Late Talkers... what to do?

[tranquilmama]

My dh and I have officially decided that we have a late talker. Our third, who is now 30 months, is very expressive and communicative but just hasn't gotten simple sounds down. His words are very very difficult to understand but sometimes context gives us clues and so we've been working it out and he feels understood.

 

I would really like to take a few weeks and spend some extra special time practicing word sounds before I go ahead and start looking for a speech therapist.

 

If anyone has dealt with this sort of delay, I'd love some direction. Thanks

[gingersmom]

Do not wait. Start looking for a speech therapist now.

 

It can take forever to get an appointment just for an evaluation. And then their schedule has to jive with your schedule and your childs nap time, etc.

 

If you are going to do services through early intervention (or whatever kicks in when they turn 3) it can take a very long time to get started.

[sbgrace]

In most states (all?) the free early intervention ends at age three and the school system takes over. In most states the before three stuff is one on one in your home and the offerings via school systems are only if your child qualifies for preschool type services. Other than that you'd be doing private therapy which is pricey. You're describing sounds like some pretty significant articulation issues and those are often time consuming to address compared to other speech delays and in my opinion really need expert help usually. Basically, I would start the process now.

[tranquilmama]

Thank you for your replies. I called and got the info in so should be receiving a call back within a few weeks. Any suggestions on things we can do in the meantime?

[ElizabethB]

You could try Leapfrog's Talking Letter Factory DVD. My son's speech really improved after watching it daily for a month. It didn't improve until the end of the month, though, when he had learned all the letter sounds. He was 2 when he watched it.

 

I also like this website, you could do it with him:

 

http://www.uiowa.edu/~acadtech/phonetics/#

[MicheleEB]

I would second taking advantage of at least 6 months of free speech therapy via Early Intervention. However, there are resources out there that you can use to work with him yourself. Super Duper has tons of flashcards that can be used to play articulation games: http://www.superduperinc.com/search/topicSearch.aspx?id=13

 

Michele

[Colleen]

 

Thank you for your replies. I called and got the info in so should be receiving a call back within a few weeks. Any suggestions on things we can do in the meantime?

Aside from not worrying about it, you mean? Because that's my suggestion. Don't worry about it. So he's not talking at 30 months. No worries. That's my experience. For the life of me, I don't know why this culture/society is so obsessed with the idea that all children should be talking/walking/using the toilet/reading/whatever by (insert age here).

 

[VinNY]

Aside from not worrying about it, you mean? Because that's my suggestion. Don't worry about it. So he's not talking at 30 months. No worries. That's my experience. For the life of me, I don't know why this culture/society is so obsessed with the idea that all children should be talking/walking/using the toilet/reading/whatever by (insert age here).

 

Because sometimes when these developmental milestones are not met in a timely manner compared to the norm, it is a flag that something maybe up with your child. I played along with the no worry game only to discover that two of my children (and my family) would have benefited greatly from early OT and speech. The older they are, the more running around and time you need to spend on therapies. Apraxia of speech isn't a fun thing to live with, nor dyspraxia, sensory issues and APD. OT gave us a better quality of life and speech therapy has helped them communicate and order their thoughts better, but more could have been done if I started when they were younger.

[gpsings]

My middle dd didn't talk AT ALL until she was 3. We tried to get speech therapy, but couldn't afford it. Turns out, she was just late. She's ahead in all her subjects...so we know she's bright, and we seriously can't shut her up now. She's the most outgoing of all of my kids.

I wouldn't worry just yet.

[gingersmom]

Aside from not worrying about it, you mean? Because that's my suggestion. Don't worry about it. So he's not talking at 30 months. No worries. That's my experience. For the life of me, I don't know why this culture/society is so obsessed with the idea that all children should be talking/walking/using the toilet/reading/whatever by (insert age here).

 

No worries?

 

My son did not speak till he was 4. And that was after almost 3 years of therapy.

 

If I had not worried (as you suggested) he would not be speaking today. Instead he would be carrying around a portable device that would speak for him.

 

I'm glad I worried.

[Denise Allen]

My 4th is 32 months and though he talks some, he does not talk well. He does not talk in too many sentences. I am not worried about it because he crawled later, walked later than my other 3. He shows his smarts in other ways. I wouldn't worry about it too much if you don't see problems in other areas. A friend whose son is in speech therapy said it is a wast of money. They do what you can do at home. Really make them look at your mouth when you speak to them. Face to face. Pronounce well and loudly, forming the words as they watch. Try to encourage them to repeat if they will, and praise them for any effort. It will make it fun and they will be encouraged to imitate you more. This is what they have learned from their time w/ a therapist. (They are doing it on their own now and seeing progress).

[specialmama]

I second the articulation/oral excercises. Put pudding or any sticky food beside his mouth and hold his hands in a fun way. Let his tongue get it. Do this often. Blow a feather across the table. Blow a light ball across the floor and down some steps for fun. Blow bubbles. Move your tongue all around and make exaggerated sounds; super fun in the mirror. Use whistles, flutes, harmonicas. Apart from physical issues, these are the first things a speech path will work on. Provided it goes well, uttering sounds would be next. Do this by holding a favourite toy and making an easy sound that sounds like the word. ie: BAH for ball. Hold the item up expectantly and the second he repeats BAH, he gets the ball. Let him have it for a minute, then take it and hold it up again. Keep doing this so long as it doesn't frusterate him a lot. You're trying to teach that his words (sounds) have power. Again, there could be a medical/physical reason for delayed speech, but if not, then there are some excercises to do. We've been in speech therapy for 7+ years now, from 3x's per week to twice a month now. I agree with the SupaDupa (sp?) website, as well as a few books, in particular It Takes Two to Talk, from the Hanen Centre. HTH

[AngieW in Texas]

Aside from not worrying about it, you mean? Because that's my suggestion. Don't worry about it. So he's not talking at 30 months. No worries. That's my experience. For the life of me, I don't know why this culture/society is so obsessed with the idea that all children should be talking/walking/using the toilet/reading/whatever by (insert age here).

