerpted from Parental Discretion Advised, originally published on Parents.com. Copyright 2009 by Meredith Corporation. All rights reserved. Reprinted with permission.
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