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Speech Delay or something more?

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#1 *ShirleyTemple*

Posted 03 February 2013 - 09:45 AM

Sorry for the essay, but I'm hoping someone might have some suggestions or advice, as I am beginning to feel like nothing is working.

My DS is 27 months old and currently has a vocabulary of 4 words (meh=mum/dad, mam-ma=grandma, der=our cat and yum). He communicates mostly non verbally and has an excellent array of gestures which he has developed since about 11months old. His grasp on language is also excellent, as he understands almost everything we say. Developmentally he has hit all other milestones on time.

He has a history of ear infections from 9-15 months (about 6 in that time). He never really babbled much before the age of 1 which I put down to his ears.

I took him to be assessed by a speech therapist at 21 months and we are regularly attending reviews every 6 weeks as she gives us activities to complete at home. We have been working with him solidly for 6 months now without any real improvement. Our next review is next week and I'm not sure what I should do.

Part of the assessment suggested that because he spends all his time with me that his frustration levels are quite low, as I know what he wants through his gestures and so his motivation to verbalise was very low. We have since put him into daycare one day per week to give him a new environment to communicate in. He does not talk at daycare at all, but is happy and participates well.

We also have a new 5 wk old baby. I thought perhaps this new adjustment (and reduced one on one time) might create the frustration required. Aside from having 'meh' yelled at me a bit more, there has been no change in his verbal speech. He has become more insistent with his gestures though.

He has also had two hearing tests in the last 6 months and although it has shown middle ear blockages, they say his hearing is sufficient for speech development.

He has been seen by an ENT who has said his ears are clear, no need for grommets.

We are going back for another hearing test and review with the ENT in march.

I guess I just expected to be a little bit further down the path after 6 months. Everyone just tells me it takes time. I want to know that I have explored every avenue for him and get him any help he needs.

As he gets older, it's getting harder and harder to see his peers talking more and more.

I am feeling helpless, as noone can give us a reason why and any suggestions/advice/experience would be appreciated!

#2 Sentient Puddle

Posted 03 February 2013 - 09:50 AM

I am sure you will get some more helpful replies - but just to say that with DS (who only had 1 word by 23 months) we were doing weekly sessions with a private speechy at that stage (started at 22 months) and homework everyday.  4 words by that age does not sound in the ball park and maybe you need to be questioning your Speechy further and asking them if further testing needs to occur?  Good luck.

ETA - you can also change Speechies if going private as like any professional - some are a better fit for you/your child than others.  I would also be heading back to my GP and asking for further referrals.

Edited by ILBB, 03 February 2013 - 09:52 AM.

#3 babychacha

Posted 03 February 2013 - 09:53 AM

I'm not sure I an offer any advice but will tell you a bit about my/our story.

DS was around 3.8 months when we started seeing a speech therapist. We went weekly and were given homework.

He used to point the fridge and say ice cream. So we were both taught he had to use all his words and say , Can I have.......  So for example one session would be all aruond "can I have" ......it was all play based. Next session....."I want"......and so on.

He was older than your child though when we started.

I just wonder why you are not going to weekly sessions or is that normal for a child that age?

#4 babychacha

Posted 03 February 2013 - 09:55 AM

If you are in Sydney, I can recommend our speech therapist.

She was the 2nd one we tried. It can be expensive to change as they want to do an assessment first...which they need to do anyone. However, well worth it for us.

The first speech therapist, whilst technically good....her personality was horrid and actually yelled at my child twice.... last time she did it, we quit.

#5 smithsholidayroad

Posted 03 February 2013 - 09:57 AM

Perhaps while still accessing speech therapy get a referral from a GP also for a developmental Paed. They can assess and put you in touch with any other specialists that might be needed. Sometimes the waiting list is huge so better to put your name down now.

Good luck

#6 Isolabella

Posted 03 February 2013 - 10:06 AM

Could just be natural late talker. I have had two. Speech explosion was around 28-29m and two words together at 30m.

DS1 as he turned three came out with "mummy I think perhaps a train may be coming soon" which was the point I stopped being concerned with him. He had less then 10words hardly ever used at 24m. At 27m assessed as expressive language of 9mo and receptive of 11mo. His speech explosion was at 28m.
He is now a very chatty, social 7.5yo who is very bright (doing 3-4th grade maths in 1st grade and reading ahead too)

DS2 was ahead with about 15words at 2yrs. Explosion and talking more at 2.5yrs sounded like he was talking underwater. Hearing test showed moderate hearing loss and fluid filled ears. Grommets in as he turned three, but it was still not until he was over 4yrs that we got a normal hearing test. This did affect his social skills not being able to communicate (as when he was trying to talk to people as he turned 4 they could not understand him, so he just stopped trying). We have had major social skills speech as he turned five to get him ready for school. Intellectually he is super smart. His receptive language was assessed as bottom 30% last Feb, then in Oct was at top 89%. A massive jump. His expressive language went from severely delayed to within Normal limits. It was just his lack of hearing holding him back. He is actually brighter then his brother.

DD on the other hand was saying "DS1 name give me ball back now " at 20m, so she is well ahead of the boys.