 

Because for some kids it's a huge red flag. I kept waiting and waiting for my middle dd because all the relatives said my dh was a late talker.

 

Well at 4yo, I was the only person who could understand her speech at all and I could understand it only 25-30% of the time. We had her hearing tested several times and it was normal. I finally ignored all the people who said it wasn't a big deal and took her for a speech evaluation. At 4yo, she had the expressive and receptive language of a 2yo. The ST told me that my dd's primary problem was an auditory processing delay. The sounds of speech came too fast for her to process. Insurance wouldn't pay for ST and the waiting list to do ST through the ps was 6 months, so I posted on all the boards I could find and got several recommendations to try Reading Reflex. I started working with her using RR and by the time she finally got her evaluation with the ps 6 months later, she was up to low end of normal (and yes, the difference in her speech was incredibly dramatic). She still had articulation problems, but other people could understand her a lot of the time.

 

This same dd was also very delayed in motor skills. I knew that she was doing things later than my oldest had, but I didn't really think there was an issue until my youngest (2.5 years younger) started passing her up in physical skills. I got an occupational therapy evaluation. My dd tested at a 6 month old level for fine motor skills and a 3yo level for gross motor skills at 5yo. After just 4 months of OT, she was up to low end of normal.

 

My dd still has some fine motor delays, but only somebody who knows what to look for will see those delays. She purposely doesn't wear clothing that has buttons, zippers, snaps, or laces.

 

Waiting is fine if your kid doesn't have developmental delays, but if your kid does, then the longer you wait, the more pain and anguish you will put your child through. A lot of times you just won't know unless you go for an evaluation.

 

I still kick myself for not taking my dd in for a speech evaluation by 2yo. It was obvious by that point that her speech wasn't developing like it should, but I listened to all the relatives who said that my dh was a late talker and all the other moms who said that she was developing on her own timetable. My dd screamed for hours every day out of sheer frustration because nobody could understand her and she couldn't understand us either. We could have stopped that 2 years earlier by doing speech therapy at 2yo when I first realized that there was a problem.

[tranquilmama]

I'm not worried, per se, but I am conscious of the fact that there is a proportional increase in frustration as he'll get older and not be able to communicate effectively. We've done a lot of the exercises already. I almost think that since his is a third child, he has been talked over a bunch and has been understood within the context of our family thus far. He starts his words and doesn't finish them. I will take advantage of any therapy we can get while we can get it. I've also looked at the Baby Babble DVD's and ordered them.

[Guest Cheryl in SoCal]

No worries?

 

My son did not speak till he was 4. And that was after almost 3 years of therapy.

 

If I had not worried (as you suggested) he would not be speaking today. Instead he would be carrying around a portable device that would speak for him.

 

I'm glad I worried.

The thing is, there is no way to know whether his speaking was due to the ST or if he was just ready to talk. One of my children was barely speaking at 2 (she had about a dozen partial words - "ca" for cat, etc). She was evaluated by the ST because she had a cleft lip/palate and intensive ST was suggested (due to her speech delay which was not related to the cleft lip/palate). This was not possible due to a variety of circumstances so she received no ST and was re-evaluated by the same ST 15 months later. She had made amazing progress (speaking in 7 and 8 word sentences) and was no longer delayed. Had she been receiving ST I'm sure this would have been attributed to the ST but obviously it was not.

 

I'm not saying that all cases of early ST aren't necessary but I think many are.

Edited September 23, 2010 by Cheryl in SoCal

[Crimson Wife]

I highly recommend reading The Einstein Syndrome: Bright Children Who Talk Late by Dr. Thomas Sowell. My DS had speech & language issues and fit the Sowell profile. DS did 9 mos of speech therapy from 2 3/4 to 3 1/2 and he made a lot of progress during that time. But after we switched insurance & speech therapy was no longer covered, he continued to make progress on his own. He's now almost 5 and within the normal range. It's hard to say how much therapy helped him vs. simply getting older.

 

I'm now keeping an eye on our 20 month old. Our old speech therapist says there is a lot of speech development between 18 mos and 24 mos so her clinic doesn't evaluate kids until the age of 2. But if I still am concerned about my toddler's speech next winter then I'm going to have Early Intervention do an assessment.

[PeterPan]

Wow, seems like there's a big spread of what people mean when they say their dc wasn't/isn't talking at a certain age. Animal sounds, partial words, all these things count in a speech evaluation. My ds made NO sounds when playing for many months (which means we lost him a lot!) and could not repeat animal or letter sounds. In the last month took off so that he'll have some sort of sound (with his toys, etc.) about half the time. That's a key symptom of apraxia. Any words he has ever said, he has only said a few times and then never said again, another symptom of apraxia. He has a HUGE gap between his receptive and expressive language skills, another symptom of apraxia. He exhibits frustration over his inability to speak, another symptom of apraxia. He has extremely, extremely good fine motor skills, common in apraxics as the body puts its energies into what it is good at (since the talking isn't coming). So yes, the SLP diagnosed him as verbally apraxic. Oral apraxia has a whole additional set of symptoms (inability to round lips/pucker, lick lips, blow, etc.).

