Pointing and Grunting – Good Thing or Bad Thing?

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 in front 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!!!

 

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Comments

  1. Annette says

    Hi Laura,
    Jake, who just turned 3 yrs old two weeks ago has given us the morning silent treatment for the week or so. (maybe longer, but more frequent now).

    When he gets up in the morning, he will just point and re-point with more emphasis to what he wants. He’s not saying a word, not making a sound, like he’s intentionally conveying the message, “I’m not talking to you, but I want that”. He even does this to his sister when he wants her to play with something, and he is usually very verbal with her! He has stopped calling for her in the mornings like he usually does when she isn’t up yet and he has stopped saying, “There’s Maya!” when he sees her in the morning.

    After several hours and getting into the daily routine, he will start becoming verbal again. However, lately, when he gets agitated he stops talking to us again.. and you can see on his face, he knows he is doing this intentionally! He still maintains interaction, but sometimes looks down or away like he being coy, because there is a slight smirk… I wish you could see it.

    I’ve noticed that sometimes, he will with hold his words, when I know he can say them! Speech therapy has been a bust lately because he has been refusing to talk, and we couldn’t get through his 6 month re-evaluation because he wouldn’t cooperate. But as soon as he was back to playing, he was fine and happy.

    If he is pointing to something, or jumping up and down saying “eh, eh” for me to get him something, I will tell him to “use your words” sometimes he will, and other times he will just shake his head “no” and keep jumping or pointing and then start yelling. At this point, I say, “use your words, please” then I will turn to walk away (not giving in to his tantrum). At that point, he will then say and sign “please” or “more” because these were his first signs, then I will promptly give him what he wanted to reinforce his verbal request. (I also try to get him to expand his request with more words too)and I always praise him for using his words.

    Do you have any idea why he would rebel against language after working so hard to get it? Is he using this as a tactic to push limits? I don’t want to battle with him over talking, but sometimes it seems like he does it just to push our buttons. This seems to me to be either very complex thinking and manipulation, or he is “forgetting” to use his words and it’s easier to go back to the old ways. Do you think it may be related to the craziness of the holidays our busy schedules and all the visitors we’ve had in the last month?

    What do you think? I don’t want to react to this incorrectly and undo all of our hard work. Please – Inspire me! :o)

    Sorry this got so long, your suggestions on this matter would be most helpful!

    Thanks!
    Annette +Jake

  2. Annette says

    oops, to edit my above post… Maya is our dog, and he gets excited to see her in the morning. Sammi is his sister, and he loves to see her as well.

  3. Laura says

    Annette – I have seen this happen before, and I think I’ve written about it in an article, but I couldn’t find it, and I don’t have time to re-read every article I’ve written, so here’s my off the cuff advice…..

    I think Jake might need a speech vacation. When kids that I see go thru this, I don’t see them for 2 -3 weeks and I tell mom and dad to make NO demands of them verbally at home during that time. This means no direct cues to “say” or “tell me.” No direct questions – “What do you want/see/like etc…” Definitely no “Use your words.” Nothing. Only light, playful, FUN modeling and with no “requirement” for him to talk except for playful teasing or expectant looks. Now during this time they can set up very playful sabotages during play, like placing his toys out of reach or giving everyone but him a snack, but again, PLAYFUL teasing so that FUN is the object of the game, not talking. If a kid still balks at this, I ask mom and dad to even stop the sabotage and just stick to no demands for speech, just lots of light-hearted one-on-one time in play. This “vacation” usually does the trick.

    It sounds to me like he’s under too much pressure because you say that when you go back to playing, he’s fine. So give him what he needs and back off for a while.

    As far as what’s caused this –
    It could be due to this crazy time of year and this is his way of saying “ENOUGH! I need to get back to my normal routine! I am sick of traveling and company and everything!!!”

    It could be because his system needs to time to catch up and reorganize, and he can’t do it externally when he’s trying to do it internally. (This looks almost like regression and then BOOM, kids make a big jump.)

