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Is my friend's baby developing normally?

 It does sound as though there may be a problem with the development of your friend's son. You do not mention whether your friend is worried about her son's development.

If she has not sought help she should do so now by seeing her health visitor or GP.

All children learn to understand language before they speak it themselves. As a rough guide, a child will be able to understand words or sentences six months before he starts saying them.

You would expect a child of 20 - 24 months to be able to understand sentences and to recognise everyday objects and pictures; in total knowing at least 50 - 100 words. His spoken vocabulary should be increasing from 30 to 60 words including being able to name the parts of his body.

By 25 to 30 months of age he should be able to ask questions and describe past events to other people. He will probably enjoy having stories read to him.

There can be huge differences between individual children. A child may concentrate less on learning to speak if he is concentrating on other skills such as walking, climbing and running, fine manipulative tasks or social skills such as feeding, dressing and toilet training.

The fact that your friend's son hasn't spoken a single word yet and that he has problems in other areas such as slow walking, socialising and sleeping suggests there may be an overall problem with his development.

He also needs to have his hearing checked as it is impossible for a child to learn to speak if he cannot hear properly.

As her friend you may find it difficult to approach your friend about what may be a problem with her son. However, you could ask her if she is concerned about him or whether her has seen his health visitor for his routine developmental checks.

These vary from region to region but usually take place at birth, six to eight weeks, eight months, 18 months and two-and-a-half years of age. If there is a problem it is likely it will be picked up at his developmental check. Alternatively she could take him to see her GP.

Your friend's son may be referred by his GP to a developmental paediatrician who will check all aspects of his development, including his physical skills, hand eye coordination and his social and behavioural skills.

He can arrange a formal hearing test by an audiologist, an assessment by a speech and language therapist and any necessary tests to check for underlying causes of delayed development. The team of therapists can then start helping his speech and other skills to develop.

We recommend readers seek personal medical attention in appropriate circumstances.