Do keep on seeing speechie and ENT. Perhaps try another speechie who specialises in Dyspraxia.

#7 Kay1

Posted 03 February 2013 - 10:19 AM

My two boys were quite similar in their speech development including the lack of frustration. They also had similar hearing/ear issues. DS1 is 7 and has great speech. DS2 is 4 and still a little unclear but improving. His hearing is still variable with periods of hearing loss and we see an ENT about that.

It sounds to me like you are being very proactive and in the absence of any other concerns I'd keep going as you are.

#8 baddmammajamma

Posted 03 February 2013 - 11:19 AM

To rule out the "something more," your best bet is to follow Bron's advice below and have a developmental paed look across your son's entire developmental profile.

QUOTE (TheSmithFamily @ 03/02/2013, 10:57 AM) <{POST_SNAPBACK}>
Perhaps while still accessing speech therapy get a referral from a GP also for a developmental Paed. They can assess and put you in touch with any other specialists that might be needed. Sometimes the waiting list is huge so better to put your name down now.

Good luck

As for the lack of improvement in your son's expressive language, I am a bit surprised that the speech therapist suggested meeting every 6 weeks (unless cost was totally prohibitive of more frequent visits) despite your son's lack of progress. When my daughter was that age and struggling with her expressive language, we were seeing our speech therapist twice/week. There is something to be said for intensity with early intervention.

As others have suggested, you might want to consider working with a different speech therapist if you aren't seeing any results under the arm's length guidance of your current one. Good luck. I can appreciate how frustrated (and tired) you must be!

#9 *ShirleyTemple*

Posted 03 February 2013 - 11:32 AM

Thanks ladies! Its nice to read some more stories, it keeps me hopeful that we are doing the right thing and he will just astound me one day!

As for the speech therapy, we started with the 6 weekly reviews as the speech pathologist thought he was just delayed and 'it would just take time' and wanted to see how he went with doing the activities at home. At our last appointment before xmas she hinted at more intensive therapy sessions in the new year if he hadn't made any progress so I think thats what we will be discussing next week. She seems quite good and relates really well with DS so I will talk to her about the Dyspraxia and seeing a Paed.

Its just hard watching him miss out on things because he doesn't talk. My DH finds it extremely frustrating, as he is such a happy, normal and quite smart (we think!) little boy, with no explanation for why he understands us but doesn't talk.

#10 *ShirleyTemple*

Posted 03 February 2013 - 11:40 AM

Thanks BMJ - I have read many of your posts and hoped you might see mine. I really appreciate your advice, as I do everyone who has replied.

I guess the speech therapist has been guided by me a bit, as I was quite happy to work intensively with him at home to start with. We have seen some communication improvements, just not really verbal ones. So I think it has reached a point where we need to decide where to go from here. He has actually stopped saying many of the words he used to say when he was 12-18 months (only about 6 words).

I will see how we go on Thursday. We are in Darwin, so I think our options may be a bit limited.

#11 baddmammajamma

Posted 03 February 2013 - 11:57 AM

Your user name makes me smile, as I was a Shirley Temple devotee as a kid.

I appreciate that every child is different, but we found that going for the more intense upfront push with speech was very valuable. Our daughter was able to get on track with her expressive language within a relatively short time of frequent therapy with a really good speech therapist. And as soon as she was better able to express herself verbally, we saw less frustrations from her.

I tried my best to do the right reinforcing things at home, but in our case, getting regular professional guidance from someone who really "knew her stuff" and could keep a close eye on our daugher's progress proved to be the game changer.

Congrats on your new arrival, by the way! My kid are spaced almost exactly the same as yours, and I remember the *fun* (not) of juggling my daughter's therapy visits with a newborn baby. Hang in there! Hope your son has a verbal explosion very soon! original.gif

Edited by baddmammajamma, 03 February 2013 - 11:58 AM.

#12 tenar

Posted 03 February 2013 - 12:02 PM

I know of one child (daughter of a friend of ours) who aged 2 had almost no words, but excellent understanding.  She also had a history of ear infections etc, along with our troubles.  

In the end they were told that the difference between her expressive language (very behind for her age) and her understanding (way ahead for her age) was a problem of itself, as she couldn't express herself in a way that was anything like as expert as the language she understood around her.  Part of the fix was for her parents to talk to her in much simpler language, as if she were a younger child, so she could gain the confidence to catch up in her expressive language.  

Maybe this would be worth asking a doctor or speech therapist about?

#13 *ShirleyTemple*

Posted 03 February 2013 - 12:16 PM

Thanks Tenar - that is what a lot of the exercises and activities we do at home are about, simplifying our language down to single words. As his comprehension is so far ahead, we tended to talk to him as such, with longer sentences which doesn't help him learn the basics. My frustrations I guess lies in the fact we've been trying these strategies for a while now, and I'd just like to see a little improvement.

Thanks again BMJ! Shirley Temple was my pop's nickname for me as a child. I think we will be looking at the more intensive speech therapy, and see where that takes us. This week is my first week alone with both kids, so it could be very interesting!

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