19 Month Old Not Talking Much. Should I Be Worried?

If you are concerned then I recommended that you contact ECI and get an evaluation. They can give you the best idea of where he should be and give recommendations. Peds mean well, but I'm a big believer in Mom's intuition (coming from a mom who didn't trust her's with her 1st)

That being said, you son may be saying more than you think, you just can't understand him. That is what happend with my 2nd son. He is 4 now and in a PALS speech program through the school district. He has come a long way, thanks to early intervention.

Good luck!!

I would not worry. My ds did not speak until 21 or 22 months. And they were still garbled words until just recently. He's 2 1/2 now. Anyways I found what helped him and me was to teach him babysign language. I looked it up online and found basic words like again, play, book, sleep, milk, water, mom, dad, diaper, pain... My son picked up the sign language rather quickly and the words came soon after. You son will speak and helping him to express himself with sign language will ease frustration when he's trying to communicate with you. Good Luck.

My son's pedi said that at 18 months he should have 5-10 words in his vocabulary, and by 2 he should have 50 words. My son (18 months) only says about 6 words now. All kids develop at different rates, and there's nothing to worry about now. My son understands everything, and he "talks" gibberish a lot, so I'm not worried about him. I know that he's more into exploring everything and running than he is talking. I wouldn't sweat it too much, and just enjoy this time when he's not talking back to you;)

I would definitely start teaching him some simple sign language. There are plenty of books on it you can find to help you. Also, for developmental milestones and ranges, check out the information at Early Childhood Intervention services. If he did need help (and I don't think you should worry until he's closer to 3), your pediatrician would refer you to ECI, so it's helpful to see how he measures up to their information. http://www.dars.state.tx.us/ecis/index.shtml

Also, check with your local library. I know that ECI comes to ours occasionally to do free screenings.

As far as his exposure to words and talking, you're doing all the right things! The fact that he's at home with you isn't holding him back. However, you might consider a play-group or local moms club or MOPS group. It will give him some time with other kids, and you can see how he interacts with kids his own age. I'll bet you'll find a lot of kiddos in his age range that don't say much!

This brings up a bit of a rant for me. I want every mother everywhere to know that if you have a feeling that something isn't right, BELIEVE YOURSELF. Do not let anyone else tell you that your mother's instincts are wrong---even the pediatrician.

There are many wonderful pediatricians, but they are NOT developmentalists. Development is NOT their specialty and most pediatricians have spent precious little time actually raising children. I have a wonderful pediatrician and use him for the medical issues of my children---NOT THEIR DEVELOPMENT!

It is a crying shame that pediatricians have somehow supplanted the roles of mothers and grandmothers in helping young mothers. Please, please, please listen to the wisdom of women who have actually raised families. Their experiences should not be tossed aside.

Now that I have finished my soapbox issue, yes, you should be concerned about your child's speech. It's great that you've had a hearing test and it was normal. However, there are two parts to "hearing and understanding". Your child's structural components to hearing are functioning properly and are delivering the messages to the brain appropriately. However, what the brain does with those messages is called auditory processing and is the second component.

Auditory processing is a VERY common area of concern and can be helped with the appropriate stimulation. A speech therapist works with the OUTPUT of speech, not the input of auditory processing----usually. Some speech therapists use a program called Fast Forword that is excellent, though expensive.

It would be interesting to see if your child can locate sound without seeing the sound. This is the foundation for auditory processing and is often the root cause of speech problems. This is absolutely something families can and do help their children with every day.

www.parentswithpurpose.com

My son went from 'non-verbal', borderline autistic, to speaking in complete sentences. Some kids are just DIFFERENT. Can your son get his point across? Can he get his cookies, drink, jacket, tv show, whatever it is that he wants, by expressing his wishes in whatever fashion works for him / the two of you?

If he can, he's communicating. If he's not, I would take him to a pediatric neurologist for an autism screening.

Assuming he's communicating, I would just sit back and keep on keeping on - go on doing what you're doing, and wait for the day when that kid shocks everyone and you wish you could put a gag on him temporarily. :)

S.

