I may be jumping the gun here, but just in case I'd like some opinions. Daniel just turned 16 months and has yet to say a real word. He doesn't really babble yet either. I mean he says dadaa, bababab, ahhhhhh,yehhhh. But you know when typical kids babble they sound like they are speaking their own language, Daniel doesn't do that yet.

Now, I know it's still early....but not really that early. He is 16 months. I dared to look back in Elayna's baby book to see what she was saying at this age....needless to say I won't be doing that again. She had about 20 words.

Ok, my ped says his ear canals are small, but she says she can see the drum. He has never had an ear infection that I know of. He has seen an ENT once and will go back again in NOv. He passed his hearing test but the doctor said due to his age, he couldn't say for sure there is no loss. His responses were good most of the time, but some noises were made and Daniel didn't react. He did say for sure he passed.....but as a routine followup we go next month.

So here is where I am at.....am I expecting too much too soon? Since hearing and speech are so closely linked, should I be pushing for more in depth hearing tests or suggest tubes? Or should I just chill out? I am so anxiously awaiting hearing Momma

Thanks everyone!!!!

Editing to add: I spoke with his ST today and told her my concerns. She says if I didn't mention it, she would have no concerns at this time. She says he has some great receptive skills and even though he has no real words, he is indicating his wants by sounds. If he wants to play a certain game, he will get excited and say Ahh Ahh Ahh very much showing his excitment. So in her opinion, he is doing well. She of course said everyone is different...and I do know that...but I just want to make sure I am doing everything within my control to help him talk.

elias has always been a very "babbling baby" but maybe is because he has an extremly good ear (i swear sometimes it scares me)

he's 19 months, and he says mama, papa and at least what we understand he imitates is: ven (come), haber (lets see), bye. on this 3 words he's doesnt say the complete word, but we understand it

what we are working with him is lots of tongue exersices. put a lolly pop outsite mouth so he can get out the tongue and lick it. also putting some honey on the top lip or bottom so he can lick it too. also of course trying to make him simple sounds as the vowels.

trying to make him to blow, with is so hard lol

but i have to say that about a month a go he started more babbling as he was speking to his toys or as he is singing or trying to tell us something, before it was only when we asked something or when we said something to him.

=)

he is young, so try not to worry too much. HOWEVER, and I hope this doesnt sound odd, I am a big proponent of kids with DS having tubes. Ciarra had some evals that showed she was hearing "fine" too. But I had a tympanogram done and her ears were flat, fluid. We had 3 sets of tubes by age 7, but it was well worth it. Her speech is not perfect by any stretch, and she sometimes still garbles words, but her LANGUAGE is huge. We can keep working on articulation. I think it is so important to be absolutely thorough with our kids and hearing, their heads are smaller, eustachian tubes are shorter and slant more, and are an easy target for germs and fluid. Tubes are such a non-issue in terms of having them placed. I just think it is better safe than sorry. Im tired, should probably edit this, but Im leaving it.
PS one more plug for dr Jim McDonalds yahoo site, it is called Communicating Partners. AWESOME resource.

Should I be asking for tubes then as a preventative measure? Or maybe I'll voice my concerns and my ped can request a more in depth exam. Is that what the tympanogram is? Does the ped or ENT give that?

The tympanogram measures if there is any fluid in the middle ear. The ENT's do it but your normal doctor should have the equipment to do it.

Max has had 5 (i think) sets of tubes and he is 5 years old. He also has very small canals, which means the tubes fall out faster. I was told he had hearing loss in one ear and maybe mild loss in the other. However he has had a normal hearing test a couple of times now. He has had so many hearing test I don't even know how many! What kind of test are they doing on Daniel? Max has had a few different kinds now. I am guessing that Daniel gets the kind where he is in the booth and tech on the other side of the window makes different sounds with different pitches and looks to see if Daniel looks the right direction. If he does he gets the scary looking animals that drum. Pretty much with all the test like this you just never know if they hear it and don't react or if they really don't hear it.

If it shows that he does have fluid, then they will probably retest in a few weeks and maybe give him antibiotics to see if it clears up. But if the fluid stays then I would push for tubes. Like I said, Max is 5, he has a few words and also some approximations plus he uses signs. But speech is Max's biggest delay.

Also, Daniel is only 16 months old! Joe, my son, is about 2 weeks younger than him. Joe is pretty quiet. He can say a few words but here in the last few weeks he really hasn't said much. I am not too concerned about it. I also just found out he has an ear infection so that maybe why he isn't really talking.

Anyway, I hope you can find out if there is fluid in Daniels ears and also get a good hearing test. I know how frustrating it can get.

Lisa, Aleena was a VERY quiet baby for about a year and a half, even close to two!! Like you, I noticed how other kids babble, although not understandable, still sounded like a language, you know, like sentence babble with inflection. Aleena's babble was not like that at all! Now at 2 years, 9 months she still does not have any real spoken words, just word approximations. Our SLP is really thrilled with Aleena's receptive speech, too, but her expressive speech is slow in coming. She is very motor-driven right now! I know some of the kids on this site who are Aleena's age and even younger are saying words and building a vocabulary. I also know some kids who are older than her are not saying a whole lot, yet. I've been told that speech doesn't really come until 4, 5, 6 years old for most kids with Ds.