    This also could be the beginning of a real preschool power struggle and he’s realized how to push your buttons….. but this does take some pretty high level problem solving skills…. and I don’t know Jake, so I don’t know if he’s there yet. If this is the reason, take heart, since it means cognitively and emotionally he’s moving right along! But brace yourself because it could indicate some rocky times ahead in the parenting department! (I speak from personal experience on this one!)

    Get back to “normal” as soon as you can with you schedule too and lighten everything up. No demands. No pressure. That’s easier said than done for a super mom, huh?

    Let me know how this works for you! Laura

  4. Annette says

    Thanks so much Laura! I had a feeling it was probably us just really pushing a bit too hard. We are just so excited to see his progress and he even tries ‘on his own’ to properly enunciate his words, I think he puts pressure on himself as well.

    I want to add.. he recently had an imaginary friend join us. He “talks” to him and will even tell him “bye bye” when I tell him to tell his friend bye bye or night night when it’s time to go to sleep. He has spoken with this “friend” a few times since his birthday a couple of weeks ago.

    I recently got a parenting newsletter about this emergence of the imaginary friend at this age. Hubby and I think it’s pretty cool.
    He also scored at the 3 & 1/2 yr old level on the Denver Developmental screening at his well check last week.

    He is doing so great.. but we are just so anxious for the expressive to catch up! I guess we are over-doing it a bit. I need a vacation too! hee hee

    Thanks again… it is so wonderful to have access to your expertise! You’re my hero! You’ve given me sanity throughout this whole experience.

    Annette +Jake

  5. Jenny says

    Hi my 22 month old is very smart when it comes to commands and her body parts, but she does not have the vocabulary that I see other 2 years old have. She has a cousin who is only 3 months ahead of her and she talks way more than my daughter. I had my daughter evaluated at 18 months and i was told to wait until 2 or 2 1/2 and see if any new words and i have seen a growth in her vocabulary. She does not put 2 words together yet and her words are really hard to understand she can’t pronounce certain letter and it worries me she might have a problem. I know all kids develop different but you really can’t help and compare them I think she does have about 50 or less in her vocabulary but not all day she says the same thing I just want to make sure my daughter is ok. Thanks

  6. Laura says

    Jenny – Thanks for your question. Your daughter isn’t horribly behind, but usually when a parent continues to worry, there is something to be concerned about. The good news is, there are lots of things you can do at home to help her develop her expressive language skills. Read and try the ideas I recommend in the articles in the expressive language category. If reading them doesn’t give you enough information to know how to implement them, or if your daughter doesn’t respond after a few weeks, you can SEE me use the strategies on the DVD Teach Me To Talk. Sometimes just changing how YOU talk to her and work with her during play is all it takes to jump start a child’s language explosion. Laura

  7. Joy says

    Hi Laura,

    I bought your DVD Teach Me To Listen and Obey, and it has been very helpful to me. My son was diagnosed with mixed receptive-expressive language disorder. He’s in speech therapy now. He is turning two next week. My problem is he’s not very interested in pointing. When we ask him to point to pictures in books, sometimes he would do it, but after one or two pictures, he would get mad. He doesn’t point to far objects too. If he wants somehting, he would either gesture with his whole hand to ask, or get it himself and give it to us, or pull us to help him with it. His therapist said his joint attention is ok. How do we get him to point more?

  8. cynthia.moss says

    i have a 15 month old grandson, he has been diagionised with a hearing problem, he says some words, but he points and grunts all day long. he has to go for to see an audiologists because he has has several ear infections, we
    actually went to see if and when he would be getting tubes in his ear. the doctor said he had no fuild behind his ears. we go tommorow to see and audiologist.

  9. Laura says

    Cynthia – I hope you received some answers at his audiology eval. Hearing is VITAL for language development. If tubes are recommended, I highly encourage parents of children on my caseload to follow-thru with this quick and easy procedure.

    However, some children have had many ear infections and don’t have language delays. Sometimes parents address the middle ear problems expecting everything to improve, yet language remains behind. IF that’s the case, have him evaluated by a pediatric speech-language pathologist. Start with your state’s early intervention program.

