20 Month Old Girl Not Talking, Only Moans With Her Mouth Closed
(Albany, New York, United States)
Hello, my 20 month old daughter has no words. She babbles very rarely, and most of her vocalizations consist of her moaning with her mouth closed. Anytime she attempts to talk, she does so with her mouth closed. She has met most of her communication milestones, including shaking her head no, pointing to things she wants or wants to show us, pointing to multiple body parts, and following verbal commands. She understands a great deal of what we say, but we're confused as to why her expressive language skills are behind.
We have had early intervention visit twice at our doctor's recommendation. Once when she was 10 months old because she learned to sit late, and once when she was 17 months old because she was not yet walking or talking. She did not qualify for services either time. She walks now and learned to do so just after she turned 18 months old; however, she has made no progress in talking. The speech therapist gave me a little booklet of activities I can do at home to encourage speech. I do these activities every day, but I'm concerned that I'm having no effect. Some of the tips include: making sound effects like moo for a toy cow, repeating words and simple phrases, naming pictures in books and flashcards, and listening to music and singing together. She has definitely expanded her receptive language skills as a result of the activities, but while she gains understanding from them, she does not participate.
I'm concerned that the above tips work well for a child who opens his/her mouth, but maybe not as well for a child who does not. Does anyone have any ideas for how I can encourage her to open her mouth? If I continue to work with her and see no improvement, when should I seek additional help? What kind of help should I pursue?
Thank you. Any ideas and advice you can offer would be greatly appreciated.