My son was the exact same way, he didn't coo much either or make a lot of noise and at our 18 month check-up our doctor was worried about it, I am not one to ruch things because I know all children develop at different ages. Then at about 22 - 23 months old he just took off, I mean he just started saying everything, its like he knew all the words they just didn't come out. One things to ask yourself is can he follow directions, if you say go get your shoes... does he do it? If so then he understands you, that was the crazy thing about my son and everyone always commented on how well he understood everything you said or asked him to do, he just didn't talk. So now he is 27 months old and talks non-stop there are still things he is working on saying, but overall he is doing great. If you have any questions, let me know. Good luck and just give him a little more time. I do think enrolling him in a Mother's Day Out program or daycare a couple times a week would be great for him and you!!

L.,
YOU CAN NOT RELY ON YOUR PED.!!!!!!!!!!!!
ALWAYS go with your gut. Call Early Childhood Intervention (ECI) and they will come out and give an evaluation. PLEASE listen to yourself and not others telling you that is normal. It may be something small but why wait! Watch out for vaccinations too. Read the Vaccine Book by Dr. Sears. Or What the Doctors Don't Tell You ABout Vaccinations by Stephanie Cave. You are the ONLY one to advocate for your child. As sad as that is I learned it the hard way. SO now I want to help mom's in the situation I was in. SO PLEASE get him an evaluation. ECI is not expensive and will help and guide you.
L.

Of course have him checked out so that you feel all is okay because how can any of us mama's really know what is going on, but don't panic. My son didn't say much, and when he did you could hardly understand him until after his 3rd birthday...but he was fine. He was my first and I had no idea he was delayed until I quit my job and stayed home. Then he started to talk and a friend commented that all he had needed was more time with me to get him talking! Nothing was "wrong" and he is all grown up (a man) and about to graduate college....in communications!

Louder than words by Jenny McCarthy,

I disagree with these moms that are jumping to conclusions. I would consult a specialist; it couldn't hurt. Also, you may want to get his hearing checked. My friend has a child around the same age - he was not saying much. It was determined that he had fluid in his ear and was blocked 90 percent! He now has ear tubes and is doing much better. Please do not get freaked out by these moms that are saying autism. Let's rule out some other things first. Good luck!!

Hi L.,

I am a speech pathologist and couldn't help but respond to your post. Your pediatrician is right that he should have approx. 20 words. He might just be a late talker but I would watch him very carefully because if he doesn't start developing more language soon I would get him checked out. The thing that worries me as a professional is that he is not using any words and that demonstrates a delay. Another thing that I would be curious to know is how his comprehension is. Does he follow directions, point to body parts, take you to what he wants and those kids of things. Our comprehension always develops earlier than our expression, but again he appears to be slightly delayed. Please let me know if you have any questions!

T.

Read "Bringing Up Boys" by Dr. James Dobson.

ECI? The poor kid's going to be pressured to do something he's not READY to do and he's not even two? Come on. He'll be pressured enough later in life. My ped told me to have my son evaluated when his vocab didn't match her chart when he was two. I went with my gut and refused. Two weeks later he began saying more that matched her chart. Even if he didn't, I'd still let him take his own time. Most weeks, he gets to be with other kids twice a week. His babysitter's son didn't start talking until he turned 3 and he's around kids all the time (home daycare) - there's nothing WRONG with kids taking their time! Do not rush your son and please let God handle your worries.

Yes, you should be concerned. The old-hat conventional wisdom says wait, but that is no longer a good rule of thumb to follow. With the increase in the incidence of autism, you need to check this out sooner rather than later. Intervention is key to helping children. No, that's not pressure to do something. The longer you let this go, the longer it will take to help him. Even if you are only dealing with Central Auditory Processing Disorder, lack of early intervention can affect his reading progress later. Development is integrated, and all skills affect other skills. I'd love to know more about the kids mentioned in other posts who did not talk until age 3 or 4. Though not always, that is often an indication of high-functioning autism and some other "hidden" disabilities.

