I want to share a question I received via e-mail this week and my response…….
I have a question about pointing and grunting in a 19 month old….and signs of speech/language development. I was always told this was a good sign that child is going to start using speech and language skills. But there is a mom that says it is a bad thing. If you have any info…. that would be awesome.
My response -
About pointing and grunting - it IS a good thing in that it signifies that a child has the “intent” to communicate, which as you know, is a challenge for kids on the spectrum. When a professional is looking to diagnose autism, we look for pragmatics, or how a child is using gestures or words to communicate his needs.
Pointing and grunting are very early expressive and pragmatic language skills we would want to see in a baby or toddler who is just beginning to realize the need to communicate. Most developmental language checklists cite this skill at the 12-15 month level. In many typically developing children, these skills emerge even earlier.
The mom may be recognizing that these skills are emerging later than we would hope, or that a child who began to use these earlier hasn’t matured
and progressed to more complex gestures, and more importantly words. A child who is 19 months old should be imitating familiar words frequently throughout the day and using a minimum of 10-15 words independently. Again, many typically developing children use well beyond this number of words.
The mom may also be looking at the pointing and grunting from this negative perspective that real words aren’t coming in yet. However, I view these as a compensation method for an older toddler who “gets” that he has to do something to get something, but he’s not ready or able to talk just yet.
Now if the child is grunting without joint attention (for example - without eye contact and that nice looking back and forth between what he wants and his mother), or he’s using another gesture, such as taking his mom’s hands to open a top, or leading her to the kitchen without any other indication of joint attention, then it does usually indicate that although the child understands on some level that these adult hands are useful, he’s sometimes still not getting the “bigger picture” of reciprocal back and forth communication.
That being said, I’d rather a child be a pointer and grunter any day over NOTHING! At least then you’ve got a pretty good starting point to build the foundation for communication - both verbal and non-verbal!
Funny you should ask this question since “pragmatic” language skills in kids with autism was the topic of my podcast last week. You can listen to show #20 for more information.
Mom’s reply to me -
Thank you for the response. I guess I look at it from a point of view as an mom of an autistic child. He did not point or grunt. He would walk into the kitchen and just stand infront of the fridge. He would bring us books and place our hand on it…but he didn’t really look at us. As he got older and we used PECS, he would drag us to the fridge and point to what he wanted….but again…there wasn’t much back and forth there. Now there is….he even turns my face towards him sometimes.
My final answer is this…
Because pointing and grunting demonstrate an intent to communicate, I’d say they are (mostly) a “good” thing. But I would hope to move that intent to more complex forms of communication - higher level gesturing, back and forth turn-taking, and finally words. But let me say it again in case you missed it the first time - I’d rather have pointing and grunting than nothing!!!