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My Grandchild's Speech Development is Slow

QUESTION: I have a grandson who will be four in March. His speech development is very slow. To date he only says a few words, and does not put short sentences together. He still utters "noises" a lot. I am worried about autism. His parents say he is just slow, and I am afraid to mention the problem to them. Any suggestions?

ANSWER: Hearing difficulty can be a cause for delay in speech and can be ruled out by your grandson's pediatrician. If this has already been addressed, it would definitely be wise to have your grandson seen by a pediatric speech pathologist for evaluating whether he is having difficulty taking in language, or getting it out! If he understands what is said, he is processing language, but simply not producing it. The question is, why?

Identifying speech delay before age six can be important, as much learning can take place through speech therapy when a child is still very young. The Speech, Language and Hearing Association may prove helpful to you and your grandchild's parents. Rest assured that speech delay is not in itself an indication of low intelligence, but instead represents difficulty with either forming sounds or articulating them. The sooner a problem can be identified, the greater the advantages will be if your grandson is suffering from this problem. If your grandson is not only showing speech delay, but also appears underdeveloped in his social interaction or tends to avoid social contact, he could be suffering from Asperger's syndrome. This syndrome is a milder form of autism, a neuropsychiatric disorder that also involves speech delay. Still, help is available for children who suffer from this developmental disorder, and the earlier they receive help, the greater their ability to learn the social cues they are missing. An evaluation checklist is available through the Autism Research Institute or through an evaluation with a pediatric neurologist.

Here's what you can do to help on your own:

1. Read, read, read! Regardless of any other factors, you can read to your grandson. Reading and talking provide the stimuli needed to trigger language association and recognition, whatever the cause of his difficulty.

2. Tell him stories. Even if he does not respond, continue to make the effort to be verbal in his presence. Tell him stories about the cat next door, what the garbage men are doing when they bring their big truck down the street, or what kinds of foods you will eat for dinner and which are your favorites! Even if he does not respond verbally, that does not mean he is not taking in part or all of what you say.

3. Teach him social cues. For example, if he does not wave good-bye, you might wave to him, and show him how he can wave back with his hand when you are ready to leave, saying "bye-bye." Patiently repeating this and other social gestures can help him develop social skills, if these interactions are lacking.

Talk with your grandson's parents about your concerns, by couching them not in predictions, but in preventive terms. Let them know that while it may not be likely that he has any serious disorder, evaluation at this age represents an ounce of prevention. Give them the resources listed here, and let them know that you are available to spend quality time focused on helping your grandson acquire language skills, in any way they find helpful.

Be sure to comment on your grandson's strengths, too. Acknowledge his intelligence, curiosity, or any other positive trait. Let them know in no uncertain terms that you are here to help, not to criticize. Although you do not wish to intrude in any way, you want to express your grandmotherly concern. After all, you have been through these stages of development. While it is true that you could be overreacting, you do not want to be remiss in not telling them what your experienced eye observes.

Come from a place of love and support, and do your best to be heard. Do not be afraid to completely express your concern, even if it is uncomfortable. But do not press the issue further once you have clearly communicated. Allow your grandson's parents time to consider your input. They will likely see the wisdom behind your love, and be more likely to seek help sooner, than if you did not say anything at all!


Gayle Peterson, MSSW, LCSW, PhD is a family therapist specializing in prenatal and family development. She trains professionals in her prenatal counseling model and is the author of An Easier Childbirth, Birthing Normally and her latest book, Making Healthy Families. Her articles on family relationships appear in professional journals and she is an oft-quoted expert in popular magazines such as Woman's Day, Mothering and Parenting. . She also serves on the advisory board for Fit Pregnancy Magazine.

Dr. Gayle Peterson has written family columns for ParentsPlace.com, igrandparents.com, the Bay Area's Parents Press newspaper and the Sierra Foothill's Family Post. She has also hosted a live radio show, "Ask Dr. Gayle" on www.ivillage.com, answering questions on family relationships and parenting. Dr. Peterson has appeared on numerous radio and television interviews including Canadian broadcast as a family and communications expert in the twelve part documentary "Baby's Best Chance". She is former clinical director of the Holistic Health Program at John F. Kennedy University in Northern California and adjunct faculty at the California Institute for Integral Studies in San Francisco. A national public speaker on women's issues and family development, Gayle Peterson practices psychotherapy in Oakland, California and Nevada City, California. She also offers an online certification training program in Prenatal Counseling and Birth Hypnosis. Gayle and is a wife, mother of two adult children and a proud grandmother of three lively boys and one sparkling granddaughter.

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