You did not mention other behaviors. There are some that indicate more about what may be going on. Does he fixate on ceiling fans? Does he play strangely, like lining up his cars and wanting them to stay that way, or maybe turning them upside down and spinning the wheels repeatedly? Does he bang his head or bite himself in frustration, especially when he cannot tell you something? How does he tell you he is hungry? If he is slamming kitchen cabinet doors or banging his head on the appliances, that's a problem. Does he point to things, to get your attention? Does he look when you point at something?

Since more than one post has mentioned the possibility of autism, here's a link to a list of signs of it -- that may help you know more about whether that could be a factor.
http://www.autismtoday.com/autism_14_signs.htm

Someone mentioned Early Childhood Intervention. Call them. If there is no reason for concern, they will tell you. They are swamped, and they will not serve a child unnecessarily. We've known people who had ECI evaluate their children, and ECI said there was no need for services.

I agree with the mom who said not to put him in daycare. Ditto for preschool with the school district when he turns 3. The best place for your son is at home, with his mother.

We work with families whose kids have developmental concerns. Please feel free to email me off-list for more information. I'd be happy to help.

Blessings,
P.

Don't compare, every child is unique. My oldest didn't talk until he was about 2, my youngest talked when she was 7 months old and spoke in full sentences at 1. So both of them started talking at the same time basically. It was very strange. Every child develops differently no matter what the charts say. Those charts are averages. That doesn't mean that they are right.

Call your local ECI (Early Childhood Intervention) to have them come out to your home and evaluate him. More than likely the will set him up for developmental / speech services. They will let you know if they think it's just a speech delay (very common with boys) or if something more is going on.

Hi L.,

My mom said I didn't talk much until I was 3. She said I just pointed to what I wanted most of the time. I didn't have to go through speech classes and ended up with a master's degree at age 23, so while I understand your worry, hopefully it won't turn out to be a big deal. My mom stayed home with me, and I guess I just didn't have any reason to talk. lol

Good luck!

L.,

You've received lots of advice. Some conflict with others. Please remember that free advice is worth exactly what you pay for it! For my two cents, I will tell you to trust your instincts as his mother. Doctors and other caregivers have guidelines they follow. As with all statistics, some will be below the numbers and some will be above the numbers.

I support your idea of mothers day out or part-time daycare. While you are his best teacher for values and discipline/expectations, your son will learn his social skills from his peers. He needs to learn how to fit in with others. He will learn how to share and how to communicate with others his age. You may be very surprised to see that he doesn't need to speak at home because you and your husband know him so well. He may have to begin using his words in a new environment.

ECI is definitely an option. I agree with one of the other posters, though, that he may still be a bit too young to gain any real value. I would go with the mothers day out first and see how he interacts with others. That may be more telling. If you feel that you need very thorough diagnostic testing, I strongly recommend the Scottish Rite Hospital. They are one of the best, and they do not take payments from the patient.

Best of luck to you.

I now have a VERY talkative 5 year old boy... everyone used to comment how quiet he was.. like it was a blessing before he was 2. Then when he was a big 2 1/2 & people got upset because he didn't answer them and they thought he was older. Bascially he had about 4 words which included our names... Mummy, Daddy, Grandma & milk... He would mostly point and grunt at what he wanted... I wasn't worried but the doctor wanted to check him - nothing was wrong - as I thought, because there wasn't a problem with his understanding. At around 3 1/2 (I think) he bascially opened his month and the words tumbled out. Within 2 weeks he was holding a long conversation. My Mum had always told me that this would happen (after 3) so I didn't get anxious about it. He literally chatters all the time now.. and he's a bit of a know-all :-) and has many 8-10 year old friends that he keeps up with!

My girl is 3 1/2.. and by 2 yrs was easily understandable. She is also a chatterbox..

I put the tv on now for peace when they are both insistant I listen at the same time.

