Speech Delay: Given Alora's age and the fact that she is only saying "dada" and "mama" without combining words or using simple phrases, speech delay is the most likely diagnosis. The family history of speech delay, particularly in the mother and a nephew, also supports this diagnosis.

Developmental Delay: Alora's lack of pointing and hyperactive behavior suggest that she may have a developmental delay, which could be related to her speech delay or a separate issue.
Autism Spectrum Disorder (ASD): The combination of speech delay, lack of pointing, and hyperactive behavior could be indicative of ASD, although a comprehensive evaluation would be needed to confirm this diagnosis.
Language Disorder: Alora's difficulty with speech and language development could be due to a specific language disorder, such as expressive language disorder or mixed receptive-expressive language disorder.

Hearing Impairment: Although Alora's hearing appears normal, it is essential to rule out any hearing impairment, as this could be contributing to her speech delay. A formal hearing assessment should be conducted to confirm normal hearing.
Neurodevelopmental Disorder: Conditions such as cerebral palsy, neurodegenerative disorders, or genetic syndromes could be underlying causes of Alora's speech delay and developmental concerns. A thorough medical evaluation and potentially genetic testing may be necessary to rule out these conditions.

Landau-Kleffner Syndrome: This rare condition is characterized by the sudden loss of language skills in children, often accompanied by seizures. Although Alora's presentation does not suggest a sudden loss of language skills, this diagnosis should be considered if her condition worsens or if she develops seizures.
Genetic Syndromes: Certain genetic syndromes, such as Fragile X syndrome or Williams syndrome, can be associated with speech delay and developmental concerns. Genetic testing may be necessary to rule out these conditions if other evaluations are inconclusive.