A: My son is 27 months old and he doesn't say much besides mom and dada, kitty, and a few other things. But he responds to everything I ask him to do, and if I count from one to five he holds up his fingers all the way to five. Nevertheless, my family is worried. Should I be?
Q: To understand where your son is at, it's important to look at both your child’s receptive language—the words he understands, and his expressive language—the words he can say. The good news is that it sounds like your son's receptive vocabulary is quite good. He is responding appropriately to your requests and can follow simple directions, like holding up his fingers to count to five. As for expressive communication, it’s important to factor in your child's ability to communicate with gestures. For example, while a child may not say with words, Mommy, I'm hungry. I want a banana, he may take his mom's hand, walk her to the kitchen, and point to the banana. This is expressive communication, too.
As for expressive vocabulary, this typically increases between ages 2 and 3 to about 300 words. According to the American Speech-Language-Hearing Association, at 27 months, children should be saying new words each month and using two-word sentences, such as "more juice". If you find that your child is only saying a limited number of words and not using two word sentences, he may be behind in his expressive language. The best first step is to make an appointment with your son's pediatrician to discuss whether he might have a speech delay.
Also, call your state's "Child Find" office. (You can go to: http://www.nectac.org/ contact/ptccoord.asp for each state's contact information.) Child Find professionals provide screening and assessment services to babies and toddlers, often at no charge. They also offer early intervention services such as speech therapy. These programs are part of a federal system that operates in all states. It may very well be that an assessment concludes that your child doesn't need any extra help and will catch up on his own, but it's always good to check this out, if only for reassurance.
It is also helpful to begin keeping a word list in which you note the words that your child uses. These words don’t have to be pronounced perfectly, but they should be sounds that your son uses consistently for one idea. For example, he may say “muh” for milk and only use this sound to ask for milk. So you can include “muh” as one of his words on the list. Bring this list with you to your discussion with your pediatrician and during any assessments that may take place.
In order to support your son’s language development, make a habit of repeating and labeling any sounds he uses for words. For example, if he says "ba" for "ball," you can say, Yes, that's the ball. Continue to read, talk, and sing with him, ask him questions, and point out and identify the people and things that fill his world. Other helpful strategies are to use short sentences (three to five words) when you talk with him, and to engage in lots of back-and-forth verbal interaction with him. You say something and then pause to give him time to respond. Over time, and with support from you, your son’s language will grow and you’ll be wondering when he’ll ever stop talking.