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Updated: Speech development & therapy
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#1 HeroOfCanton

Posted 14 December 2012 - 01:21 PM

I'm not sure if this is the right place for this, but it seems relevant to the age group, so here goes.
I apologise, this is going to be long, as I don't know how else to give all the information that seems relevant to my query!

When DD was about 23 months old, we took her for a check up with the MCHN, as I had a concern with something, although I don't remember what.
The MCHN said she was worried that DD didn't say enough words (about 30 at the time) and referred us on the the speech therapy drop-in clinic here in the ACT for an assessment.
The pathologist who ran the drop-in put through a formal referral for a formal assessment with Therapy ACT, and we got to the top of their list in October this year, DD was 28 months then.

Just to clarify, we had no concerns about her language development when we went to the MCHN, or to the drop-in clinic. Soon after our initial MCHN visit, she started spouting more words, and a few phrases - she did (and does still) express herself very well with a mix of verbal & non-verbal cues.
By the time we got to the pathologist with Therapy ACT, we were a bit concerned that she was 'lazy' in her speech, in that she would babble a few nonsense words before coming out with what she wanted to say, for example:
"dadablahbedah on de couch" when she meant "want to sit on the couch" this babble would be accompanied by gestures to the couch, and patting to indicate sitting.

The Speech Pathologist (SP) noticed this as well, and took note of our concerns, she also noticed that DD licks toys and books (but she ignored the fact that they are all food) and asked if she had any other 'sensory issues'. We said nothing out of the ordinary, she doesn't like having her feet played with or her hair brushed, but felt that sort of thing is fairly normal...?
We left at the end of the appointment and SP said she would refer us on to a playgroup for kids with language delays. She also suggested we begin talking to DD in small sentences "girl in cup" "sit on chair" "Evie eat food" etc to try & develop her sentence structure.
She acknowledged that she is fairly bright, can count to thirty unprompted, knows her whole alphabet and the sounds letters make etc, and that it was unusual for her to know these things "without being able to talk"

When we try talking to Evelyn like SP suggested, she looks at us like we are fools, and really doesn't respond to it at all. So we've minimised it in our daily interactions with her. Opting instead to be mindful of speaking slowly & clearly.
As it happens, the day after our appointment, DD started using a number of 3-word sentences, and some 4 or 5 word ones ("c'mon stupid TV, turn on!"  ph34r.gif ) She can also recite simple books and will sing songs, saying 10+ words at once if she thinks no one is looking!

In the copy of the report we received from SP a few days after our appointment, we noticed that she had make a very big deal of these 'sensory issues' that DD supposedly has and implied that there is a level of intellectual impairment.
Yesterday, we received the enrolment forms for the playgroup she told us about, and the playgroup is described as "providing educational assistance for children up to 3 years who have additional physical, intellectual or sensory needs"
This is totally different to what she suggested might be useful, and also sounds totally off-base for what assistance, if any, DD might need.
I admit, I was a bit taken aback reading the SP's report about our assessment, as there is a lot in there that she's taken out of context (the hair-brushing for example) and put a spin on it to make it seem like there are issues when there isn't.

Basically, my question is this:
Are we failing DD as parents if we decline the place in this playgroup?
From what I have described above, does DD seem like she needs any physical, intellectual or sensory assistance? I feel like if we take the place, a child who genuinely needs the assistance is missing out, but if we decline it, I'm sounding like one of those mothers who insists their child is perfect and gifted etc etc. and couldn't possibly have any special needs.
I fully accept that she's a 'late' talker, and is a bit lazy with it, but all other signs point to her being a very switched on little girl, her comprehension is great (obedience not so much sometimes!) and she can communicate quite well using a mix of words, gestures & general body language.

Is this a case of us knowing our child better than someone who has met her once (regardless of their qualifications)?

edit: sorry for the novel!!!

Edited by *Browncoat*, 21 December 2012 - 05:14 PM.


