Mrs. Leigh Ann Smith brought her son to me because she was worried about his language development. I observed him, and my observations showed that he was at risk for a language delay. I conducted an interview with Mrs. Smith in order for me to determine some of the factors that would show whether he was in fact a language delay child or just a late-talker. Here is a transcript of our interview:

Me: Mrs. Smith, how old is your son, Casey?
Smith: He is 29 months old.

Me: When did you first become worried that your
child was at risk?
Smith: Well, when he was just an infant, he was
not making very many vocalizations. He really
did not start babbling until he was about ten
months old. I know that his sister, Katherine,
started babbling when she was about five
months old. I know that every child develops
differently, so I wasn’t that worried about it
then. Now that I look back, I wish I had
worried about it.

Me: I know how hard it can be to interact with
someone when he does not want to interact
back. Did this affect how you interacted with
your son?
Smith: I guess it did somewhat, but not in a
negative way. It made me interact with him
more because I wanted to push him to show
some sort of interaction with me.

Me: When did Casey finally say his first word?
Smith: When he was 20 months old.

Me: What did he say?
Smith: dada

Me: When you were pregnant with Casey, did you
use any illegal substances?
Smith: No.

Me: Did you drink any alcohol?
Smith: No.

Me: Did you smoke?
Smith: Sadly, I did smoke occasionally.

Me: I know that smoking is a very hard habit to
break. When you say, “occasionally,” what do
you mean? How often did you smoke?
Smith: I might have smoked about two cigarettes a
week.

Me: Were you around anyone else who smoked?
Smith: Yes, my husband smokes about a pack a day.

Me: Okay, next question. Did you drink a lot of
caffeine while pregnant?
Smith: I probably just drank one Coke a day. I
have to have my Coke!

Me: What about chocolate? Are you a chocolate
person?
Smith: Not really. I do not eat much chocolate.

Me: Well, that is really all of the questions that I
have to ask you for now. Do you have any
questions for me?
Smith: Yes. I heard that children who have developed late in language can sometimes be affected when in their school work. Is this true? Shoul I be worried?

Me: In some cases, yes. Many late-talkers and language delayed children will show poorer scores in language skills up to age nine. They have also shown to be less skilled in reading at ages eight and nine (Rescorla, 2002). As long as we work with him, though, he should be okay. We need to keep him in therapy so that we can work on those kinds of things.

Me: I would like to schedule another visit with you
and your son. If it is possible, I would like to
observe him in his normal environment. I want
to watch him wherever he talks the most. If I
could come to your home or meet you at the
park then that would be great. Is that possible?
Smith: That is fine. If it will help my son, then I will
do it.

Me: Great! How about Tuesday at 3:30?
Smith: Sounds good to me.

Me: Okay, I will see you then.
Smith: Bye!

That concludes my interview with Mrs. Smith. I found out a lot of helpful information. As of now, I still do not have enough information to determine whether Casey has a language delay or if he is a late-talker. I am leaning towards a language delay due to the consumption of nicotine and caffeine. These are two substances that can cause a child to have a language delay (Bernstein, Tigerman-Farber, 2002). They can cause other problems as well, but Casey does not show any of those problems. He very well may be a late-talker, which is why I have set up another appointment to observe him. These factors could just be coincidence. Further evaluations will show whether or not he has a language delay.
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LATE-TALKER

Language that is delayed.
At age two, children may not be
Talking like they should.
Expressive and receptive skills that are
Typical of a two-year old may not
Appear in a child that has a
Language delay.
Knowing the language milestones will help you know if
Early intervention is necessary and if your child is at
Risk for a disorder.
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October 7, 2002

Today has been a great day! My son, Casey, said a new word. He said the word, "ball." Casey is 29 months old, and his vocabulary is very limited. We took him to see a speech pathologist, and she says that she is not sure if he is a late-talker or if he has a developmental language disorder. She thinks that he is most likely a late-talker because he is developing normally in every other aspect. Also she says that his receptive skills are very high. Casey follows directions very well, and he does everything like a normal child does, but he does not express things very well. She wants to continue seeing him just in case he does have a disorder. She said that children who are not using as many words at age two as his or her peers, then they are at risk for a language impairment (Patterson). She is going to continue working with him until we know for sure.

Sometimes, I make excuses for him. I sometimes think that my husband and I don’t make him talk enough. If he points to something, we go ahead and get it for him. Or if he grunts a lot, then we usually assume he is hungry. We ask him if he wants something to eat, he smiles, and so we get him something. We don’t exactly encourage the talking as much as we should. We are good parents, and we love our children, but we do not promote language enough for Casey.

I also think that another problem is he uses his older sister, Katherine, as an example for his language. I have learned that children do not exactly provide the best example of language for other children. Casey usually runs around and does whatever Katherine does. She talks so much that he can hardly ever get a word in.

Casey’s vocabulary is very limited. He does not combine many words like I think he should be doing at his age. He likes to say sissy, mommy, daddy, doggy, drink, and his new word, ball.

I told the speech pathologist my concerns about my husband and I not promoting language. She gave me some suggestions to use around the house. She said that when Casey wants something, I should try to make him say what it is that he wants. She also told me that if he is doing something then I could say what it is that he is doing. For example, if he is eating a pizza, I can say, “Good job Casey! You are eating that pizza so good.” She told me not to make my statements too complex because we do not want him to be overwhelmed and not want to speak. She said that I need to be patient, and he will learn.

--Leigh Ann

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October 17, 2002
Well, we made another visit with the speech pathologist today. Casey had not improved much. He is still using the same vocabulary he was using the last time. I just do not know if he will ever talk. I am beginning to get impatient. She gave me some information that showed what Casey should be doing at his age and how he should be developing. She said that he is developing normally, but at a slower pace. She said that because of this she is not very worried. I guess that I should not be worried either then.

I looked at the information that she gave me. It said that children should have a 50-word vocabulary at about 18 months of age. They should have a 250- to 300-word vocabulary at 24 months (Collins, Cooper, Parenti, 2002). Casey is 29 months, and he has about a 60 word vocabulary, so he has the vocabulary of an 18-month old. That just worries me. I know that children develop differently, but I want my child to develop normally!

I guess that I just need to listen to the speech pathologist and not to myself. She knows more about language development than I do (she was trained for that kind of stuff). I just hope and pray that he will soon start talking. I will feel much better when that day comes

--Leigh Ann
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