 

The amazing thing is, he started his therapy today, and she had him SPEAKING today using PROMPT. I kid you not! He said: more, up, ball, on, me... And he said these words multiple, multiple times. If he simply "wasn't ready" then therapy couldn't do that. But PROMPT therapy inputs sensory info to help the brain connect what it wants to say (which he clearly wants to) with the muscles necessary. Apraxia is a motor control problem, not merely a delay. Waiting doesn't get rid of it.

 

So I haven't a clue what's wrong with the op's dc, but I'd suggest that she read about the forms of apraxia (verbal, oral, etc.) and read the symptoms. Get The Late Talker book. Read about PROMPT and watch the 45 min. video on youtube explaining it. Watch youtube clips of apraxic dc your dc's age and see if they are similar. And by all means read the reviews on amazon of the parents who bought that Einstein Syndrome book and REGRETTED it later because their dc WASN'T one of those.

 

I haven't a clue if my dc would eventually somehow break through and speak, but I sure am not going to sit around and wait, not when I KNOW what the problem is and KNOW it's treatable.

 

If you think it's apraxia, I wouldn't screw around waiting. EI sort of puts you in a rat race, at least around here. (preliminary evaluation in order to approve a real evaluation which turns out to be with an inexperienced newbie who can't do the best therapies anyway) I'd find the best person you can and get on their appointment list for an evaluation. You may have to wait a month or more. Apraxia doesn't respond as well to regular speech therapy, so you're looking for someone with more experience in it. I'm driving 2 1/2 hours to mine, because it's all she does, all day long, just apraxia and feeding problems. Others closer blew me off and basically offered "communication" work, sitting around trying to pull out sounds and learn signs. With the PROMP-certified SLP my ds started talking the first day. That's a HUGE thing to me. I've NEVER heard him say these things.

Edited September 24, 2010 by OhElizabeth

[Tokyomarie]

It sounds like you had a great start on your son's new therapy!

 

I am a parent who will eternally regret a) not getting my son started in speech therapy earlier and b) not getting him professionally evaluated earlier for dyslexia and continuing language difficulties. We lost too much time by waiting- both when we didn't get speech going until nearly 3.5yo and again when I didn't stand my ground and insist that he get properly evaluated for dyslexia no later than age 8. We lost too much time and now we're doing professional remediation that should have been done years ago. I tried to do it on my own but it wasn't enough.

Edited September 24, 2010 by Tokyomarie

[Guest Cheryl in SoCal]

Wow, seems like there's a big spread of what people mean when they say their dc wasn't/isn't talking at a certain age. Animal sounds, partial words, all these things count in a speech evaluation. My ds made NO sounds when playing for many months (which means we lost him a lot!) and could not repeat animal or letter sounds. In the last month took off so that he'll have some sort of sound (with his toys, etc.) about half the time. That's a key symptom of apraxia. Any words he has ever said, he has only said a few times and then never said again, another symptom of apraxia. He has a HUGE gap between his receptive and expressive language skills, another symptom of apraxia. He exhibits frustration over his inability to speak, another symptom of apraxia. He has extremely, extremely good fine motor skills, common in apraxics as the body puts its energies into what it is good at (since the talking isn't coming). So yes, the SLP diagnosed him as verbally apraxic. Oral apraxia has a whole additional set of symptoms (inability to round lips/pucker, lick lips, blow, etc.).

 

The amazing thing is, he started his therapy today, and she had him SPEAKING today using PROMPT. I kid you not! He said: more, up, ball, on, me... And he said these words multiple, multiple times. If he simply "wasn't ready" then therapy couldn't do that. But PROMPT therapy inputs sensory info to help the brain connect what it wants to say (which he clearly wants to) with the muscles necessary. Apraxia is a motor control problem, not merely a delay. Waiting doesn't get rid of it.

 

So I haven't a clue what's wrong with the op's dc, but I'd suggest that she read about the forms of apraxia (verbal, oral, etc.) and read the symptoms. Get The Late Talker book. Read about PROMPT and watch the 45 min. video on youtube explaining it. Watch youtube clips of apraxic dc your dc's age and see if they are similar. And by all means read the reviews on amazon of the parents who bought that Einstein Syndrome book and REGRETTED it later because their dc WASN'T one of those.

 

I haven't a clue if my dc would eventually somehow break through and speak, but I sure am not going to sit around and wait, not when I KNOW what the problem is and KNOW it's treatable.

 

If you think it's apraxia, I wouldn't screw around waiting. EI sort of puts you in a rat race, at least around here. (preliminary evaluation in order to approve a real evaluation which turns out to be with an inexperienced newbie who can't do the best therapies anyway) I'd find the best person you can and get on their appointment list for an evaluation. You may have to wait a month or more. Apraxia doesn't respond as well to regular speech therapy, so you're looking for someone with more experience in it. I'm driving 2 1/2 hours to mine, because it's all she does, all day long, just apraxia and feeding problems. Others closer blew me off and basically offered "communication" work, sitting around trying to pull out sounds and learn signs. With the PROMP-certified SLP my ds started talking the first day. That's a HUGE thing to me. I've NEVER heard him say these things.