#2 Carmen02

Posted 14 December 2012 - 01:30 PM

wow they came to a conclusion about her fast, to be honest i would be getting her seen by another speech therapist to see what they say. Im just talking as a mum of 3 who has had speech delays, my two sons have severe speech delays (DS is 25mths and has 5 words max) my sons also have sensory processing disorder, which really can't be diganoised properly without an Occupational therapist seeing her. my 2yr old loves to chew everything drives me nuts. good luck with it and ill defiently be going for a 2nd opinon

#3 Jenferal

Posted 14 December 2012 - 01:43 PM

I recently went through the rigmarole of Therapy ACT etc, but haven't been given any speech therapy sessions through them, I've gone private. the GP gave me 5 rebated visits per year(more if needed).
When I say me, I mean my daughter naturally! She's 3 next April.
With her, she has words and 4 or 5 word sentences, but doesn't pronounce the first part of most words properly. I understand her fine, my parents,not so much. I'm seeing someone at Brindebella Speech pathology in Deakin.
She's given us exercises to do at home which are designed to help Sammie make the sounds she needs.
She DID say that kids in child care TEND to speak better, but she also told me it doesn't always make a difference.

Honestly, with Evie, i can't see how that specific preschool would help that much. But it wouldn't hurt to go once or twice to see how they run things there.
I've never taken S to playgroup('m not good with meeting people and strange places freak me out a bit) but if Evie gets socialization elsewhere, she may well pick it up eventually.
My GP said some kids are just late talkers.
Sammie also uses gestures to communicate. Always has. I blame all the songs at Giggle and Wiggle with the hand gestures, she got lazy and just used her hands as it was easier than trying to talk or learn the words of the songs.
When do you need to decide?


#4 Jenferal

Posted 14 December 2012 - 01:46 PM

As carmen suggested, maybe get a second opinion. I got an appointment really quickly with Brindabella. They email you a survey to fill in and send back or take to the appointment with all sorts of questions, PLUS they do an assessment in person as well, which might give you a different diagnosis,

#5 HeroOfCanton

Posted 14 December 2012 - 01:54 PM

QUOTE (Carmen02 @ 14/12/2012, 02:30 PM) <{POST_SNAPBACK}>
wow they came to a conclusion about her fast, to be honest i would be getting her seen by another speech therapist to see what they say. Im just talking as a mum of 3 who has had speech delays, my two sons have severe speech delays (DS is 25mths and has 5 words max) my sons also have sensory processing disorder, which really can't be diganoised properly without an Occupational therapist seeing her. my 2yr old loves to chew everything drives me nuts. good luck with it and ill defiently be going for a 2nd opinon

To be honest, a second pinion never occurred to me! I feel like a fool! It's very rare that I deal wiht the 'private sector' for health matters, so I guess I just figured all the speechies would be employed by ACT Health  ddoh.gif  I've just started googling and it looks like there are plenty of options around here - thanks original.gif

Jenflea, it appears that we have until late January to decide, we can;t contact the playgroup 'teacher' until January 29 to arrange an enrolment interview, so it should be enough time to see someone privately for a second opinion. I've found a place called 'Buzz Speech Pathology', who do in-home visits - this might be really good, because Evie is quite shy out & about, especially so with strangers, but very secure at home, so it might be a better 'baseline' for someone to assess her.

The SP did say that her pronunciation and sounds are spot on for her age, as I did mention that 'l' is a 'y' sound "y-yon" for lion and "deep" for sheep etc.
Thanks for sharing your experience!

#6 mum2jp

Posted 14 December 2012 - 01:56 PM

It does seem like a very quick conclusion to come to but it wouldn't hurt to try the playgroup. They may have some idea's for activities you can try at home and it may give you an ideas of what level of sensory issue she has if any when you try the activites with her. I agree with the PP about the OT assesment. I teach preschool aged children and with any sensory/ motor concerns we always recommend an OT, a speech therapist can usually identify sensory issues to do with speech (like dyspraxia- as this has a direct affect on how the muscles work to create speech) but an OT asessment will be more indepth and may be able to refer you to some sort of sensory gym if need be.

Does your DD go to childcare? If so have a chat to her teachers as well to see if they have any concerns.

#7 Paddlepop

Posted 14 December 2012 - 02:10 PM

Definitely get a second opinion if the diagnosis doesn't feel "right" to you.

My DD had seen a speech pathologist 3 times, and she concluded that DD had problems with speech sound development and expressive language delay. Her suggestion was that we should basically put DD into daycare 5 days a week and that would pretty much fix her problems.

Last week DD saw a different, more experienced speech pathologist who diagnosed DD with dyspraxia, particularly verbal and motor dyspraxia. No other health professional had picked up on this, not even my normally very good GP. Dyspraxia makes a lot of sense and feels "right" with DD's other development milestones (v.late crawler and v.late walker) and any difficulties she has with general day to day life. What DD needs is a lot of one on one intervention where she can watch the adult's mouth form words so that she can learn how to move her own mouth. Some social interaction with other children is encouraged, but the speech pathologist certainly doesn't regard full time daycare as the solution, unlike the other sp.path.



