Q: My grand daughter is 21 months old. She is very intelligent and understands what we say. She has a good hearing but she speaks only three words so far. Her weight and all other tests show that she is normal. She is on a thinner side. What tests should be done?

A:I think that the child would benefit from plenty of adult attention and interaction. Talk to her and play with her and listen to her. When she wants something, you could give her the word for it and persuade her to use that word. (Water, milk, sleep etc.). No force, please! Make sure she gets enough nutritious food. At this age she should be fed 7 to 8 times a day, a little at a time. She can have some of the food the family eats, provided it is not too spicy. Give her a variety of foods and encourage her to pick up (biscuits, pieces of cooked carrot or potato) her food from her plate or cup. She should get about 14 hours of sleep and have activity and rest periods alternately. Children's music should be played for her and she should respond to it or join in with one or two words. Children who are hesitant to speak may pick up music and be good at singing. If the house is very quiet and no one talks to her and she gets all her needs attended to, perhaps she gets by with very little speech. By the time she completes two years of age, she would have added to the number of words she speaks. If around that time, you still have a feeling that she does not speak much, you could consult a Psychologist. However, many children I know have started late and then caught up.