This is why you have to look at everything and not just whether there is a speech delay. Unfortunately, many ST's only look at whether there is a speech delay and nothing else. My dd had several things that contributed to her delay; the trauma of adoption, the trauma of 2 major surgeries (both before the age of 10 months), fluid in her ears until 7 months of age, and then ear tubes that clogged several time (allowing fluid to build). I wasn't concerned because of these and the fact that she was progressing typically, just not where she "should" be if she was a "normal" child. The thing is she wasn't a "normal" child and that needed to be taken into account. We couldn't do ST at the time because we were about to bring home another baby and couldn't leave the house and since I wasn't concerned (due to the above reasons) we waited. She caught up and was actually ahead in several areas by the time we made it back for her next evaluation. I am very glad we waited because she is a strong willed child and I am pretty certain pushing her before she was ready would have caused some serious behavioral problems due to the frustration of being asked to do something she wasn't ready to do. She is in ST now for some articulation errors (due to her cleft) but they are minor and she is mature enough now (almost 4) to work on them without serious behavioral/frustration issues. If she presented as your child did that would be en entirely different matter. I just wish ST's would really look at everything and not just jump into intensive ST when the child is progressing normally, just at a slower rate than the "norm."

 

My youngest (2 1/2) also has a speech delay but he was also adopted at 11 months of age (hearing only Korean until that point). Not only was he adopted but he was in the baby hospital (like daycare, where they stay before going into foster care) for 4 1/2 months and then with his foster family for 5 1/2 months before we got him. This kind of trauma affects many things, including speech. He is delayed but is also progressing pretty typically, just at a slower rate than "normal." He may eventually need ST but at this time we aren't ready to begin ST. Unfortunately, as much as I really like the ST who evaluated him, she didn't take into account how the trauma he has been through affects his speech. He has no special needs but came home much older than his sisters (they came home at 5 months and 6 months of age) and I can see how that has affected him in more ways than just speech.

 

Anyway, that is why I think you have to look at everything and not just whether or not a child is speech delayed.

Edited September 24, 2010 by Cheryl in SoCal

[PeterPan]

Exactly!!! And that's what so frustrates me about people making blanket statements, because there's no way the situations are identical. And when you get someone who actually is very experienced in apraxia, they can tell the difference in these things. This lady sees and notices things I totally miss. To my mind, an evaluation WITH A REALLY GOOD THERAPIST can't hurt. But I understand people's reluctance. The first SLP I visited treated us like a cash cow. We were going to walk in, pay for an evaluation where she was basically going to say her predetermined spiel (appears delayed, let's try some therapy), wasn't willing to give a diagnosis, wasn't willing to say yay or nay on anything, and certainly wasn't willing to say what her therapy could do for him (except some broad, vague category of "communication"). Well hang it all, my ds can communicate. He just can't TALK! Turns out they do sort of a flimsy, tentative evaluation (often with the lowest therapist in the office or sold out to someone else who is a newbie), and they just figure they'll evaluate more as they go.

 

I'm just saying I can see people's reluctance to get an evaluation, when it's a situation like that. I certainly didn't like it, because I had no sense that they would be upfront and say he DIDN'T need therapy or that he WOULD come out of it on his own. Their only incentive was to say he did, and they felt they could do that (and command $300 a week in therapy fees!) without any concrete diagnosis. Wowsers.

[Guest Cheryl in SoCal]

Exactly!!! And that's what so frustrates me about people making blanket statements, because there's no way the situations are identical. And when you get someone who actually is very experienced in apraxia, they can tell the difference in these things. This lady sees and notices things I totally miss. To my mind, an evaluation WITH A REALLY GOOD THERAPIST can't hurt. But I understand people's reluctance. The first SLP I visited treated us like a cash cow. We were going to walk in, pay for an evaluation where she was basically going to say her predetermined spiel (appears delayed, let's try some therapy), wasn't willing to give a diagnosis, wasn't willing to say yay or nay on anything, and certainly wasn't willing to say what her therapy could do for him (except some broad, vague category of "communication"). Well hang it all, my ds can communicate. He just can't TALK! Turns out they do sort of a flimsy, tentative evaluation (often with the lowest therapist in the office or sold out to someone else who is a newbie), and they just figure they'll evaluate more as they go.

 

I'm just saying I can see people's reluctance to get an evaluation, when it's a situation like that. I certainly didn't like it, because I had no sense that they would be upfront and say he DIDN'T need therapy or that he WOULD come out of it on his own. Their only incentive was to say he did, and they felt they could do that (and command $300 a week in therapy fees!) without any concrete diagnosis. Wowsers.

I agree about getting an evaluation with a GOOD therapist! Unfortunately, even then many who just have speech delay (no signs of apraxia or other issues) are still recommended ST when it likely isn't necessary, or not necessary yet. My children's issues related to adoption aren't well known by ST's so I can see how they overlook that but I know several whose children have mild speech delays with no other issues/etc but are told they should be in ST 2 days/week. That's what gets my goat :glare:

 

The first ST you saw sounds like a doozy :001_huh: Thankfully, my dh doesn't have any signs of apraxia (he was evaluated by a good therapist) but we will be monitoring him closely and he will be re-evaluated in a year if there is still concern, or sooner if he regresses at all.

[redsquirrel]

I have a son with a speech delay. I know how hard, very hard it is to pick up that phone and call early intervention. It was one of the hardest things I have ever done. None of my friends supported me. They all told me about kids who didn't talk and told me to read "The Einstein Syndrome". I felt like I was somehow betraying my son when I called.

