The 2 Year Review

I have been dreading James’ 2 year review for months.  I am terrible for comparing James to other children and think he is definitely behind on his speech.  Of course, with mum guilt I naturally blame myself for this.  I have been keeping a list of the words he can say on my phone for the past couple of months.  I last counted it to be 43, but I do think he probably has nearer to 50 words as there are likely to be a few I have forgotten.  I am someone who gets so consumed in what he can’t do, that I scour the internet to see what he should be doing.  I have looked at the NHS website autism indicators so many times trying to figure out if he is autistic, just because of his speech and fussy eating.  I often have trouble sleeping at night because I worry that James isn’t developing quickly enough.  At todays 2 year review, at the very least I expected to be referred to a speech therapist and at worst I thought they would want to test him for autism.

The health visitor contacted us this morning to change the time of his appointment.  We were due to see her at 15:15 but she wanted to change it to 13:45 or to one day next week.  13:45 is not ideal as it is bang in the middle of nap time, but after calling my husband at work we decided 13:45 today would be better than me having to go another week worrying about James’ development. My husband, the one of us who doesn’t worry about these things, seemed fairly positive about going to James’ appointment.  I on the other hand told him that I would see it as a personal failure if James has any problems. I am the one James spends most of his time with, so I see it as my responsiblity to help develop his learning.



We arrived at the appointment and the health visitor saw us immediately.  I have found health visitors a complete mixed bag.  Some we have seen have been wonderful and others less so and would just refer me to the NHS website for help and advice.  This health visitor however seemed nice. James on the other hand walked into the room and just started crying.  I think it was a combination of being overtired and unsure of what was going to happen to him.  There were toys on the floor though, and soon his desire to play with an abacus overtook his desire to embarrass me with a perfectly timed tantrum.

Prior to James’ visit we were given two questionnaires to fill in.  These covered communication, gross motor skills, fine motor skills, problem solving and personal and social aspects of his development. My main concern was communication as James couldn’t do any of the things in that section of the questionnaire.  My husband and I are still trying to decide whether he knows his own name, or even if he understands the concept of names.  He doesn’t say mummy or daddy and more often than not doesn’t respond to his own name. These things had been playing on my mind. What was I doing wrong that made my child further behind than his friends?


The health visitor looked at our questionnaires and could see our concerns were speech and fussy eating. She asked us how many words James could say and we said 40-50, of which she asked if they were prompted or unprompted. They are both. He is getting better at copying words but also surprises us by saying words we haven’t said to him for a while, such as splash when he is in the bath. We were informed that at 2 years old children can say anything between 20 and 250 words, which reassured us. She said that because he is increasing his vocabulary then there is no need to refer him to a speech therapist and there is no cause for concern. She told us that if we were worried at a later date we can attend a speech drop in session, and also directed us to the Talking Point website for ways to help. We discussed our concerns about James not really responding to questions or his name. She suggested that when we talk to him to get down to his level so he can see we are talking to him. We were informed that by 2 years and 6 months he should have 50 words and be linking two words together.

As for James’ fussy eating, we listed the foods that he will eat prior to the appointment. We talked about when he started refusing to try new foods, what happens when we try to get him to try new foods and what he does with new foods on his plate. She said if we are happy and he is healthy then he can continue eating his safe foods, and agreed with our plan to introduce new foods when he has better speech and understanding. Other suggestions she gave us were to put new foods in a bowl next to his plate so he becomes familiar with them and see if he will touch them. She also suggested a game to play away from meal times, where we would have one bowl of a food he likes and another with a food he has decided he doesn’t like and then get him to transfer the foods into different bowls. This is the sort of game James likes so I am keen to give it a go.

IMG_0754Overall I came away from the appointment feeling a lot more positive about James’ development. I need to be patient, less critical and stop comparing him to other children, all of which are difficult to do. I am immensely proud of James and love seeing him develop. I was especially proud when the health visitor commented on how dexterous he is and how well he concentrates. He may not be as advanced as some children his age in terms of speech but he is definitely progressing which is exciting to see, and he is really strong in other areas. I need to appreciate that I have a wonderful child that is full of personality and great fun. I think sometimes we just get bogged down with milestones that we forget that every child is different and develops in their own time.


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