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My 20-month-old doesn’t say more than three words.
Q: My son is 20 months old and does not say more then three words. He calls me and his father “Da” and he grunts for everything. I have tried to show him how to tell me what he wants instead of grunting, but he just gets upset with me. He’s had three hearing tests and has had tubes put in his ears, so now we know his hearing is fine. He understands everything we say to him; I read to him and try to talk slowly when I do. I'm at a loss—please help!
A: I have written several articles for this web site on ways to encourage language development, and I hope you will read all of them. You’ll have no trouble recognizing them by their titles: “Word Processors Extraordinaire,” “Wiring the Brain,” and “From Babbling to Talking.” But I can feel the intensity of your concern and want to respond here, as well. It is not easy to deal with the complexities of language development in a brief response, but I am going to try.

First let me say that it sounds as though you are already doing a lot of things right—having his hearing checked, speaking slowly, reading to him. Those activities are critical. Equally critical is a calm and loving manner when you speak to him and encourage him to say words. If you are too up tight and show that, he will become more anxious and even less able to form words. Hearing words in a context of love is an essential ingredient for early language development. Believe it or not, some babies hear only commands, criticism, and prohibitions.

Now for a simple suggestion: begin by helping him say short but important words that begin with the “m” or “b” sound. Learning to say “Ma” (or Mama) for you is a good place to start. Stand in front of a mirror and slowly say “Mama.” See what your lips do as you make the “m”? Now try “ball.” You can’t make those words without moving your mouth into a certain position, and the necessary position is easy to see. Contrast that with your mouth position for the letter “d.” You can’t see that very well, can you? You can go on to these hidden sounds later. Do this with your son, speaking slowly and exaggerating your mouth movements. Make sure he is looking right at your face when you do it. Songs that feature certain sounds can also be a big help (“Baa baa black sheep” has lots of “b’s” in it.)

So try these things in a playful way, not letting yourself get upset if he doesn’t do it right. And remember that there is wide variation in the ages at which young children acquire language skills. If he is still not using words well by the time he is 3, I would take him to a speech therapist. But before that time he may surprise you with a torrent of words—so much so that you’ll wonder why you were ever concerned that he was slow in talking!