The main thing to think about is that YOU are your child's advocate. Do what YOU think is the right thing to do. I was concerned about my child being speech delayed and other issues and the pediatricians never seemed concerned. ECI judged him to be at the low end of "normal" on speech and motor skills (and thus would do nothing to help him). I was irritated to no end that no one wanted to help my child. So, I just used my private insurance to get him evaluated by therapists. They indicated he needed speech, physical, and occupational therapy. After a year of therapy, he was a completely changed child. He just needed a little help to get to the more "regular" normal range and now all of his teacher's comment on how well spoken and bright he is (he is now in the gifted reading program at school).

L.

WOW, there have been tons of responses here, so I will be quick. My advice is, of course, to trust your gut...what is it telling you? I too worried about my son, who at 18 months said very little, but sometime after his 2nd birthday, he started and has yet to stop! I wondered about him, but was comparing him to my older daughters. He is an observer, and when he started talking, it was in complete sentences. Dont let other people make you feel like something is wrong with your son, if you dont really feel like there is! Do not send him to day care, or even a MDO in my opinion..you are his mother, and his best teacher, NO ONE can do a better job that you! I told myself that I would wait until my son was over 2 to start the evaluation process, and I was right to wait. I hope everything works out well, you are doing a great job!! ~A.~

My son was the same way until he turned 2. It was like he went to bed not saying anything and woke up the next day talking in complete sentences! I would continue reading and talking to him as much as possible. Even telling him what you are doing when you are doing the dishes. A play group probably won't hurt. He would be able to hear other kids talk and that might give him the confidence to do the same. Good Luck!

If the pediatrician has checked his hearing and isn't referring you to others, I wouldn't worry too much. My son didn't talk much at all, so I had him evaluated at about 18 months. The psychologist showed me him through a two way mirror talking up a storm with the worker there. He just didn't talk at home because he didn't have to. Start making him ask for cookies, food, toys, etc. Force him to make sounds even if he doesn't make words. My son later had speech therapy in kindergarten and first grade and fixed all his pronunciation problems. A mother's day out or play group will probably help, though. My youngest grandson wasn't talking much (his older brother doesn't give him much of a chance!!!) and they put him in daycare three days a week. Now he babbles all the time. (He's 15 months now.) He doesn't have too many words, but he is trying much more now.

Good luck and remember, every child is different and girls talk much more than boys.

D. Kimbriel
Grandma to 2 great boys

My son is 18 months and says 4 words. His pedi says this is completely normal and should not have a lot of words at this point, not until around the 2nd birthday. I'm not concerned at all. If you feel there is a problem then get him checked out, but don't base your child's development on other kids.

Daycare probably won't fix speech. Children develop at different ages. Girls tend to speak sooner and more often. Although, my 2nd daughter didn't really talk until after she turned 2 and then she was very, very chatty. My oldest son could say quite a few words early on, but just didn't. He is still a boy of few words. The point being, there is a lot of difference in the range of 'normal'.
If you are very concerned about your son, get him tested. If there is nothing wrong, you have peace of mind. If there is something there to work on, you know what you're dealing with.

PLEASE, PLEASE get your baby evaluated now! DO NOT rely on your pediatrician! If there is a problem such as autism the earlier you intervene the better chance your little one has of overcoming it, especially if caught before the age of two. Do NOT wait!! My daughter listened to others who told her not to worry, that my grandson would catch up, and all the instances she heard about where the children didn't talk until age four, etc. After having his hearing tested did nothing further while waiting for him to "catch up" until it became obvious that he was not going to. Please listen to your gut as another responder mentioned and have your child evaluated as soon as possible!! You will thank your lucky stars you did.

Call ECI (Early Childhood Intervention)and let them evaluate your son. If there are any developmental issues, including speech, they will work with you until he is 3. Don't wait.

My daughter could only say 5 words at that age. She was evaluated by ECI and started thearpy with them. It didnt help any so we started Speech threapy through Therapedia which did wonders for her!! She picked up a new word a week. She is 2 1/2 now and is up to 50 words. Still delayed but learning new words and that is all that matters.

