Toddler who does not speak at 4 needs to be evaluated


February 27, 2000|By T. Berry Brazelton, M.D. | T. Berry Brazelton, M.D.,new york times special features

Q. My grandson is 4 years old and does not speak. He is a very wild child who will not listen to requests to be quiet or slow down. What do you think of this?

A. I hope that his parents have had his hearing evaluated. From your description, it sounds as if your grandson could have hearing problems. He surely needs an evaluation by a speech therapist and by a child therapist who could rule out Pervasive Developmental Disorder. That's a general diagnosis for disorders such as autism and others which may be behind your grandson's unreachableness.

Early intervention is important, so the sooner he is evaluated, the better.

Q. My 15-month-old son is the "perfect baby" who goes to bed at 7:30 p.m. and sleeps until 7 a.m. He is a wonderful, curious child who awakens with a smile daily.

My concern is with his pacifier and his bottle. He likes to have a pacifier in his mouth all the time, as well as one in each hand. He uses the pacifier to soothe himself, and he sleeps with one.

Should I limit his use of the pacifier -- and when is it appropriate to take it away? I don't want him to be 3 years old with a pacifier in his mouth.

I also give him a bottle at night before he goes to bed and sometimes in the morning, but not at all during the day. When do I stop with the bottle?

A. I am not concerned about the bottle. The way you are using it sounds fine -- as long as you don't leave it with your son in his crib at night. That could harm his future teeth.

It sounds as if the pacifiers are very important to him -- as "loveys." It needn't be traumatic to wean him from them. When he gets a bit older, you can tie them to a more acceptable "lovey," such as a teddy bear. Let him hug and love the bear and the pacifiers until he is able to use the bear for comfort instead of the pacifiers.

But I want you to be sure that you are his main "lovey." When a child is too good, it's easy to miss out on the cuddling chances he may need. Be sure to pick him up frequently to love him -- to rock him and cuddle him. You could also expand his bedtime routine to include a shared book or lullaby along with the bottle.

Questions or comments should be addressed to Dr. T. Berry Brazelton, care of the New York Times Syndication Sales Corp., 122 E. 42nd St., New York, N.Y. 10168. Questions of general interest will be answered in this column; Dr. Brazelton regrets that unpublished letters cannot be answered individually.

Pub Date: 02/27/00

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