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 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!!!
Comment by Annette on 28 December 2008:
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
Comment by Annette on 28 December 2008:
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.
Comment by Laura on 28 December 2008:
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
Comment by Annette on 28 December 2008:
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
Comment by Jenny on 29 December 2008:
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
Comment by Laura on 29 December 2008:
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
Comment by Joy on 14 May 2009:
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?