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Behaviors in a Child with a Communication Disorder

Feb 14, 2022 Mom's Question: "My little one is 23 months old and has a very limited vocabulary, so he screams at the top of his lungs constantly. We tried to take away the pacifier with no success. Any advice on how I could help him with this behavior?"

First of all, I can totally empathize with you from a mother’s perspective. My son, Nicholas, is almost 8-months-old and when he doesn’t get what he wants, boy does he scream. Not just any scream – it’s a loud, shrieking, indescribable scream. The kind that makes you want to wear earplugs all day and wonder about your child’s behavior and your patience and parenting style.

I’m going to break up this blog into different sections so I can, hopefully, answer all your questions as they relate to a baby screaming!

Screaming because of a Limited Vocabulary

Any time a child cannot communicate their wants and needs, they WILL act out in a variety of ways. This can be behavioral, such as screaming, kicking, or hitting OR it could be emotional, such as crying to socially isolating. If it seems like your child is attempting to communicate, but can’t, here are some things you can do to help:

  • Create picture cards to make communication easier. This can be a simple board with everyday objects and activities. Make sure you have the staples, like food and drink. The usage of this board will heavily depend on your child’s age and their ability to understand the board. It may take a few weeks for them to get the hang of it, but don’t give up. Start with only a couple words and gradually increase when your child gets the hang of it. 
  • Give your child options. If they want something to drink, model the words “milk” and “water” (or whatever choices you want to give). This demonstrates proper vocabulary usage, but also eliminates too many options. 
  • Encourage pointing, gesturing and having your child take you to what they want. Once you understand what they need/want, make sure you tell them the words. For example, if they are pulling you to the bathroom, ask your child, “go to the bathroom?” Expose them to the language you want them to use. 
  • Keep your sentences, directions and explanations short. Children can only handle so many words in one sentence and giving them more overloads the auditory processing center of the brain. This can lead to frustration and misunderstanding. 
  • Say the key words 3 times and then move on. For example, ask your child to say “more.” If they don’t repeat it after you, model it two more times and then switch to the next topic. Studies have shown repeating stimulus items three times is more successful than hearing it once or more than three times. 

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Bottles vs. Sippy Cups

This information is not to alarm or make anyone upset, but instead should be used for knowledge and information purposes.

Bottles should be taken away at 12-months-of-age. The longer a child has a bottle, the harder it is to give up AND it can lead to articulation and speech delays. In addition, the use of pacifiers past three-years-of-age can also lead to speech development issues. 

As a mom, I can tell you what I have done with my 3-year-old daughter and what is currently happening with my son (8 months). 

Nora and Nicholas were breastfed for 6 months but did receive bottles of formula to supplement. I started giving Nora a 360 cup and sippy cup/straw cup when she was about 9-months-old and let her play with it any time she wanted. Every once in a while, she would use it appropriately and get water out of it.

When she turned 12 months, switching to the straw cup was no big deal. At bedtime, we’d still put milk in it so it wasn’t that big of a change. I just started giving Nicholas the same cups and he is totally interested, as well!

Pacifier Usage

They both used/are using pacifiers when napping or sleeping. With both kids, they only get the pacifier when sleeping; no other time is that in their mouths.

I suggest you try and do the same. Eliminate the pacifier during the day, first. Then take away during 1 nap, then 2 naps, and then at bedtime. 

At 23 months, we took Nora’s pacifier away. It was right before Christmas, so we told her that Santa had to take the pacifiers back to the North Pole to give to other children who didn’t have any. She cried/whined for three nights and then never looked back.

Nicholas still has his pacifier because he is only 8-months-old. I plan on taking his pacifiers away before 2-years-of-age OR sooner if he’s ready. I won’t be able to use the Santa excuse, but I’m hoping the Easter Bunny will do the trick!

Take Away Points about Behavior of Child with a Limited Vocabulary

Children will fight you on changes, initially. Oh, and babies cry. The important thing to remember is that YOU are the parent. YOU are the adult. You are stronger and wiser than a toddler.

It’s very hard to hear them scream, but you need to stay strong and not give in. By giving in, you are only rewarding the behavior that you are trying to eliminate. 

If they do a positive behavior (e.g., drink from the straw), reward them with praise and high fives. Kids love to know they are being good and will keep doing the behavior that you acknowledge positively. 

We are working hard to answer all of your questions, so keep asking away!

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The author’s views are entirely his or her own and may not necessarily reflect the views of Blub Blub Inc. All content provided on this website is for informational purposes only and is not intended to be a substitute for independent professional medical judgement, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Comments (4)
  • Hi, my daughter refuses to talk even though she has the words. She can say more, leave, no, yes, t.v. but other words she doesn’t want or maybe she struggles to say. Please help.

    • Hi Zimra! This is a typical thing that we as speech pathologists hear. My child knows the words but is “stubborn.” Here’s the thing – if they can communicate, they will. I do not have the background information on your child to give you detailed information, but it sounds like there is something blocking her from communicating with you. How old is she? Is she putting the words into phrases? Does she initiate conversations in other ways? If you want to write us back and provide more details, we might be able to give you more information or insight!

      Stacie Bennett, M.S. CCC-SLP

  • My son is 23 months and was talking up to 18 months. He had all the words and more making sentences and even found books interesting. Now that he is almost 2 I am concerned that talking is not happening. He points to something and I pick up what I think he wants and he pushes it back shaking his head no. Once I find out what he wants, I tell him what it is and he just mmm or eeeeh. I am working hard on trying to get him to use the words he knows but I get Ma and eeeh or mmm and it’s frustrating. And if I don’t get what he is pointing to, it’s a fallout head banging on the floor or stomping of the foot. I don’t know if it’s because he is mentally or physically delayed or it’s because he’s still nursing 2x a day and at bedtime or what. I am just a very concerned new mom and trying to find answers on what to do. He does understand what I ask him to do such as clean up his mess, or put his clothes away. He just started acknowledging his name.

    • HI. First of all, nursing does not affect a speech delay or cause a regression in speech – so do not worry about that. I would suggest you getting your son evaluated for early intervention/private speech therapy. It sounds like he’s had a regression and isn’t progressing as much as he should be for almost 2 years old. In addition, try and not give him things right away. Place the object by your mouth and model the word. See if he can approximate any sounds from the word. If he makes any attempt, praise him, repeat the word and give him the object.
      Stacie Bennett, M.S. CCC-SLP

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