 

Looking back, it was one of the best things I ever did. And I say that as a mom whose kid got a lousy initial eval. They told me he was prob. autistic. I knew they were wrong but got the therapy anyway. It turns out he has a motor problem. He is almost 6 and gets speech, OT and PT. He is a happy, sweet little boy. He just needed the speech therapy to help him tell us what he wanted to say.

 

You are doing the right thing. Speech therapy is pretty fun for kids. We had only great therapists from Early Intervention. The therapy continued through the school system when he turned four but it was still home based. Now that he is old enough for kindergarten in my state (NY) I have to take him to the school for his therapy. So far, it has been easy and everyone has been great.

[cathmom]

Do not wait. Start looking for a speech therapist now.

 

 

 

Yes!

 

Aside from not worrying about it, you mean? Because that's my suggestion. Don't worry about it. So he's not talking at 30 months. No worries. That's my experience. For the life of me, I don't know why this culture/society is so obsessed with the idea that all children should be talking/walking/using the toilet/reading/whatever by (insert age here).

 

My twins (especially one of them) were obviously delayed at 2 years old. I was of the "don't worry, they're making progress" approach and didn't do anything about it. My oldest child hadn't really talked until 3, so I wasn't worried. Then at their 3 yo checkup, they were even more delayed and I agreed to an evaluation. Now they are FIVE and I still can only understand them about 50% of the time, and my dh even less than that. Do you want to know how stressful it is to have 2 five yos that you can't understand? How upset they get? How many times I pretend I understood what they said just so they don't feel bad? I really, really wish I had not waited that year.

[wapiti]

What to do in the meantime while you're waiting for your evaluation - this site may offer a few tips for working with your child if you scroll down a bit http://www.latetalking.org/

[Embassy]

I would contact your local early intervention program or visit a private therapist to have an evaluation.

 

While you are waiting I would check out http://www.helpmychildtalk.com for some things you can try with him at home.

[LizzyBee]

Aside from not worrying about it, you mean? Because that's my suggestion. Don't worry about it. So he's not talking at 30 months. No worries. That's my experience. For the life of me, I don't know why this culture/society is so obsessed with the idea that all children should be talking/walking/using the toilet/reading/whatever by (insert age here).

 

The thing is, it can be really difficult to tell the difference between a child who is just late and one who really needs help. Our dr is very laid back, but wanted me to have dd9 evalulated when she was 2 because she was barely talking at all. I ignored his advice. When we went back for her 3 yr check up and he asked me about her speech, I realized that she was now talking in paragraphs, but no-one could understand her. I would not have had her evalulated if even one person understood her and was interpreting for her, but that wasn't the case. Her evaluation showed that her articulation was below the 1st percentile for girls her age. I was later told she probably had apraxia of speech although she was never officially diagnosed with that. It turns out that she has rather severe dyslexia and she was in speech/language therapy until she was 9.

 

OTOH, we had our middle child evalulated before she started K because she still had trouble with a few sounds, along with a lateral lisp. The therapist said she was borderline and we could do a few months of therapy, but she'd be fine if we didn't. We elected not to do therapy, but we worked with dd at home on the lateral lisp. She turned out fine without therapy, but it put us at ease to have a therapist tell us that therapy was not essential.

Edited October 21, 2010 by LizzyBee

[LizzyBee]

My dh and I have officially decided that we have a late talker. Our third, who is now 30 months, is very expressive and communicative but just hasn't gotten simple sounds down. His words are very very difficult to understand but sometimes context gives us clues and so we've been working it out and he feels understood.

 

I would really like to take a few weeks and spend some extra special time practicing word sounds before I go ahead and start looking for a speech therapist.

 

If anyone has dealt with this sort of delay, I'd love some direction. Thanks

 

If your insurance company will pay for ST, I'd go private rather than with early intervention or the school system. Ask around and find out which is better in your area, but in most areas, private therapy is better quality. Our insurance paid for all of dd's therapy - speech and occupational - through age 8 for OT and 9 for ST.

[springmama]

My son was evaluated at 14 months and it was determined that he was delayed in a few areas so we went ahead and did speech therapy. The red flags for us were not that he wasn't using words, but he hadn't yet made certain sounds. He wasn't walking or pulling himself up to stand yet.

 

Anyway, the evaluators recommended a hearing test. He had never had an ear infection or even a really bad cold, but he failed the hearing test because he had fluid in his ear.

 

We gave him antibiotics for 10 days, then retested. His hearing was much better.

 

Meanwhile, we started speech therapy 2x a month. He loved it! He had his very own fun teacher coming to see him. She brought really great toys and gave him all of her attention!!! When he saw her coming up the walkway he would just squeal and giggle because he knew she was going to spend a full hour playing with him.

 

He made so much progress that after a year in therapy he surpassed his age on many of the test criteria and he's fine now. He does not need his special teacher anymore and talks all day long.

 

I have no idea if he would have caught up without speech therapy but boy he had so much fun. If I hadn't taken him for the evaluation in the first place, I might not have had his hearing tested and it may have been awhile longer before we realized he needed some help with fluid in his ears.

[Terabith]

My daughter started speech therapy at 15 months, and it was wonderful. Maybe she would have been fine without it, but I am not sure, and I know she IS fine now. I don't see a downside for it. We did it through early intervention, and it was a lot of fun for her, I appreciated having another adult who came by, and Anna made a lot of progress quickly. I really don't see a downside to early speech therapy. It was one of the best parenting decisions I think I made.