#8 HeroOfCanton

Posted 14 December 2012 - 02:14 PM

QUOTE (mum2jp @ 14/12/2012, 02:56 PM) <{POST_SNAPBACK}>
It does seem like a very quick conclusion to come to but it wouldn't hurt to try the playgroup. They may have some idea's for activities you can try at home and it may give you an ideas of what level of sensory issue she has if any when you try the activites with her. I agree with the PP about the OT assesment. I teach preschool aged children and with any sensory/ motor concerns we always recommend an OT, a speech therapist can usually identify sensory issues to do with speech (like dyspraxia- as this has a direct affect on how the muscles work to create speech) but an OT asessment will be more indepth and may be able to refer you to some sort of sensory gym if need be.

Does your DD go to childcare? If so have a chat to her teachers as well to see if they have any concerns.

No, she doesn't go to childcare.

I just spoke to a Speech Pathologist for a while on the phone, and she has given me a list of private Speechies who are focused on kids in my area. She did ask about the sensory issues and feels from what we discussed that they might be a contextual thing, and not of concern, but obviously, she's just on the phone, so didn't make an actual call on that.

What other sensory issues should I be looking for? She's quite happy to eat anything texture-wise, she'll play with sand, water, jelly, good, rocks, so she's not put off by texture.
I'm probably missing something amongst all the talk of sensory issues - I admit I'm not too aware of what I should be looking out for!

Edited as I saw Paddlepop's reply!

DD was also a late crawler & walker, 9 & 14 months respectively. It's interesting that they can be related, and I'll look into Dyspraxia as well. Her gross & fine motor are both really good now, she's met all her milestones in this regard - does that make a difference with dyspraxia?

Both DH & I have an instinct that everything is okay. We feel that there has to be early & late talkers for them to get their 'averages', and it's likely that she's just a later talker - but like I said, I want to rule it out and don't want to be the parent that insists everything is okay when it's not!
We're definitely going to get a second opinion, and see what they suggest.

Edited by *Browncoat*, 14 December 2012 - 02:19 PM.


#9 Carmen02

Posted 14 December 2012 - 02:18 PM

sensory issues are alot of things my older DS cant stand loud noises, touching certain things, food is a major issue, can't stand some clothes, has to have shoes on. my other DS who is 25mths puts absoutely everything in his mouth, he headbutts everything (which the OT says is sensory seeking) as well as stands on his head for no apparent reason (sensory seeking) he has to be in small tight spaces as well. Varies so much

#10 HeroOfCanton

Posted 14 December 2012 - 02:26 PM

QUOTE (Carmen02 @ 14/12/2012, 03:18 PM) <{POST_SNAPBACK}>
sensory issues are alot of things my older DS cant stand loud noises, touching certain things, food is a major issue, can't stand some clothes, has to have shoes on. my other DS who is 25mths puts absoutely everything in his mouth, he headbutts everything (which the OT says is sensory seeking) as well as stands on his head for no apparent reason (sensory seeking) he has to be in small tight spaces as well. Varies so much

I see. DD doesn't experience any of this consistently - sometimes she'll love shoes, other time she'll hate them, she loves noises, but has just learned to cover her ears.
I feel this is all just toddler stuff though. I do get that it's varied, but I feel like the SP made a big deal out of nothing and has taken some focus away from the issue of her speech.
She just licked a book because it had ice cream in it, then licked the toy apples...?

#11 madmother

Posted 14 December 2012 - 02:30 PM

I think you need a second opinion. Our first speech therapist was abysmal.

QUOTE
Both DH & I have an instinct that everything is okay. We feel that there has to be early & late talkers for them to get their 'averages', and it's likely that she's just a later talker - but like I said, I want to rule it out and don't want to be the parent that insists everything is okay when it's not!


I will tell you I too felt this way. Until my son was formally diagnosed with ASD. I nearly ripped the head off the first babysitter who had suggested this.  ohmy.gif

My gut instinct was right overall - he is now an incredble, wonderful, awe-inspiring nearly 15 year old. But he is also on the autism spectrum, without a doubt.


#12 Jenferal

Posted 14 December 2012 - 02:35 PM

Sammie 'chomps' the pictures of apples in books original.gif
Oh and with the feet thing....my husband is nearly 40 and can't stand his feet being touched. he has no other sensory issues at all, and I'd say the MAJORITY of toddlers hate having their hair brushed, it pulls and it means they can't be off playing or whatever.