    Also take a look at the other articles here on the website for more ideas for how to work with him at home. Grandmothers can make a huge difference!!

    Let me know if you need more advice. Good luck! Laura

  10. diya says

    Hi laura..i hv a 30 month old daughter..she started saying words when she was around 20 monhts..her vocabulary is slowly building. She counts 1-10, says alphabets, days of the week, certain rhymes,animals etc. However she has not yet started saying complete sentences. She manages couplets sometimes. There have been instances in my family where kids have started talking only after three years, so hv been advised by my family to wait and watch.

    i need your advise, do u think that she needs theraphy ?

  11. Laura says

    Diya – How does she communicate with you? Is she able to ask you for a drink or a snack? Does she respond to your questions? Is she able to carry on a little conversation with you? How does she follow directions? These kinds of things are FUNCTIONAL language, meaning the kinds of words she uses everyday to get her point across. The kinds of words you reported are EDUCATIONAL, meaning academic concepts that she will eventually need for school, but that are NOT important for 2 year olds to know to get through their day. I would NOT emphasize these kinds of words when you are talking to and playing with her because it really doesn’t matter if she knows shapes, colors, numbers, or ABCS. It DOES matter if she can tell you what she wants to eat and drink or why she’s upset. For example, her brother hit her, the toy is broken, etc…

    If she’s not able to communicate her wants and needs, doesn’t follow directions, or isn’t able to carry on a little conversation with you, then she does need therapy. If she IS accomplishing these things with single words and short phrases, then she likely is a late bloomer like other children in your family. However, I would still probably have her evaluated anyway just to rule out any other problem that may be contributing to her language delay. It’s so much better to take care of these issues earlier rather than later.

    My DVD Teach Me To Talk may help you SEE how to work with her at home to improve her vocabulary and help her transition to phrases. It’s important that you work with her at home, even if she’s not going to get speech therapy with a professional.

    Thanks so much for your question! Good luck to you both!! Laura

  12. diya says

    Thanks a lot Laura for the prompt reply. Am really sorry that i was not very clear while communicating my issue.

    Yes. She understands what we communicate to her and does follow directions. She does communicate her needs, wants etc. She does so in jst one word.she still not started using phrases and that is what worrying me. I see kids of her age communicating much more in complete sentences (i knw i shdnt make comparisions ..but cant help it).

    I have been talking to her a lot since her birth, reading books, playing games etc..so i feel a lil disappointed that all that has not been so helpful.

    one more thing..i communicate with her in my native language, however when it comes to reading books and schooling ..its in english, do u think this is leading to some delay and i should communicate to her only in english?

    Thank you laura..for this website, for your advises you give to worried moms like me..its really great…keep up the good work and god bless!

  13. Laura says

    Diya – Part of the issue could be that you’re raising her to be bilingual. The research tells us that children in bilingual homes speak later than children who are exposed to only one language – and it’s no wonder since they are having to sort out 2 different systems for vocabulary and grammatical rules. What language will she need for school? I’d focus solely on that language and see if she doesn’t begin to use more phrases. There’s an article here on the website with more tips for helping children learn to use phrases. It’s called, “Making the Leap from Words to Phrases.” You can find it in the expressive category (on the yellow menu bar at the top of this page) or search for it over at the top right hand corner of the top of this page. Good luck to you both! Laura

