Steve Pavlakis MD Peds Neuro DrMDK.com
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Interviewer: If the child is 18 months old, how many words would you think as a neurologist the kids should be speaking? Interviewee: Well at 18 months a child of that stage should be walking and should have a handful of words. More importantly, they should understand a child at 18 months can follow commands verbally. A child at 18 months can point the body parts with verbal queues and may even be able to say some of the body parts. So, that would be the kind of interaction we would expect at 18 months. Interviewer: How many words do you think would be spoke from them? Interviewee: There are normal kids that do not have any words at that age but understand. But I think 20 or 30 words would not be unreasonable for the 18 months. Interviewer: But sometimes kids use pointing gyration with her own type of language. Interviewee: Correct. That is correct. Interviewer: And that could be perfectly normal. Interviewee: Perfectly normal and a perfectly normal 18 months do not have any words or may have one or two words but understand point, follow commands. And those children are not of concern but again if a child has no words or whatsoever at 18 months, that is something that you would discuss with a pediatrician, not necessarily need to go to a neurologist because it can be normal. Interviewer: If multiple languages is spoken in the house, sometimes it makes it more difficult for the kid to speak English because of the fact that is happening around the kid. Interviewee: That is correct. There are two issues her that are interesting. One is some children do not have a lot of expressive language and that can be normal and studies have been done a long time ago in the 80’s on this and people found that those children who do not speak a lot tend to be quiet as adults, could be smarter than everybody else but they tend not to be talkative people. The second issue is having multiple languages which is the main thing about Brooklyn and that probably half of the people we see speak at least two languages at home. Sometimes we see more than that which is confusing. In a child who does not have a language disability, those children can acquire both languages very normally. Although may have some relative delays especially in vocabulary and the like up until about age four years. After that there is not much on the way of real delay. With child that has no inherent language problems can pick up two languages quite literally may have some mild expressive delays but not a lot relative to children that have one language. And by age four should be pretty much entirely cut up. Interviewer: A lot of this could be based in good observation by your pediatrician, looking for expressive language in the language, is that correct? Interviewee: That is correct. So, you want to look at expressive language meaning what you say and at the younger ages when there is not a lot of expressive language even more importantly the receptive language of what the kid understands. Interviewer: So, in other words there is no fixed role. Many kids will learn a different rates but the overall picture should be look at by your pediatrician. Interviewee: I think that is right. The pediatrician should look at those first and if there is a concern, the patient may need to be referred to a neurologist. But there is no real fixed rate especially with expressive language which is really all over the government and one has to be very careful about using that alone. Interviewer: Thank you Doctor—
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