Q&A: 18 Month Old has had Ear Infections and is not Talking

blockquote_bgMy son is 18 months old and barely talks. He has had numerous ear infections and now has tubes. At one point, I thought his hearing was affected, but his hearing was tested in December and it was fine. He also sucks a pacifier. He has an older brother who does a lot of the talking for him. He is able to communicate with pointing and grunting, and we give in to it. Should my son be seen by a specialist?

You were correct in first having his hearing checked. Numerous ear infections can impact speech development and it is good he has had tubes placed. The tubes help to clear the fluid from the ear and help to make sounds and words more clear, which allows the child to hear and learn the sounds more accurately.

When children have an older sibling, it is common for speech to be delayed, especially if the older child talks a lot. The older child will often talk for the younger child when the child wants or needs something. This can delay the younger child’s speech. Several suggestions for this situation: 1) Try to set aside specific time every day (15-30 minutes 1 or 2 times a day – or more if possible) when you can have focused time with your younger child; 2) Interact with your child in an activity he enjoys, such as playing with a ball or trucks. Model one word for your child and encourage him to imitate the simple word. If he is unable to imitate the word, encourage him to produce a sound related to the activity. Praise him for any sound or attempt he makes; 3) Encourage your older child to help in “teaching” the younger child. If the older child is old enough, have him try to help the younger one make sounds, say simple words or perform oral motor activities such as sticking out his tongue, blowing raspberries, etc. You can also explain to the older child that the younger child has his special times to “talk.”

With regard to the pacifier, I would suggest stopping/reducing the time your child is using it. If your child is using the pacifier throughout the day, I would suggest reducing the use to only sleep times, and eventually weaning off the pacifier altogether. If the child has the pacifier during wake times, it does hinder speech production and oral motor movements.

It is very positive that he is pointing to objects/things he wants. This is a form of communication because he is exchanging with you. When he points to the object, you should name it and encourage him to imitate the word/sound. It is very easy to give the child what he wants without encouraging this, but really focus on having him make an attempt to “tell” you with a sound, a head nod (yes/no), a word, or simple sign language.

These are some suggestions for you to try. If you continue to have concerns, you should address them with your child’s pediatrician and schedule a speech and language evaluation with a speech-language pathologist, who can determine if there’s a need for therapy.