She was delayed in other areas as well and something didnt quite seem normal as the other children so I have had her looked in to by other therapits and doctors.

Turns out my daughter has PDD/NOS- Pervasive Developmental Disorder/Not Otherwise Specified. Also has Sensory Intergration Dysfunction, High functioning Autism and Static Encephalopy (Sp?).

She looks and acts like every other child. She is just delayed a little bit and reacts differently to certain situations than other children.

The Sensory Intergration Dysfunction has a lot to do with her delays. Children learn by their sensory sources (touch, sight, feel, taste, ect) and if the brain isnt functioning correctly they have a hard time relating and picking up as quickly.

My daughter has just now picked up the skill to mimic which has helped a lot in her learning and picking up new words or skills.

Listen to your gut you know what is best for your child. If your concerened ask for a second oppinion. For 2 1/2 years people looked at me like I was over reacting and parinoid mom. I fought for her to have Speech Therapy, Physical Therapy and Occupational therapy. I paid out of pocket even when ins wouldnt pay.

Turns out that I was right all along and my daughter did have some problems. If I wouldnt of done all that I did early on she would not be doing as well as she is now.

If you have any questions re Speech Therpay tips email me and I will give you my number and I can give you some pointers on how to help improove his speech...things you can do at home.

My 20 mo old DD also talks little. I haven't had her evaluated by ECI, but I have talked to lots of people, including my cousin who is a certified early childhood speech pathologist. She gave me a checklist for evaluating DD based on non-verbal cues. It turns out that my DD is at or above age level in everything else--she clearly understands A LOT (we can sit and ask her to point to stuff, and she will); she communicates using babysigns; she engages in pretend play (tea party, doll house, etc); she shares, hugs, etc, so interacts very well with others. As a result, we're confident that the speech will come when she's ready. So the question for your son is, how is he progressing in other things? If he seems at or above age level in everything else, then don't worry, and he'll talk when he's ready. If the lack of speech seems to correlate with other areas for concern (e.g. not interacting or communicating in other ways), then you should try to get him some help--if he does need it, the earlier the better. GL! I know how hard it is to compare your kids with others, when every kid is different!

No to daycare!!! No, he doesn't need to be apart from you at all- that would only worsen other things. Honestly, pediatricians sometimes make people feel like their child is behind, but no way, I totally wouldn't worry about it. He says 20 words, that's phenomenal!!! Yeah, just keep talking to him about everything, telling him what things are, and he'll be speaking more than kids his age in no time. As long as he's happy and content, don't worry about it at all.
Keep up the good work M.!

Well, it is hard to know what is going on with your child since you haven't explored any specific testing. Your child may be a late bloomer but it should be speaking more and even kids with learning challenges or autism can be taught so start making your child use words. Make it a game and help him start making proper sounds for what he wants. If he can't achieve that oever several weeks, no improvement, and if your child is having other concerns ( how he interacts with others or lack of play) pursue getting him tested immediately. Even kids diagnosed with autism, there are great programs that can help them learn and function properly.

As long as he is communicating and not gettig frustrated, and you know what he needs, don't worry too much yet. You might teach him some sign language just for fun, too. Lots of babies are learning sign language now and it helps them communicate until they are ready to talk. You can also insist that he say the things he can say, like when he wants some water or juice, say "Use your words," and then get him a some juice when you hear the word. Praise him for doing that. Get really excited when he says something new. You might be surprised, one of these days he'll break out reading or something - you can tell what's going on in that little head by how happy he is.

