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Q: My 20-month-old grandson does not talk yet, not even verbalizing simple words such as mama, daddy, bye-bye. He is intelligent and easy-going, understanding readily what is said to him. He points and utters 'ah' to get his messages across.

-- A Grandparent in Raleigh, N.C.

A: Like many kids with older siblings, Mae Kovacich's second son had no reason to talk. He got what he wanted with points and "ahs." His older brother filled in the blanks.

"We convinced our older son that his little brother would never learn to talk if we did not insist on his actually saying words," the Stone Mountain, Ga., mother says. After the family pretended not to understand what the 2-year-old wanted, he started talking.

A reader from Schenectady recalls that her half-brother became adept at using the "ah" sound exclusively to convey what he wanted. But when he was 3, his mother had to leave him for three weeks with his dad and older brothers. When she returned, the boy surprised her with: "Hello, Mother. Did you have a pleasant journey?"

With talking, what's normal covers a broad range. Each child follows his own timetable. Wait and see, or push for testing and intervention? For speech testing, age 2 is a milestone many health-care providers use. But gut instincts and the "better-safe-than-sorry" philosophy are always good guides.

Get your child evaluated if you have concerns, says Nan Hingston, a licensed speech-language pathologist and mother from Buffalo. If your child qualifies for services, therapy could begin.

Things to ask yourself about a late talker, she suggests:

Has he had a history of ear infections? (Maybe he has fluid in his ears and cannot hear you.)

Has he had his hearing tested?

Do you give him chances to use language, or do you give him what he wants without his having to ask?

The range of what might be going on seems endless, as parents' letters suggest:

Possibly there's nothing to worry about, if he is achieving other milestones. Is he storing up sounds and syllables in his brain, just waiting to speak in three- and four-word sentences in a few months?

Are his tongue muscles too weak?

Other readers have their children in therapy for less common, but more serious speech-delay problems. A grandmother in Ontario, Canada, whose grandson is 3, says he points and utters "ah." "He just cannot seem to get the words out," she says, and he's in therapy for a controversial language disorder called Apraxia. (Find more information at

A language delay can be a serious cause for concern such as autism, says a father in Norcross, Ga., who has a severely disabled child. Go to a developmental pediatrician, he suggests.

Services for children under 5 vary from state to state, but in North Carolina, there is a network of 18 regional centers called the Developmental Evaluation Center Program. The service includes psychological, academic, speech/language, medical, occupational and other evaluations for children.

"Early intervention is the key," says Caroline Ashburn, a school psychologist in Sanford, N.C.

Donna Malloy of Roswell, Ga., a clinical nurse specialist in child and adolescent psychology, says that even if a child's hearing tests fine now, past ear infections could have severely impacted his language development. When he had the infections, he did not have the benefit of attaining experience in forming words and therefore could be behind in language skills.

Other parents' tips for stimulating language in toddlers:

Talk to your child about what you are seeing, doing, feeling and touching as you do household chores.

As you drive, talk about the sights and sounds: "See the blue house" or "Red means stop."

Recite nursery rhymes, count out loud, sing your child's favorite song.

Can you help?

My 7-year-old son struggles socially at school. He is impulsive and somewhat immature for his age. He does OK with kids at church and on his sports teams, but he says nobody will sit with him on the bus and he's left out when kids pair up at school. How can I help?

-- A Mother in Apex, N.C.
If you have tips or a question, call toll-free (800) 827-1092, send e-mail to or write to Parent to Parent, P.O. Box 4270, Davidson, N.C. 28036.

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