So, all that to say, I'm with ya! I know what you mean! I am soooooooo glad we taught Aleena sign, because we CAN communicate and I am able to realize her understanding of conversation around her because of how she responds with her signs. I encourage, support and do what the SLP tells me to do and the rest is up to Aleena!

Matt was always a very talkative baby, but definitely didn't have any spoke words by 16mths - however he did have a couple of signs. He's always had fluid in his ears, and has never passed a hearing test! But it never stopped him talking. (It's only now it's stopped - and that's a different matter!!!)

Hannah is the same age as Daniel and says 'Woo' for dog, 'Mummy', 'ook' for look, and 'more'. That's it. She also had about 5 signs. So Daniel, to me sounds like he's doing fine. Boys, on the whole, tend to acquire speech later than girls anyway. And 16mths is still very young.

With regards getting tubes. I would say definitely don't get them as a preventative measure. Who wants to put their child through surgery if it's not necessary? It sounds like Daniel is hearing, just hasn't worked out how to process what he hears into sounds he can make. And that's not just to do with his brain processing it, it can also be down to lower muscle tone in the mouth and tongue, etc.

Speech will come to most of our kids, it just takes time. Be glad that he's making sounds and babbling, and that his receptive language is good.

I think in the US many ENTs do use tubes preventively, it is a pretty accepted practice for many reasons. One being that the structure of our childrens faces/bones/ears are different and tubes can make a tremendous difference medically. This snippet explains a bit about immunology and tubes:

http://www.emedicine.com/ent/topic211.htm

Immunological activity may play a significant role in the frequency of AOM and its outcome. While most research has focused on the immunological aspects of OME, certain relationships between AOM and the patient's immune status have been demonstrated. First, the production of antibodies may promote the clearance of a middle ear effusion following an acute attack. Second, previous exposure or immunization may have a preventative role by suppressing colonization of the nasopharynx by pathogens. Third, the formation of antibodies during an attack may prevent or modify future attacks. Unfortunately, antibodies to both S pneumoniae and H influenzae are of the polysaccharide type and develop late unless conjugated to proteins. Finally, minor and/or transient immunological defects may give rise to recurrent OM.

Much attention has been focused on the immunoglobulins and the patient's ability to form them. Immunoglobulin G2 and immunoglobulin G4 are responsible for immunity against polysaccharide antigens; deficiencies in the formation of these antibodies invariably lead to OM. Many patients with Down syndrome have been demonstrated to have decreased function of immunoglobulin A, immunoglobulin G2, and/or immunoglobulin G4, partially explaining their increased risk for chronic rhinitis and OM.



this site has LOTS of info on speech and DS. It is a wonderful resource:

http://information.downsed.org/library/periodicals/dsrp/07/3/093/DSRP-07-3-093-EN-GB.htm

The phonological systems of children with Down syndrome are influenced by a variety of factors that can create difficulties perceiving and producing speech. In addition to the cognitive deficit that is the primary marker of the syndrome, hearing loss and differences in anatomy and physiology are contributing factors. Input may also be implicated. The precise influence of each factor is difficult to determine and may vary from one child to another. In conjunction, however, these factors have deleterious effects on speech and language development.

Given the other deficits faced by children with Down syndrome, it is likely that recurrent hearing loss compromises their language learning environment and that greater degrees of hearing loss and/or extended periods of middle ear disease will be associated with poorer outcomes on speech and language measures. In her review of language among children and adolescents with Down syndrome, Chapman (1997) notes that much of the variation in communicative abilities can be better understood if hearing status is taken into account.

In terms of intervention related to hearing status, the needs are clear: infants and children with Down syndrome will benefit from an aggressive treatment for hearing loss associated with middle ear pathology. Balkany (1980) identified three goals of such treatment: (1) normalization of hearing through insertion of tympanostomy tubes and, in some cases, fitting of hearing aids; (2) interruption of the cycle of recurrent otitis media with effusion through use of prophylactic drugs; and (3) prevention of chronic ear disease through adequate otologic care. In addition, Yarter (1980) suggested that infants and young children also receive an auditory training program concurrently with their program of speech therapy.



Dr Leshin says:
would add that any sign of chronic hearing loss associated with fluid in the middle ear, not just a severe loss, is an indication for drainage of the fluid.


another good resource is here:
http://www.intellectualdisability.info/complex_disability/hearing_ds.htm

Typanogram is really just a little puff of air blown into a childs ear and the reverberations of the ear drum are measured. Many kids with DS have what is commonly called "glue ear". Our ENT showed me exactly what he meant when he did Cs first set of tubes, I could NOT believe what came out of that little ear, thick nasty fluid, like glue. She had not had any ear pain or infections, just a flat tympanogram. You have to follow your own instincts on this, but I wholeheartedly support prophylactic tubes for our kids.

