Can baby sign language interfere with a child's speech development? Should a preteen crawl in bed with her parents after a nightmare? Growing Up Healthy answers your queries. Have a question about children's health and well-being? E-mail the author. We’ll post select answers in future columns.

Q: Baby sign language has become extremely popular recently. I’ve heard only wonderful things about it, including that it eases frustration and promotes verbal language. However, my niece has been taught baby sign language and is now 18 months old and has yet to speak a word. She seems content to just demand food and drink with her hands. Does baby sign language actually delay verbal language in many cases?

A: The short answer is no, according to Dr. Lynn Mowbray Wegner, a pediatrician in Chapel Hill, N.C., and a spokesperson for the American Academy of Pediatrics. In fact, signing is a very good ... err ... sign. It means your niece is communicating effectively, which is a major step at this point in her life.

The exact form of this communication varies. Some parents rely on gestures based on American Sign Language. Others create their own signs for everyday objects and emotions.

“Communication is communication. Signing, gesturing, using communication boards and other assistive methods are all acceptable in the very young child who is trying to get his message across and understand what others say to him,” says Wegner.

Part of the problem may be that you think your niece should be speaking by now. That’s not really true. While it’s fairly common to read or hear that toddlers “should be” saying a certain number of words by a certain age, psychologist Vikram Jaswal, director of the Child Learning and Language Laboratory at the University of Virginia, encourages parents and caretakers not to buy into this. “In my experience I’ve seen a huge individual variation in the rate of vocabulary and language development in general,” says Jaswal.

Although many kids will say their first words around their first birthdays just as many speak later. Some babble endlessly and some seem to skip it altogether and start spouting full (although brief) sentences. “Late or early speaking says nothing about the child’s future capabilities or brilliance,” says Jaswal.

Since we assume that your niece is living in a typical environment where other people speak to her and speak to one another, speech is almost sure to come. “Kids typically try to use the type of communication that’s conventional in their community,” says Jaswal. If you want to help your niece along, though, talk more to her and ask her more questions. Basically, try to engage her. The more she's spoken to, the more likely she is to try it herself.

In fact, even when caretakers are signing to your niece, they should also be speaking the words they're signing, says psychologist Linda Acredolo, co-author of "Baby Signs: How to Talk with Your Baby Before Your Baby Can Talk."

"Talking and signing together flood the baby with language," says Acredolo whose research, published in the Journal of Nonverbal Behavior, indicates signing may even give children a slight future verbal edge. "At 36 months, the [signing] babies in our study were speaking, on average, the equivalent of non-signing 47 month olds," she says.

It also helps if there are plenty of people around who do their best to understand what the child is trying to say. When adults don’t respond to a toddler’s vocalizations with correct replies and actions, the child may try to "fix" the miscommunication with physical gestures, pointing, patting the person or using signs that have been successful in eliciting past responses, notes Wegner. So if adults usually didn’t understand your niece’s babbling but they do understand a sign, she may opt for that method of communication right now (although in the long run it won’t influence her ability to speak).

Consider, also, when you see your niece. If you usually see her at night, your view of what she does could be skewed. At 18 months, if it is late in the day and she’s very tired and very proficient with signing, it may be easier to sign or gesture than hunt for the correct word and articulate it so the audience understands, says Wegner. This is especially true if the child's articulation is not precise and the adults have to really exert effort to understand what she is saying. Adults also get tired late in the day and may not listen carefully (or they may not be familiar enough with the child) so they don’t give the child the response the child is seeking.

There are times when concern is warranted, though. If a child has been using words and then stops and seems withdrawn or socially remote, Wegner says, it’s cause for further investigation. A pediatrician may identify temporary hearing deficits, other developmental delays or underlying health conditions affecting the child.

Other than that, don’t worry. “If the child is enjoying it and the parent is enjoying it, it creates a good interaction. It’s fun and it’s not going to be detrimental … the more you communicate the better the child’s experience will be,” says Jaswal.

Q: Is it OK for my 11-year old daughter to crawl in bed with her father and me when she has nightmares?

A: Not only is it OK but you’re sending your daughter a good message, says Dr. Richard A. Ferber, director of the Center for Pediatric Sleep Disorders at Children’s Hospital Boston.

“If a child is scared — for whatever reason — parents need to do whatever it takes to make them not scared,” says Ferber. “It tells the child that you’re there for her.”

Ferber also notes, however, that while an occasional (e.g. once a month) nightmare isn’t out of the norm, a child who says she’s having repeated nightmares may actually be having other problems.

“A real nightmare is when the child wakes up from a frightening dream and is terrified," he says. "There’s usually a story to the dream.” An 11-year-old should be able to describe the story.

If, on the other hand, your child calmly comes to your bedroom and tries to slip in bed with you night after night, you’ll have to dig deeper for the solution. She may be afraid of being alone. Or perhaps there’s something going on at school or home that’s causing her to worry or be afraid. Discuss this with your child and perhaps your pediatrician.

Also, if she’s taking any medications you may also want to discuss whether they could interfere with her sleep. Many experts also say that adhering to a regular bedtime and reading or having quiet time instead of watching television immediately before bed helps ensure more restful sleep.

Victoria Clayton is a freelance writer based in California and co-author of the new book "Fearless Pregnancy: Wisdom and Reassurance from a Doctor, a Midwife and a Mom," published by Fair Winds Press.

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