#13 Guest_vääräsääri_*

Posted 14 December 2012 - 02:40 PM

QUOTE (*Browncoat* @ 14/12/2012, 02:21 PM) <{POST_SNAPBACK}>
She acknowledged that she is fairly bright, can count to thirty unprompted, knows her whole alphabet and the sounds letters make etc, and that it was unusual for her to know these things "without being able to talk"

She can also recite simple books and will sing songs, saying 10+ words at once if she thinks no one is looking


This would have me wondering (and also thinking the playgroup could be a good thing), not so much the potential sensory issues. Those are fairly big disparities between different abilities, that can be a red flag for developmental concerns. The sensory stuff you've described seems in my unprofessional opinion to fall within the realm of normal - although what would otherwise be normal may become more meaningful if there are other issues at play too, IYKWIM.

Anyway, based on our experiences with getting funding, access to intervention, etc: it's possible that the SP wanted you to get a place in this playgroup because she had concerns and thought it would be beneficial, but these concerns didn't necessarily fully fit into what the playgroup looks for, so she may have emphasised the sensory issues to make sure you get in? Sometimes they have to use the right words. I wouldn't take the report to heart too much, its intended audience might be more the playgroup than the parent. I'd either do as PPs have suggested and just see what this playgroup can offer, or seek a second opinion. No harm in doing both, in fact...  


#14 Paddlepop

Posted 14 December 2012 - 02:44 PM

QUOTE (*Browncoat* @ 14/12/2012, 02:14 PM) <{POST_SNAPBACK}>
DD was also a late crawler & walker, 9 & 14 months respectively. It's interesting that they can be related, and I'll look into Dyspraxia as well. Her gross & fine motor are both really good now, she's met all her milestones in this regard - does that make a difference with dyspraxia?

My DD didn't crawl until 14 months and didn't walk until 21 months. She was also late to roll over, support her own head and to sit up by herself.

From my very limited (so far) reading about dyspraxia, children do tend to meet the milestones later.

As for your DD licking a picture of an ice cream, I think that is actually quite smart and cute!

#15 HeroOfCanton

Posted 14 December 2012 - 02:47 PM

QUOTE (madmother @ 14/12/2012, 03:30 PM) <{POST_SNAPBACK}>
I think you need a second opinion. Our first speech therapist was abysmal.

I will tell you I too felt this way. Until my son was formally diagnosed with ASD. I nearly ripped the head off the first babysitter who had suggested this.  ohmy.gif

My gut instinct was right overall - he is now an incredble, wonderful, awe-inspiring nearly 15 year old. But he is also on the autism spectrum, without a doubt.

Thanks for this. I must admit that when I first read 'sensory issues' on the report, I was taken aback and immediately jumped to the thought that she was saying DD might have ASD. Once I re-read I calmed down a bit, but still do feel that she's taken this one thing and made it into something it's not.

QUOTE
Sammie 'chomps' the pictures of apples in books original.gif

Evie too, and slurps at drinks!

vääräsääri, that does make sense, but doesn't necessarily make me feel better about taking the place IYKWIM?

#16 nothing123

Posted 16 December 2012 - 07:51 PM

Browncoat - crawling at 9 months and walking at 14 is not considered late on either of them.  Completely normal.


#17 IsolaBella

Posted 16 December 2012 - 08:29 PM

Just a quick question, but have you had her hearing checked.

DS1 was a natural late talker. Less then 10 words at 24m. Assessed at 26 m as having the expressive language of a 9 mo and receptive language of a 11mo. Don't get me started on the part if the report the exaggerated sensory, repetitive traits. I was suggested to see dev paed as he was showing major signs of Autism. By 36 m he was saying " mummy I think perhaps a train may be coming soon". RE assessment by the same people at 3.5 yrs said no Autism flags and above average on expressive and receptive language for his age. They questioned me about what intensive therapies I had done.... None as I didn't think there was a problem. He is finishing year 1. Is a year ahead in maths and reading. Also very social.

So we come to DS2 who had 20 words at 24m so we were going well. At28 m when he started talking more it sounded like he was talking underwater and hearing test showed moderate hearing loss. Grommits in at nearly 3 yrs, but it took until 4 yrs to get a clear hearing test.  Note he had only ever had one ear infection. His speech at 3.5 yrs was like you DDs. Jargon jargon sentence jargon sentence. The speech is said he used words he knew in context but added his own jargon for words he us unsure if. She described it as being typical of someone who has had variable hearing. O when their hearing is good they learn new age appropriate things, but will then miss chuns at other levels. She said he was doing some things not expected until 6 yrs while not being able to do others which you would expect a 2 yo to do.