Kennedy never babbled. She rarely made a peep until about 2 or so. And now at 3 has quite a vocabulary, even putting together 2,3 and 4 words, according to her ST. It will come. Kendall spoke at a year old. It took Cameron forever, I thought he would never speak, and finally at 3, he was a little motor mouth.
I wouldn't worry too much, Kennedy also had great receptive speech but no expressive speech at that age.

I just skimmed the other responses, so sorry if this overlaps...

Cameron is 18 months and sounds a lot like your Daniel. He babbles some, no words, but babbles things like da-da. He is signing, around 8 signs. He had tubes put in his ear in Feb. Before that hardly babbled at all. He started 4 days after the tubes. I agree with Ciarra's mom - I am a big believer that tubes can really help. we had the tympanogram and Cameron's ear drum was flat, plus he has fluid that was always there. They can cause loss and problems with hearing by just being there. He has no hearing loss, but still doesn't seem to react normally to all sounds. I think it more of a developmental thing. He only had one ear infection before the tubes, so that wasn't a factor for us.

It sounds to me like Daniel is doing great. I also have Brooke and I NEVER have looked at anything I had written down for her in terms of development. It would be too hard for me to do that. I just try to think about Cameron and not compare.

Abby was/is just like Kennedy (LovelyKennedy). She too didn't speak much until around her 2nd birthday. That is why we chose signing to help her communicate. It really hasn't been until recently that she found her voice and is starting to put 2 and 3 word together.

I heard a tip from a friend who just had a speech consult. For low tone kids it's good to liven up their mouths with spicy food and extremes of temperature (of course nothing to hurt them We have been giving Eliza pieces of ice and she really moves her mouth around. We've also tried spicy taco meat and curries both of which she LOVED.

I asked a mom of a 5 year old with Ds who I think has really good speech when she started saying words - she said around 2 for her daughter before that it was all pretty much signs. Eliza is saying Mama and Mo - for more but it is constantly on my mind when i compare her with her 13 motnh old male cousin. They will get there when they are ready!

lISA-

oUR BABES ARE AROUND THE SAME AGE. mATTHEW IS DOING SIMPLE THINGS ONLY "i CAN UNDERSTAND!"

mooooom...."mom" da for dad.....and mmmmm for more. I think every child will have their own way of communication. I know your fear, your concern, your questions....I am right there with you girl....Matthew, I WISH i had pushed the sighns from the beginning....but I was in this total denial....now at 16 mths I am just now introducing.

I did the same checking back at Kyle's book....all filled out perfectly...and all to the high range of development.....it is a hard pill to swallow....but I am not kidding...with 3 kids I have learned none of them have been or will be the same....they are ALL so differnet. As I am sure many would agree. Daniel sounds like he is doing wonderful~! I am so proud of him and YOU! I look up to you and your family....

Lisa,

I have a typical daughter who is just a few weeks older than Daniel. Her speech is very delayed. Before the baby was born, she was speaking a few words, but now very little other than Dada. She can do a few signs. But what I have learned through my experience of mothering these children of mine is how very diffierent each of them is. Some of my children were absolutely eloquent at this age, speaking in long sentences. There were also some with similar delays. In the long run, they are all doing fine now. I know and understand it is different with a Ds child. We do have to worry a little bit more and be more proactive. But he does sound as those he is doing fine.

I just wanted you to know about my daughter his age. My two year old's speech was quite delayed as well. She is now such a chatterbox that we just marvel that there was a time we wished she would speak more.

I think you are such a good mom!!!

Ibby

Thank you everyone...you have no idea how much it helps to hear from all of you. We have our appointment with the ENT in Nov and I am going to ensure he has the appropriate testing to make sure there is no fluid hiding in there. If there isn't, then I know I have done all I could medically....and the rest is up to practice practice practice. Elayna never stops...so hopefully Daniel will be able to get in a word or 2 if Elayna lets him!!

Lisa, I've been meaning to reply to this thread and never got around to it. We also had a chatty oldest girl with a little brother right behind. Alex didn't say a single word until he was over 2--his sister did all the talking for him and he couldn't get a word in edgewise. Boys tend to talk a little later than girls anyway, even without the DS. You might want to enjoy the relative silence--before you know it you will be wishing he would just stop talking!

One key thing also that your ST mentioned was Daniel's receptive language skills which, to me is paramount. We sometimes forget that we need the receptive lang skills also, not just expressive. So, if Daniel's receptive skills are great, and he IS expressing his needs, engaging with you in his ways, then you are on your way! And ANY babbling is great in my book!

I also think it's a great idea to rule out ear issues. We got lucky and Russell has only had 1 or 2 infections ever, and nothing major, so we got to avoid tubes. Our ENT said that at this point, Russell probably won't ever need tubes.

Good luck!!!!

A.