Littlebit points carefully to each body part on the toy in front of me, naming the one on the toy and then pointing to the corresponding part on her.

“Eye”, she says in her clear voice, “E-ah” “mmmouff”.

At thirty three months her speech is limited and the time has come for the evaluation I’ve been dreading. It’s time to admit that Littlebit is more than slow to speak. Her delay is large and maybe profound (as badly as it hurts me to use that word). She says “Mom” and “Mommy” and “mama” but never Dad or Daddy in any variation. She says “hi” and “bye” and “no” and “help” clear as a bell, but she never says milk or juice (she does say “wa” which means drink and “wawa” which means water). She makes a dozen different animal sounds, completes simple rhyming phrases in her favorite books and makes up her own lyrics to songs, but never says please or thank you.

She creates her own signs and has since infancy. She has a sign for yummy and one for come, but won’t say either of those words.

Her peers talk in multiple word sentences (“Hop!” she interjects while watching Blue’s Clues in answer to Steve’s question). Littlebit’s sentences are only two or three words long at most and very, very rare. She babbles and says “woah” and “wow” and “ooooooh” (in happiness and disappointment), builds jigsaw puzzles and pretends without stories. Developmentally, save for her speech, she is perfect. Maybe advanced. At thirty three months she can pedal a tricycle and can identify as many letters by sight (lower case and capital) as she can say. She is a very effective problem solver. She can find the tiny mouse on every page of “Goodnight Moon” and which hat is red and which shoes are pink. So why, exactly, can’t she talk?

Autism? Hearing problems? Cognitive delays that we’re missing as smitten parents? Refusal? Nothing? All as likely and unlikely as the others.

Autism, as least anything profound, seems UNlikely. She has no symptoms listed here, save a few repetitive behaviors and the ability to turn off her hearing, which I’m not sure are abnormal among toddlers at all. She certainly doesn’t display any of the symptoms listed here,
save for the words and gestures issue, but she does communicate mostly effectively albeit simply and has been asking, plainly, for help for more than a year (“HALP!” she insists for anything from a stubborn puzzle piece to being stuck on top of the baby gate she’s attempting to scale “HALPMEEEE”)

The signs go on and on, but Littlebit never really fits any of them save for her delayed speech and even then (according to this site) she has more words than should be a concern. Have you ever sat down and tried to figure out how many words your kid actually says? It’s a multi-day project because you forget things she’s said until she says them or something else triggers. She is sometimes sensitive to loud sounds but, again, sign of autism? Or a toddler who doesn’t like the noise the vacuum makes or the lawnmower makes (“BAD!” she insists when the dog barks).

What about hearing loss? She doesn’t display the signs listed here and can respond to a whisper from across the room.

So what does that lead? Googling causes of speech delays is scary. Like, make your stomach jump into your throat scary when you start reading words like “mental retardation”, but when you read down the list of language toddlers should have attained, the only thing Littlebit misses is the words themselves. Does that indicate nothing more than a “constitutional delay”, meaning Littlebit is just a late talker or a Developmental Language Disorder, meaning more is at work than Littlebit having a lack of desire to speak.

According to experts, now is the time to seek help. The magic age is upon us. Littlebit, blessed with a September birthday, won’t start preschool until she’s nearly four giving her time to catch up. I make the call and dread the appointment with her Ped. who will agree that, yes, she’s delayed and, yes, she’ll need to be evaluated. Why, exactly, should I dread this? It’s Littlebit, really. Her joie de vivre. I’m afraid to be told, clinically, that Littlebit isn’t perfect. That the millions of things we love about Littlebit are all attributed to a fault or flaw that has harmed her or caused her not to grow or progress like she should have. Her hands grasping at mine to draw them around her as she falls asleep might not be due to anything more than her inability to say “just hug me” or “don’t stop”. It’s frightening to consider.