Problem for us has been social as he could not communicate with peers and lost confidence. From 5 yrs we have done social skills speech groups to bring him up to scratch for school. RE test if speech and language puts him on the lower side of average for expressive language and in to 86% for receptive language. Much improved for a boy at 3.5yrs who was below average to severely delayed.

So a second opinion and a hearing test would be my suggestion. Ds2 was following instructions etc even though he was not hearing right. He had great coping mechanisms..

Edited by lsolaBella, 16 December 2012 - 08:29 PM.


#18 HeroOfCanton

Posted 18 December 2012 - 10:48 AM

lsolaBella, we're on the waiting list to have her hearing checked. I really doubt that's the problem, but obviously it can't hurt to get it checked out.

Interesting you say that nothing123, the SP noted on the forms that she was 'late'.

I sent an email to the SP yesterday, asking her to clarify why we'd been referred on to the playgroup, and she said she had no concerns about her sensory development. Basically, she has no idea why she's been referred to the playgroup for kids with sensory, intellectual or physical needs, as she didn't notice that any of those were out of the normal range  wacko.gif
I'm going to call the playgroup facilitator and get her to check the referral as well, as it may be a case of the paperwork being given to the wrong person.

We're also having a private SP come to our house this friday, and do a 2 hour assessment with Evelyn & I, so that will hopefully give us a better idea of whether or not the playgroup is a good idea - depending on which playgroup she's actually supposed to be going to.

Thanks again for all the suggestions. I'll update after our appointment on Friday.

#19 HeroOfCanton

Posted 21 December 2012 - 05:12 PM

okay, update:

We had a private Speech Pathologist come to our house today, and did a full 2 hour assessment with us.
First thing she said was that it doesn't sound like Therapy ACT actually did a full assessment, and that chances are it could be a bit skewed, as Evelyn seems like a shy child, and being in a strange room, strange building etc could' throw her off'.
She managed to 'assess' about half of her criteria just by watching Evelyn play, then we sat her down & did a few (or a lot of!) picture exercises; and her comprehension & understanding seemed to be well beyond her age level, and even the SP was surprised at how 'high up' she was going, it took til the exercises made for kids 3.5-4 years to stump her!

We won't be getting a full report until the New Year, but after going away and 'scoring' all of her observations, the SP feels that her speech was within the normal range, but that her understanding was quite advanced.
She's happy that Evelyn is well within the normal range for speech development, and most likely is just a 'late talker'.
We're going to meet with her again in January to discuss exercises to do to help her sentence formation and things, but other than that, the SP had no other 'interventions' to offer.

I'm really glad we got a second opinion, and in the New Year, provided there's no other concerns that pop up with her language, we'll be declining a place in the playgroup. We've also got a hearing test booked for early February.
Thanks to everyone who shared their stories, and encouraged us to get a second opinion - I'm really glad we did, as having a SP come to our home meant that Evie was much more calm & relaxed, and just did her own, usual thing while the SP observed - I feel it's a much more accurate picture of where she's at.

Edited by *Browncoat*, 21 December 2012 - 05:15 PM.


#20 IsolaBella

Posted 21 December 2012 - 05:24 PM

That is wonderful news.

dS2s great leaps this year have actually just been him developing rapidly without formal intervention on the Speech side if things. I would model appropriate responses if his structure was wrong.

His RE assessment was to get a baseline to compare to Feb and see where we are at. speechie said today after we finish things in Jan to leave it for awhile.

We have been working on the social side of things to build confidence as he retreated when not understood and formed bad social patterns. So school readiness skills and Some Tweaking of speech and language and all should be good.



#21 baddmammajamma

Posted 21 December 2012 - 05:31 PM

Well done, proactive mamma! original.gif

#22 baddmammajamma

Posted 21 December 2012 - 05:32 PM

Well done, proactive mamma! original.gif

Such good news that EB wanted me to post it twice. wink.gif




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Twin brothers have become dads on the same day ? with their partners giving birth in the same hospital, and even the same birthing pool.

 

How many weeks til Christmas?

On your To-Do list

Get the "Santa" shopping done without the kids in tow.

 
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