[Guest Cheryl in SoCal]

My daughter started speech therapy at 15 months, and it was wonderful. Maybe she would have been fine without it, but I am not sure, and I know she IS fine now. I don't see a downside for it. We did it through early intervention, and it was a lot of fun for her, I appreciated having another adult who came by, and Anna made a lot of progress quickly. I really don't see a downside to early speech therapy. It was one of the best parenting decisions I think I made.

Not all children think it's fun, even when the therapist is awesome. It also costs money (whether it be tax payer dollars, rising insurance costs, your own money, etc). When it's necessary this is money well spent but unnecessary therapy costs money. I'm not against ST (obviously, since I do have a child who is receiving ST) but think the system (in general) is too quick to recommend ST, and IMHO often does so when it's not really needed.

[PeterPan]

So did the op ever decide on an evaluation or not for her dc? We're 5 weeks into our speech therapy (PROMPT for moderate verbal apraxia), and it is going AMAZINGLY well. I was talking with a friend about this just yesterday, as she was saying her boy didn't talk when he was two but that the siblings talked over him (something people accuse us of), etc. But the more we talked, the more obvious it became that other people's idea of not talking isn't the same as what a speech therapist means. Animal sounds count as words. Being utterly silent when they play (making no noise for toys, etc.) is a problem. Saying words a couple times and never again is a problem. So it's really not a pat thing of just talking or not. It's now incredibly clear my ds was/is apraxic. And the amazing thing is how the PROMPT therapy unlocks his speech. He has totally stopped the HITTING we were so frustrated by! He doesn't need it anymore, because with the sensory input of prompt he can get out words. All the words were there, and he just couldn't get them out! He now can say little phrases like "Yeah me" or moo for a cow. Granted it's with help, but this is from a boy who two months ago would disappear and be lost in the house, unable to make a sound and tell us where he was! So yeah, we're big fans of good speech therapy here. (Note that GOOD delimeter.)

 

So maybe that's just an update for anyone who is interested. :)

[wapiti]

So did the op ever decide on an evaluation or not for her dc? We're 5 weeks into our speech therapy (PROMPT for moderate verbal apraxia), and it is going AMAZINGLY well. I was talking with a friend about this just yesterday, as she was saying her boy didn't talk when he was two but that the siblings talked over him (something people accuse us of), etc. But the more we talked, the more obvious it became that other people's idea of not talking isn't the same as what a speech therapist means. Animal sounds count as words. Being utterly silent when they play (making no noise for toys, etc.) is a problem. Saying words a couple times and never again is a problem. So it's really not a pat thing of just talking or not. It's now incredibly clear my ds was/is apraxic. And the amazing thing is how the PROMPT therapy unlocks his speech. He has totally stopped the HITTING we were so frustrated by! He doesn't need it anymore, because with the sensory input of prompt he can get out words. All the words were there, and he just couldn't get them out! He now can say little phrases like "Yeah me" or moo for a cow. Granted it's with help, but this is from a boy who two months ago would disappear and be lost in the house, unable to make a sound and tell us where he was! So yeah, we're big fans of good speech therapy here. (Note that GOOD delimeter.)

 

So maybe that's just an update for anyone who is interested. :)

 

Sounds very interesting, actually - do you happen to have any links describing what PROMPT therapy is? I hadn't heard of it before (it's been years since my kids have been in that not-talking-at-all therapy stage, though my 15-month-old doesn't exactly have any words yet - keeping my fingers crossed that she comes up with something by my 18-month deadline ;))

[PeterPan]

Do a search for PROMPT speech therapy and see if the youtube video will turn up. There are short videos of a few minutes each where people show their dc being evaluated or receiving therapy. Then there is a huge, 45 minute video of the developer of PROMPT explaining it. That was very, very enlightening to me, as she talks about what it is, why it works, shows them doing it with clients, etc. Just amazing.

 

To sort through the apraxia thing, well there are lots of websites like ApraxiaKids where you can read all about it. It's a really specific profile, because it's a motor control problem, NOT an overall delay. So my ds's receptive language skills are WAY beyond his expressive. He might say a word very clearly *one time* and never be able to say it again. Or he might say it adequately 2-3 times over a period of a few days and never again. That losing of words is typical of apraxia. He couldn't repeat animal sounds. He didn't imitate letter sounds. He made no noises when playing, none at all. As in if he and I were the only ones home and he was playing by himself, you'd hear a pin drop, NOTHING. And his fine motor skills are through the roof good, which the SLP said is common in apraxia too. (The brain puts all its energy into motor skills, since the talking isn't going well.)

 

So PROMPT has the therapist touch the articulators trying to create a sensory input at the muscle, at the thing that needs to work. They play with the dc, getting them into a scenario where they want to say the target words, and they give this input while the dc is thinking the word, hearing the word, and wanting to say the word. They blend sign (ASL) and speech and accept it all. The SLP definitely encouraged us to look into nutritional measures. I now have him on flax oil (a banana flavored product that he will take) but other people do fish oil. Many people are using a nutritional shake called Nutriiveda. I decided not to do it at this time, but rather to focus on making his food easier to chew. We did not realize he has low muscle tone (like my dd and I), and the low muscle tone results in chewing fatigue. Between that and not talking, the apraxic kids can have little cherub cheeks. Supposedly these tighten and firm up as they talk more. He's still my little angel and has very kissable cheeks. :) Anyways, we've been working harder on the chewing thing, trying to make his food more ground, easier to get down, digest, and absorb. The flax oil DEFINITELY helps his speech. It doesn't replace the therapy, but when he takes it he finds it easier to get words out.

