Advice please: how early for a formal evaluation?

[Guest guest]

My 21 month old son has very few words, and relies on the first

consonant for many of the words he does use. He uses ssss to indicate

juice or sesame street, da for that or daddy, caa for cat or car, and

bee for his own name (). Pretty much the only whole words he

does say are ball (baw) and cookie (cooo-kee, often whispered), yeah,

no, key and ma (or mama when he's upset).

We had him evaluated for EI services two months ago and the result was

that he qualified for 1 half-hour session per week. (He scored

normal-to-high on the non-expressive areas of the test, so they would

not qualify him for anything more. We actually had to beg just to get

the half-hour per week, as they wanted to give him a half-hour every

other week initially.)

He has now had 3 sessions with his SLP, who has told me that it is

hard for her to say just yet if what is going on is apraxia,

stubbornness (he is an extremely strong-willed/stubborn child) or a

run-of-the-mill speech delay. (Her belief is that it is a combination

of apraxia and stubbornness, but she wants to spend more time with him

before saying anything definitive.) Right now she is working to get

him to imitate gross-motor gestures (like clapping) so that we can get

him in the habit of imitation so we can start with imitating words.

I live in Brooklyn, and would like to make an appointment to see a

neurodevelopmental pediatrician (Dr. Agin would be our first choice)

so that we can get a real idea of what is going on here (and maybe an

official diagnosis, whatever it may be), but I want to make sure we

make the most of our evaluation with her. So (if you're still reading

this) my questions are:

Do we wait until he is 2 (or older) before having him evaluated? Can

you get a reliable diagnosis before 2?

Is there a benefit to continuing to work with the speech therapist we

are currently working with (although at the ridiculously low amount of

30 minutes per week) in the hopes that she can make progress at least

with the stubbornness aspect which may then allow us to determine how

much is personality and how much is neurological?

I don't want to lose any more time, but I also want to make sure the

evaluation is as productive as possible. What is the best age for a

complete neurodevelopmental evaluation, anyway?

Thank you for your help and guidance.

-Jen