  14. Trisha says

    Hi Laura – First of all I would like to thank you for this very informative site. I just started to navigate through it this morning and I look forward to further reading and possibly the DVD. I am a mother of 3 children (5 yr., 22 months and 6 weeks). My 22 month old son has been communicating by just grunting & pointing. His only words are dada and mama at this time. He understand everything we say and follows commands. He was referred to speech therapy by our Dr. and his first visit was yesterday. He scored a 98% on receptive skills, but showed expressive skills of a 10-12 month old. He constintly mumbles with his lips locked and it sounds nasel. He, at times, will open his mouth to mumble but doesn’t last very long. For the past several months, I have played it off as him just being a “boy” (our daughter is the oldest and talks constantly!!) and I thought he would just talk when he is ready…not I am concerned after seeing the therapist work with him…I have to say it was an eye opening experiance. My pediatrician seems to think that therapy will work and typically toddlers show a turn-around after just a few sessions. In your experiance, I am open for any suggestions / recomendations that you have to offer. The speech therapist did suggest that we purchase a vibrating tooth brush to stimulate his muscles in his mouth. She pointed out to me that his cheeks are chubby, show little bone structure as they should start to show at this age with talking. she also asked me about his eating habits and if he stuffs food into his mouth…he does do this. Why would she ask me that and should I get a second opinion, get further testing or be this concerned? Is this just a “every child develops differently” deal? thank you for your advice and I look forward to looking at more of your site!!

  15. Laura says

    Trisha – If he doesn’t have more than 2 words, he does exhibit a language delay, and it does warrant speech therapy. I’d strongly recommend that you pursue services for him. Developmental delays often DO NOT resolve on their own without professional assistance, and you’d feel so guilty if you waited and waited and waited with no real progress and wasted valuable intervention time for him.

    I am not a fan of the oral/sensory techniques the SLP recommended you try for late talkers. If you want to work on speech or language, you’d better work on talking! (That’s not just my opinion… that’s research based. There’s no real hard evidence that using the techniques she’s recommended result in language improvements.) Mouth overstuffing is also developmentally appropriate around age 2 since children are working out the cognitive processes of determining size. However, that’s not to say that he doesn’t have some lower muscle tone in his face and decreased sensory awareness in his face…. it’s just to say that the toothbrush alone will likely not result in him learning to communicate.

    The milestones we use for children with regard to development already factor in the “every child develops differently.” The milestones we use are when 90% of all children have achieved a skill. A child at 18 months should have a MINIMUM of 15 words or so and then a MINIMUM of 50 words by 24 months. A truly typically developing 18 month old says 50 words by 18 months and 200-300 words by 24 months.

    I hardly ever think it’s appropriate to wait for services. That’s not to say that as his mom you can’t do the bulk of his intervention at home. Keep reading the website, and by all means, check out the DVDs so you can see how you should work with him at home to target language. Laura

  16. Trisha says

    Laura – Thank you for your response! I have taken your advice and moved forward with speech therapy for my 2 yr. old as he is still only saying 1 clear word (dada. We have taken him to speech therapy on a weekly basis for the past 7 weeks and see little improvement. He is still mouth stuffing as well as continued stubborness when it comes to sigh language. Our therapist sent me home with a Sensory Test and has referred me to see an OT as well. I dont see clear signs of Autism, just a few little tweeks (ie. spinning wheels on car, speech development issues, enjoys touch on own terms, not interacting or playing with others (just his sister), prefers repetitive play like moving his car back and forth on the sofa or floor). Although I feel that these signs could also be typical of a 2 year old boy, I am concerned. I feel as if my pediatrician is leaning on a “wait and see” basis. I hear so much about early intervention…Do you offer any tips or advice in finding proper therapy in different regions? I reside in NC (charlotte area). also, do your DVDs offer training in developing play skills? At present, the speech therapist is working on play skills as well as vowel sounds. Thank you so very much for your time and advice.

  17. Laura says

    Hi Trisha. I’m so glad he’s in speech therapy. The kids who make the most progress are those whose parents also work with them at home. The DVD I recommend first for parents is always Teach Me To Talk since it outlines the basic play-based approach. I haven’t seen your child and can’t say for sure what’s going on or what will work best, but usually working on functional words and signs first is more productive than single vowels, but perhaps she’s trying to improve his ability to vocalize or imitate anything. However, when you target real words, you can help him change his world! If she’s working on play, it’s likely to improve his comprehension and imitation skills. Teach Me To Listen and Obey 1 and 2 will help with that as well. I’d highly recommend those DVDs for you so that you’re targeting what’s most successful in improving his overall developmental communication skills using strategies that work for parents at home. Good luck to you all! Laura

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