 

I wasn't really freaky about this at 15 and 18 months, because I tend to be very go with the flow and assume things are normal. He had said words once or twice, so I assumed that was enough. But over time we realized he wasn't going FORWARD with his speech, not at all. So it's not just what they say or don't say, but the trend and warning signs. Losing words is a bad sign. Not babbling, no jibberish, no sounds when they play, that's a red flag. It's not just a word count. Oh, and a huge differential between expressive and receptive language is a red flag. When I started to read about apraxia, it wasn't a hard leap to make, because my dd has been diagnosed by the OT with a slight touch of apraxia (not verbal but spatial) as well. So as soon as I realized the connection, I knew I had a problem.

 

Everything I read online was that traditional speech therapy is about worthless for apraxia. That's not the nicest way to put it, but that was my conclusion with researching. So once I decided it was probably apraxia, it was logical to go for the best treatment approach for apraxia, which is PROMPT. I read many stories online (and my SLP has quite a few of her own) where the dc had traditional therapy for 6 months to a year and made NO progress. That's at 2-3 times a week and $100 a pop! So I drive 2 1/2 hours to another city where I can get PROMPT with a fully-certified therapist. I found closer therapists who CLAIMED to do prompt and had never even done the workshops. PROMPT is not just prompting, and apparently this kind of claim is common. You have to contact PROMPT to get a list from them. There are several levels of training and then a certification process after that. The person I am going to has had all the training, helps in workshops, and is certified. To me, it shows. She says that it shocks her to realize how LITTLE she understood it at the beginning, after she had had only one workshop and THOUGHT she knew what she was doing.

 

So all that was to say that IF you think it's apraxia, don't screw around. Get the best person you can. I had a regular speech therapist tell me she couldn't diagnose apraxia till later, that we'd just do a trial of therapy and focus on "communication" and see what happened. Well I didn't need him to communicate; I needed him to TALK! With PROMPT he started talking the very FIRST DAY. I kid you not. It was unbelievable. And the apraxia is totally obvious when the therapist knows what they're doing, because they get the kid TRYING to talk and can see him TRYING to do it. It's little things like the way their jaws drop and get locked down. The motor control problems are obvious to someone with a lot of experience.

 

Well I could go on here. It's a really hot topic to me, because I got so annoyed with that (very nice) SLP who CLAIMED to do PROMPT and had never even done a workshop. The GALL of someone to claim something about something SO important!! To me it's on the level of someone claiming to be a surgeon and never having gone to medical school. This is my ds's speech we're talking about! By starting early and with his good progress, our SLP says he might be done in 1 1/2 years. There are kids at his same moderate level of apraxia who do a year of traditional therapy and make NO progress. Think about that. I just think it's horrendous. And how un-fun it was for him to be the little mute man on the playground, with kids staring at him, wondering why he squealed so funny instead of talking, etc.

 

Well that's enough from me. Happy researching. :)

[wapiti]

Thank you, thank you, thank you Elizabeth for taking your time to write all that out - that's so kind of you. It's been years since I've had to deal with this, but even back then, when my three older late talkers were little, the information out there was so confusing I'd always end up putting my head back in the sand and continuing with our traditional speech therapy. Back when my oldest was two, the things I read about apraxia were controversial and sometimes contradictory.

 

Well I didn't need him to communicate; I needed him to TALK!

This was all of my kids. Two of them later went through OT for SPD, and at least one of them has ocular motor issues, and her original speech therapist from EI when she was a toddler spoke about oral motor issues, so I don't think it's out of left field to think about apraxia, though these days I'm entirely ignorant. Looks like I have a lot of reading to do.

 

With PROMPT he started talking the very FIRST DAY. I kid you not. It was unbelievable. And the apraxia is totally obvious when the therapist knows what they're doing, because they get the kid TRYING to talk and can see him TRYING to do it. It's little things like the way their jaws drop and get locked down. The motor control problems are obvious to someone with a lot of experience.

 

Well I could go on here. It's a really hot topic to me, because I got so annoyed with that (very nice) SLP who CLAIMED to do PROMPT and had never even done a workshop. The GALL of someone to claim something about something SO important!! To me it's on the level of someone claiming to be a surgeon and never having gone to medical school. This is my ds's speech we're talking about! By starting early and with his good progress, our SLP says he might be done in 1 1/2 years. There are kids at his same moderate level of apraxia who do a year of traditional therapy and make NO progress. Think about that. I just think it's horrendous. And how un-fun it was for him to be the little mute man on the playground, with kids staring at him, wondering why he squealed so funny instead of talking, etc.

 

Well that's enough from me. Happy researching. :)

 

This is amazing. And thanks for the tip about therapists (reminds me of how I view OTs, some know more about SPD than others, some claim to, etc.). I've always believed that speech therapy was necessary for my late talkers, and still do, and yet I've never been able to pinpoint moments where it was clearly helping. One of them at 7 is still getting therapy, at school, for articulation. But it's my youngest who I have in mind - I also have two kids in between my baby and the late talkers, who started talking in the nick of time, just before 18 months - my baby is doing the same thing all five of her siblings did, no babbling, occasionally says something that sounds exactly like a real word here or there (and suprising ones, correct in context, that make you turn and say huh? did she really say that? I keep thinking it was her 2 1/2 yr old brother, but then he's on the other side of the room) but they never get repeated. Her older sister used to do that - as a toddler she could only talk sort of subconsciously, to herself, when no one was listening, but could not do it on command. When my baby gets really mad, sometimes there's gibberish, akin to swearing in a foreign language :lol:. But no mama/dada. None of them did. Like her only other sister, she's on the later side with walking - not really walking yet at 15 mo (her older sister is hypotonic and learned to walk with orthotics; this dd doesn't appear to have the low tone though. just tiny feet and a huge body :), and yet, there's something weird about her gross motor control that I can't quite put my finger on, even after my experiences with my other kids).

