Speech delay, round 2

[jess9802]

Hello! I've posted previously about my older son's speech issues (basically, severe phonological disorder/suspected apraxia at 3y9m; 18 months later his articulation is age-appropriate). I've often said one of my biggest regrets was waiting as long as I did to get DS1 evaluated, as I suspected a speech and communication problem by 11 months. The problem with him is that he met the bare minimum on all of the milestones until he was 3, and then it was clear something was wrong with his speech. Fortunately he has progressed really well.

DS2 is 13 months old and I just called this morning to request an evaluation for him. I can count on one hand the number of times I've heard him babbling in the last six months (a very soft gagaga in the carseat). He mostly makes vowel sounds and screeches and occasionally blows raspberries. He doesn't point, clap, or wave, although he seems to follow a point. Name response is spotty. I suspect he had an ear infection starting at 8mos that wasn't diagnosed until 9mos. There was no follow up, and when we went in for his 1yr check he still had an ear infection in that ear. The ear infection is finally cleared up, but we're not sure if something is going on with his hearing. The audiology exam is in one week.

Anyway, I'm feeling sort of sad over his speech development at this point; at this age DS1 had a word or two, was waving, clapping, pointing, etc., and clearly understood what we were saying to him. DS2...not so much. 

So...hello again, and any anecdotes on speech therapy for a very young toddler would be greatly appreciated!

[URMySunshine77]

Hi Jess,

I don't have related experiences, but I just want to voice my support. I hope you find some answers.

[brachysira]

You can see my thread on parenting recently--several people said that speech therapy before 3 seemed to them to be a racket. But that was more saying that if you can't understand a 2 year-old, don't pay to fix it until they are 3. In your case, I would go ahead and try to get an evaluation from Early On or whatever it is called in your state. Things like waving aren't necessarily speech milestones and a more general approach may be what you need. At the same time, you can continue to proceed with hearing and other assessments your pedi suggests, but you can contact EO yourself and immediately, as it takes a while to get a response.

[jess9802]

Apr 12, 2017 19:48:33 GMT -5 brachysira said:

You can see my thread on parenting recently--several people said that speech therapy before 3 seemed to them to be a racket. But that was more saying that if you can't understand a 2 year-old, don't pay to fix it until they are 3. In your case, I would go ahead and try to get an evaluation from Early On or whatever it is called in your state. Things like waving aren't necessarily speech milestones and a more general approach may be what you need. At the same time, you can continue to proceed with hearing and other assessments your pedi suggests, but you can contact EO yourself and immediately, as it takes a while to get a response.

Thanks for pointing out your thread on Parenting. FWIW, our experience with DS1 was that he met the milestones for speech at the appropriate ages, but just barely. It was only when he turned three that it was undeniable that his articulation was very delayed. At that time our pediatrician referred us to a private SLP in her practice. We loved her, but our insurance refused to cover it, and at $200/session, it just was not practical. We went through EI/ECSE instead, who assessed him about a month later, and determined that his articulation was in the 4th percentile, so he qualified for services for three years. He started receiving speech therapy at his preschool. He continues to receive speech therapy, and the IFSP has been re-written to include more pragmatic aspects of speech and peer socializing. He starts kindergarten in the fall, and will not need to be reassessed to continue speech services until Fall 2018, which is good because his articulation is now about the 50th percentile. Anyway, that's a long way of saying both the private SLP we saw and his current SLP have said that articulation issues before age three are really difficult to test and treat. 

We've had a good experience with EI/ECSE, but that was for a three year old, and not such a young kiddo like DS2. 

[mrsbuttinski]

I haven't read the thread on parenting.

My take:

It is extremely rare for an actual SLP to work with a child that young through the Birth to 3 services (IDEA Part C/EI). The only time you might see this would be around feeding issues.

At this age, he'll probably be referred to a developmental teacher rather than SLP.

I like this site for speech and communication norms:

www.asha.org/public/speech/development/01/

[chickypoo2468]

Apr 13, 2017 5:58:13 GMT -5 mrsbuttinski said:

I haven't read the thread on parenting.

My take:

It is extremely rare for an actual SLP to work with a child that young through the Birth to 3 services (IDEA Part C/EI). The only time you might see this would be around feeding issues.

At this age, he'll probably be referred to a developmental teacher rather than SLP.

I like this site for speech and communication norms:

www.asha.org/public/speech/development/01/

This is interesting bc I wanted the SLP for feeding and she was completely useless in that area. He now goes to private feeding therapy.

I actually got rid of his EI SLP last week bc he made zero progress with her. And her sessions lacked any sort of consistency and I felt like it was a waste of time. My son doesn't communicate at all and doesn't really seem to understand much either. Or just doesn't listen. Who knows. But it was a bad fit. (Or else maybe he is too young like you're saying)

Is your child delayed in other ways? Or just doesn't talk? Is the clapping sensory related? You might even be able to work with an OT.

My older daughter did ST when she was 2 but it's a lot easier when they are an active participant and can interact and work with the therapist.

Waiting lists can take months though so it doesn't hurt to get on one. You can always discuss options at the eval. EI also offers developmental therapists so maybe that would be a better route, we don't have one though so I don't know the requirements to get one.

