Q: Our son is 28 months old and just starting to talk. He may be apraxic and he sucks a pacifier all day and night. He seems to be very bright. What is your opinion about the pacifier?

I have seen otherwise normally-developing two-year-olds who do not talk at all become completely verbal within a few weeks after their pacifier is tossed out. I always recommend elimination of the pacifier in cases of speech delay, except in those rare cases when the child is so delayed in motor and cognitive skills that the pacifier is instrumental in developing sucking and swallowing skills.

This is not to say that excessive pacifier use is THE reason your son is behind in speech. However it may be contributing to the delay. In my opinion, a child with limited speech should NOT be allowed to suck a pacifier all day, and I recommend that the habit be eliminated. My book, How to Stop Thumbsucking addresses this issue. Also The Pacifier: Making the Decision by Charlotte Boshart may be helpful.