The best teachers for children, are other children. They to imitate each other,picking up words and sounds. They learn through play. I highly recommend a mothers day out, 2 times a week. 8-11:30. That'll also give you a couple hrs a couple times a week get things done. :-)
I called ECI when my son was 26 mos and he barely qualified,even though I was sure he was WAY behind. They also ruled out autism. He saw and still sees a speech therapist once a week for 30 min, but I honestly think the dvd i play in the car gets better results.
The dvd is Baby Babble(part 1 and 2). If your son watches any TV or if you have a dvd player in your car, THIS is what you want him to watch rather than cartoons(except for Sesame Street). It's a dvd that was made by speech pathologists. My son started repeating everything in the dvd after listening to it for one week. I still play it in th car and now my 11 mo old daughter says about 10 words including thank you,ball,up,and bubbles. She says them at the appropriate times so she is not only saying the word, but obviously understanding what the word means.
And I think it's b/c of the dvd.
There is a parent tutorial segment in it that demonstrates how to get your child to make certain sounds through tactile gestures(blowing bubbles,blowing in a flute,smacking lips with chapstick) so that they can begin making the mouth movements that produce certain sounds.
The tutorial also explains how to to encourage speaking,
It's great and I highly recommend it to ANYONE with young children.

Hi L.,

I wouldn't be too worried. All children develop at different rates. I have been told by a speech therapist that some children develop more quickly physically while others develop more quickly verbally. For example, my son is 20 months old today and says 75 or more words (I've lost count). BUT - he also just started walking when he was 15 and a half months old - while others are walking at 11 to 12 months old. Did your son walk early, get his teeth early, etc? This may explain why he's not quite as verbally developed as the pediatrician says he should be. When my son wasn't walking, my husband was very quick to remind me that all children develop at different rates. My stepson is 7 years old and wasn't saying a word at the age of 2. (His natural mother wanted him labeled as autistic - that's a long story I won't get in to... but my husband wouldn't have his son strapped with that kind of "diagnosis" at that age). Then all of a sudden he started speaking in complete sentences. He's now very talkative, an outstanding student, and has the vocabulary of a child twice his age. I think it's important not to get too hung up on the number of words your child knows - and not to have him diagnosed with something that he doesn't have. If you are really worried about communicating with him, perhaps you should speak to a speech therapist and get him started on sign language. A friend of mine has a daughter who wasn't saying a word (no autism or hearing problems) at the age of 2.5 - 3 but could communicate to her mother what happened at school that day with sign language. Then, one day she started speaking in complete sentences. Obviously, these are isolated cases and if you are really worried you should speak to a professional - but I'm sure you're son will catch up - just on his own time - not the pediatrician's timetable. I know it's frustrating at times, but I think at this point you should just be patient and wait for the progress to come. Good luck.

Talk more with your doctor, but if your child has other ways of communicating his needs, and if he is delayed only with speech, then there is probably no cause for concern. All kids reach developmental milestones at different times, and that's especially true with speech. Some kids just aren't that motivated to learn to speak, especially if they are getting their needs met without talking. My nephew (now 8), is probably the most articulate and intelligent little boy I've met, and he didn't say a single word until about 3 years old. At 3, he suddenly decided to speak, and started using complete sentences almost immediately.

Dear L.,

I do not want to scare but just to make you aware of my situation. When my 9 year old son was 18 months old he lost all communication with us due to the MMR immunization. Which, by the way the doctors will never admit to it. I was able as a Mom to track his problems back to this vaccine.

If you continue to notice a speech delay in your son I would take him to be seen by professionals who are experts in their field with speech delay. 7 years ago we moved here from the East Coast. We were told before arriving to Texas that he would never speak. He would have to sign, grunt or point at pictures for communication. With continued prayer over him and participation in the PPCD program here in Texas, my son speaks and is behind in school but catching up every day. The PPCD program is for preschool aged kids. This program is phenomenal. It helps kids socialize and catch up in various areas that they are delayed in.

Sometimes these things are hereditary. I had two nephews that also had a speech delay. Most of the time these kids are very intelligent. Einstein did not talk until later. But, today there are programs to help kids that have a speech delay.

My biggest advice to you is that you need to go with your gut feelings. Mom's have a connection with their kids that Dad's do not have. I always knew there was something not right with my son. I am not trying to diagnose your boy, but just trying to share my own story with you. Go with your gut and lay hands on your child daily and pray over him . Jesus loves children. Jesus mentions children in a special way in the New Testament. If you attend church, have your pastor anoint your child with oil and pray over him.