[mrsbuttinski]

chickypoo2468,

Not all SLPs are trained extensively around feeding issues just as not all are great with specific difficulties like pragmatics and apraxia.

[chickypoo2468]

Apr 14, 2017 10:03:28 GMT -5 mrsbuttinski said:

chickypoo2468,

Not all SLPs are trained extensively around feeding issues just as not all are great with specific difficulties like pragmatics and apraxia.

We were told she was the go to for feeding. She would watch me spoon feed him purées and say things looked fine lol.
Maybe they just don't have anyone better :/

[luvboston]

chickypoo2468 our OT works on feeding.

[mrsbuttinski]

Apr 14, 2017 10:06:51 GMT -5 chickypoo2468 said:

Apr 14, 2017 10:03:28 GMT -5 mrsbuttinski said:

chickypoo2468 ,

Not all SLPs are trained extensively around feeding issues just as not all are great with specific difficulties like pragmatics and apraxia.

We were told she was the go to for feeding. She would watch me spoon feed him purées and say things looked fine lol.
Maybe they just don't have anyone better :/

Probably not.

I think I recall your frustration at the time.

[chickypoo2468]

Apr 14, 2017 11:14:23 GMT -5 luvboston said:

chickypoo2468 our OT works on feeding.

My OT is appalled at everyone on my team lol. She does try to hide it but it's obvious. She tries to pick up the slack but you can only do so much in an hour a week :/

I'm glad you said this though

[mrsbuttinski]

Apr 14, 2017 16:13:45 GMT -5 chickypoo2468 said:

Apr 14, 2017 11:14:23 GMT -5 luvboston said:

My OT is appalled at everyone on my team lol. She does try to hide it but it's obvious. She tries to pick up the slack but you can only do so much in an hour a week :/

I'm glad you said this though

IME, this is common. Even when you have put together a formidable team, there can be professional jealousies. DS's dev pedi, for whom I have tremendous respect, encouraged us to jettison DS's psychologist for another one and to stay with a more nurturing LD school through graduation rather than harden DS off in the top notch and more diverse public school. DS's psychologist, who is probably as responsible for his successes as we parents are, considered his private LD teachers to be "flaky" (his wife and DD were public school teachers) and the SLP he worked with in elementary to be "well-meaning but dumb" (she had a bit of a crush on him). For the record, the SLP was terrific.

[chickypoo2468]

Our OT is afraid to step on toes (like there's some EI code) so she wont actually say anything unless I'm asking her opinion on specific things. I agree with her though :/

[chickypoo2468]

And I'm sorry! I didn't mean to derail the topic. I was just giving my own experience (still new to this) in case it helped any

[jess9802]

chickypoo2468, no, DS2 doesn't appear to be delayed in any other area other than speech/communication. He did just start walking this week, though. We had DS1's IFSP meeting on Tuesday, and his SLP had been advised of the referral for DS2. The SLP talked to us a little bit about where DS2 was developmentally, what our concerns were, and gave us some tips on trying to encourage speech while waiting for the evaluation. I'm really going to miss working with him!

[lucilleaustero]

Apr 15, 2017 9:46:59 GMT -5 jess9802 said:

chickypoo2468 , no, DS2 doesn't appear to be delayed in any other area other than speech/communication. He did just start walking this week, though. We had DS1's IFSP meeting on Tuesday, and his SLP had been advised of the referral for DS2. The SLP talked to us a little bit about where DS2 was developmentally, what our concerns were, and gave us some tips on trying to encourage speech while waiting for the evaluation. I'm really going to miss working with him!

I read that thread on parenting. And maybe there are kids getting services that would have simply matured and outgrown their delay on their own; but, if those services helped one kid from falling through the cracks, thank the stars for services.

My son is 2y8m and has been getting ST since November through EI. Everyone feels that he is apraxia, but he will not be formally diagnosed until age 3. Not sure as to the why, but I called around to several places and that seems to be the norm in these parts. He had no words at a year, but was developing typically in every other area. He was a late term preemie and there have been some interesting studies  done on why a larger proportion of late term preemies have articulation issues than earlier preemies or full term babies. Anyway, he now has many words and uses them spontaneously and makes three word sentences. His articulation still sucks, but is getting better every day.

It can't hurt to have him eval'ed. Your experience as a speech mom counts for something. We recognize much earlier than others if something is delayed with our children.

[jess9802]

DS2 had his hearing evaluated yesterday (Visual Reinforcement Audiometry). He did not respond to the lower tone sounds like the audiologist wanted to see. He saw a different audiologist today for more comprehensive testing. Again, he did not respond to the lower tones in the VRA test. He did pass the otoacoustic emissions test, but his eardrums are not moving as much the audiologist would like to see. So, he has some degree of hearing loss, though it may be due to fluid behind the ear drum (he is very congested right now and has seemed perpetually congested). He goes to see an ENT on May 2.

The woman at Early Intervention called this afternoon. We discussed waiting until after the May 2 exam to see whether we're truly dealing with a hearing impairment (temporary or otherwise) or some other cause for delayed communication.