 

Anyway, thanks again for pointing me in this direction. I'm so hoping her speech takes off soon (my yardstick is still 5 words by 18 months; she has zero with about 10 weeks to go). And I've been procrastinating on even paying attention to the situation. (What will DH say when I tell him about yet another new kind therapy :glare::lol:) Off to research :auto:

[PeterPan]

It definitely sounds like you have something to be concerned about. And what you might do is go ahead and find the PROMPT therapist you want, schedule the evaluation, and when you finally get to that appointment date you can either cancel or keep. Better than waiting two months and then waiting more months to get in.

 

Yes, when it rains it pours. None of us are so low tone we can't walk or anything. It just shows up as lots of fatigue when writing or exercising, how we sit (overflexing joints), etc. I've been reading about mitochondrial disorders and carnitine issues, which is where I think we might be headed next. At this point I think we're just going to try some carnitine and see what happens.

 

The OT had a nifty trick for hand pain with writing. She had dd write, and when her hand started hurting she had her stop and hold a mini-massager for a while. The vibration was a new sensory input and it stopped the pain, allowing her to go on to write more. Cool trick!

 

Our progress with PROMPT isn't vague at all. It has been so dramatic, I've been keeping a written log. There is progress every single week, and that is with *1* appointment! Traditional speech therapy you do multiple treatments a week and still might not make progress. Totally amazing. And yes, that thing of perfect words out of the blue but never again and not even believable they're so clear, that's what dd would do. But you'd NEVER hear it again. And anything he said a couple times got lost within a week. With PROMPT we don't lose it either, because you can give the sensory input to help it come!

[wapiti]

It definitely sounds like you have something to be concerned about. And what you might do is go ahead and find the PROMPT therapist you want, schedule the evaluation, and when you finally get to that appointment date you can either cancel or keep. Better than waiting two months and then waiting more months to get in.

 

Yes, when it rains it pours. None of us are so low tone we can't walk or anything. It just shows up as lots of fatigue when writing or exercising, how we sit (overflexing joints), etc. I've been reading about mitochondrial disorders and carnitine issues, which is where I think we might be headed next. At this point I think we're just going to try some carnitine and see what happens.

 

The OT had a nifty trick for hand pain with writing. She had dd write, and when her hand started hurting she had her stop and hold a mini-massager for a while. The vibration was a new sensory input and it stopped the pain, allowing her to go on to write more. Cool trick!

 

Our progress with PROMPT isn't vague at all. It has been so dramatic, I've been keeping a written log. There is progress every single week, and that is with *1* appointment! Traditional speech therapy you do multiple treatments a week and still might not make progress. Totally amazing. And yes, that thing of perfect words out of the blue but never again and not even believable they're so clear, that's what dd would do. But you'd NEVER hear it again. And anything he said a couple times got lost within a week. With PROMPT we don't lose it either, because you can give the sensory input to help it come!

 

Seriously this is fascinating. I'm kicking myself for not hearing about this eight years ago when dd9 started speech therapy. This approach sounds so obvious in hindsight. I wonder if there are any other applications to this form of therapy. I wonder how one could use sensory input to affect language processing (e.g., dd9 has issues with reading comprehension and making inferences and sees a language therapist; surely I can come up with something for ds7, mr. sensory issue dude, the one still getting therapy for artic).

 

Now I'm going to have to get a mini-massager for my poor handwriters - and then probably extra ones for the littles to play with.

 

I just remembered that when my boys were getting EI speech, the therapist recommended these vibrating mouth toys, though they weren't part of the therapy itself. I think we still have them - I better not let ds2, my battery hound, find them... :)

 

(for lurkers, here is what I am looking at https://promptinstitute.com/index.php?page=clinic-information )

[PeterPan]

I got a couple of the vibrating mouth toys (an alligator and a hippo) for my ds2, and my dd11 likes them. So I guess they're good for sensory kids of all ages.

 

The mini-massager is a patch. I'm sure all kids have different reasons, but the OT has nailed why my dd's hand hurts when she writes. Her low tone in her trunk means she leans over more than she should and weight shifts. She holds her left hand in funny and doesn't rest her weight on it to stabilize her paper, so ALL the weight of her weak trunk goes onto the wrist with which she is writing. That's why it gets tired! So the OT is doing exercises for her strength and tone (trunk, shoulders, etc.) and also Callirobics to work on the fluidity. So it's not just one issue. The massager is a patch to help us get by till we can get the real issues fixed.

 

We only know what we know and we're all doing the best we can. The internet wasn't so prominent 10 years ago, some therapies weren't around, and it certainly wasn't so easy to find out as now. As far as what they can do now, I don't know. It's certainly worth talking with a PROMPT person and just asking. The one I go to specializes in apraxia, feeding disorders, autism, etc. So it's not like these kids have just one problem. When you talk with someone in that loop, who knows what you'll find out. They might be able to connect you to the next person you need.