Expressive Language Score | Speech and Language Problems | Ask at Therapist

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Speech Delays and Language Concerns

Back to: Therapist Questions & Answers - Speech & Language Concerns

My two-year-old was born with Lyme disease. (He got it in utero.) It took us 13 months to figure out was wrong with him. Anyway, he seemed fine once he was treated. Prior to receiving antibiotics, he had FTT until he was about 2 months old and barely reached his milestones. For example, he sat on his own at 11 months. A neurologist saw him at 13 months and 16 months and seemed to think that he was bright and didn't seem to think that the Lyme disease had affected him cognitively. The Lyme doctor seemed to think the same. At 24 months, we had him evaluated. His speech was ten months delayed, but more distressing was that his cognitive testing came up 5 months delayed!

I was told I shouldn't worry at this point - that he seemed very alert, that he would most likely catch up or that it could be a receptive language problem getting in the way. My question is whether or not this is true - that he can catch up. What I've read online doesn't seem very positive.

It doesn't surprise me that he is showing language delays given that he was also very delayed in other areas (FTT, sitting, etc.). If you are receiving speech and language therapy and are following through with their recommendations at home, your son should be able to make great receptive/expressive language gains.

Just as his sitting eventually developed, often we see the same with language. It may take a little longer, but he will continue to make gains. I know you are concerned about his lower receptive language score (5 months delayed) but one positive is that he is still above his expressive language score (10 months delayed). We (SLPs) do show concern when the expressive language score is above the receptive language score because all through life we know more than what is expressed so the receptive score should remain above the expressive score.

If he is not receiving speech and language therapy, I do recommend it. Also, if you begin to see any regression, please speak with your doctor and neurologist.