EARLY intervention is the key to a child's success with a speech delay. The sooner your boy is socialized and helped the sooner he will be talking.

Don't be alarmed by this because more and more kids are haveing speech delays in our country. My opinion is due to immunizations and diet.

TIP: We waited until our child was 6 until we got the second round of MMR vaccinations for him. WE did not want to overload his small frame with move vaccines since he was already having trouble with the first round of MMR. WE actually had our pediatrician help us with all the paperwork in delaying his second round of MMR shots. A wise move on our part which I feel saved him from falling into a very dark place. We may have lost him forever if we did not delay that second round of shots.

As parents in our world today we have to be very proactive in our children's lives. WE have to be more knowledgeable about their well being. Our child developed very bad tantrums because he could not communicate like our other two kids could. Thus, he became ADHD. He was on meds for a little while which which was right for him and our family. We praise God that he does not take meds any longer. At one point my child was on totally organic food was well. The organic food helped him gain back speech that was lost. Our family gives all the honor and Glory to God for healing Jacob. We were proactive and we also became a family that prays together. I remember my two older kids laying hands on our child and praying for Jesus to heal him. An image I will never forget. We never know why we have to go through tough times but I will tell you that we are prayer warriors now for others in need and we share our story about our precious Jacob when God tells us to share.

A great pediatrician who takes alot of time with our child is located in Allen Presbyterian Hospital. Dr. Moulton. I highly recommend him for kids with delays. He is loving and listens to the needs of the parents and takes alot of time with each patient.

I will be praying for your situation and God bless you and your family.

L.
P.S Never give up hope about any situation in your life. God is still a healer and HE is the Great Physician.

L.,
i had a nephew who barely said a word until he was 4 yrs old.
the doctors checked everything as well. turns out he was fine just didn't want to talk til then.
however, have you taken him to be checked for autism or by a speech therapist?

As long as he is trying to say words and sounds come out of his mouth he should be fine. I would only be worried if he weren't attempting to talk at all. We didn't undertand what my daughter was saying until she was around 26 months old. They all develop differently. Good luck!

I wouldn't worry yet. He has some words so he has the capacity, he just hasn't had the explosion yet. It is coming. Like the old joke, we try to teach our kids to walk and talk in the first two years and then spend the rest trying to get them to sit down and be quiet!
Just remember that every kid is different so you can't compare him to other kids because they will always be ahead in some ways. Especially in the area of language girls develop faster than boys so don't worry, it evens out eventually.
My best suggestion is to ask him about favorite things and let him point and give him the word for it, eventually he'll five the word back. Books are great and so are descriptions of everyday things. For example "look, we are drying off with a warm, fuzzy, blue bath towel. It has a hood. Doesn't it feel good to be warm and clean and dry."

call your local early child hood intervention (ECI) team, they come out and do an evaluation of your chold and if he qualifies then he can receive speech services in your home usually for little to no cost at all depending on income and we have had all 3 of our boys in ECI due to speech delays...

if you live in Coin county you would call the colin county early childhood intervention and so on...someone else may know the 800 number but I cant find it right now...

HTH
A. J

I have the same issue with my son. At 19 mos. I called ECI and they came out and did an eval and now he is in speech therapy every week. He makes sounds for things instead of saying the words for them. Like for elephant, he will make his arm like a trunk and make the sound of an elephant. Cars...won't say car but makes all the noises they make...driving, crashing, backing up etc.... He doesn't use the words mommy or daddy with purpose. He knows who we are and will point to us if asked where we are but won't call me mommy or mama or anything. It sounds like your son is a lot like mine. He is super smart and knows lots of signs but just won't say the words. He understands everything we say to him and follows directions well. It is so frustrating. I know what you are going through. It is sooooo hard not to compare to other kids his age. But I am confident that since we are working with ECI, he will catch up without any problems. You should call ECI and have him evaluated. Best of luck and if you have any questions you can pm me. :) Hang in there!