I recently got asked this question.  Names have been changed.

Question:  My son, Jason, who is almost 18 months old has been referred by his pediatrician for a speech therapy evaluation.  I don't know if it is necessary or not.  What should I expect and should I enroll him?

Answer:  Let me start with what you should expect.  Your therapist will probably ask you questions to get a case history.  She will be looking for any red flags in Jason's history that may indicate a speech/language problem.  She will then probably play with Jason to get him used to her.  She will give him one or possibly two tests (I try to stick to one when they are 18 months old).  The test may look like playing, but she's trying to get him to show her different receptive and expressive language skills.

Now let me give you some "milestones" for 12-17 month old speech and then 18 month old's speech since I know Jason is close. There will be two categories: Receptive Language (what Jason hears, understands, and responds to) and Expressive Language (what he is telling you without any prompts). Expressive language is not always talking as long as it is COMMUNICATING (he is getting a message to you). However, talking should be involved by this point.
12-17 months:
Receptive Language:
*recognizes his/her name
*understands no
*understands simple instructions
*places an object in a cup on command
*gives a toy on request

Expressive Language:
*points and gestures to call attention to an event or to show wants
*imitates familiar words
*waves good-bye and plays pat-a-cake
*uses mama and dad and several other words, usually nouns
*practices words
*likes to make the "sounds" of familiar animals and things
*attempts to communicate by mixing jargon with real words
*vocalizes for enjoyment

18 months:
Receptive Language:
*points to own toes, eyes, and nose
*brings familiar objects from another room when asked
*follows simple commands

Expressive Language:
*Uses 10-20 different words
*starts to combine 2 words, such as "all gone" , "daddy bye-bye"
*uses words to make wants known, such as "more", "up"
*imitates words and sounds more precisely
*knows and says the name of 5 things
*begins to reduce use of real words with jargon

Whether or not you should enroll him is a personal decision.  I've seen patients as young as 18 months old.  In that particular case, the 18 month old was not saying any words.  He only needed services for 6 months and was exited.  He is now doing fine and doesn't need any more therapy.  My personal belief is that the younger we can get them, the less time they spend in speech therapy (that excludes severely handicapped children, kids with multiple diagnoses, or a diagnosis that will follow him/her for a lifetime).  Wait until you see the test results and see what the therapist recommends.  You can then take all the data and make a decision that is right for your family.

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