Speech Problems

[mom31257]

I am concerned about a friend's child and don't know what's normal with speech development. She will be 4 in 2 months. Her speech is definitely not like any other child I know that age. She seems to know what she is saying, but her speech is more like half words and grunts. There is definitely not a lot of consonant pronunciations going on. Is this normal? She is the 3rd child of 4.

[twinmami01]

No, not at all. Both my boys have severe speech apraxia. They were almost three when I realized something was wrong. I would refer your friend to a local Scottish rite clinic for either a free or low cost speech eval.

[mom31257]

No, not at all. Both my boys have severe speech apraxia. They were almost three when I realized something was wrong. I would refer your friend to a local Scottish rite clinic for either a free or low cost speech eval.

 

I am somewhat close to this friend, but I'm not sure how to go about it. I don't want to offend her, but I'm concerned. They may already be doing something, but I don't see improvement if they are. Even their oldest son who is friend's with my son talks about it to my son.

[twinmami01]

 

 

I am somewhat close to this friend, but I'm not sure how to go about it. I don't want to offend her, but I'm concerned. They may already be doing something, but I don't see improvement if they are. Even their oldest son who is friend's with my son talks about it to my son.

 

 

Sometimes, progress is difficult. My boys are 11 and it's been a long journey. In their case, it's not a speech delay. If it's that obvious with your friend's daughter, I'm sure someone has asked about it before. I wouldn't find it offensive, at least not me personally. Just let her know up front you don't mean to be offensive. Hopefully she would understand your coming from a good place.

[wapiti]

They may already be doing something, but I don't see improvement if they are.

 

FWIW, whether or not you see improvement is not indicative of whether there is therapy going on or whether there has been improvement that you may not be in a position to detect. It can be a very, very slow road. Also, the school district will do a free evaluation - she would need to call the special ed department.

[Crimson Wife]

With apraxia, apparently the way most SLP's are trained to provide speech therapy is not very effective. OhElizabeth and at least one of the other ladies on this forum rave about the PROMPT Method.

[mom31257]

FWIW, whether or not you see improvement is not indicative of whether there is therapy going on or whether there has been improvement that you may not be in a position to detect. It can be a very, very slow road. Also, the school district will do a free evaluation - she would need to call the special ed department.

 

 

I don't know that they would be doing anything yet because they avoid going to a pediatrician and are very much into all natural medicines and therapies. I am not saying they would be opposed to speech therapy, but I think they would be inclined to think it is just a difference in growth and will take care of itself.

 

I don't think she would want the school district involved. I think they would go a private route first.

[PeterPan]

Amy, if they aren't using a ped, that's why it's not coming up. My ds has moderate verbal apraxia. There are, as twinmami said, levels, and it's *motor control* not a developmental delay. It's actually why it's SO imperative that your friend grapple with this and not sweep it under the rug. There's this tendency when something happens to want to say it's all normal, a timetable issue, our kids will outgrow it, blah blah. Motor control is NOT a developmental delay. You can have both, yes. However when you have a huge gap between expressive and receptive, that's your big red flag, ding ding ding, that it's NOT a developmental delay.

 

No don't bother with the school system, yes go private. Look for PROMPT. The therapist will talk with her on the phone, so all she has to do is CALL or email and TALK with them. The therapist can tell her the age norms and talk through what's going on. They'll be able to sort out what is motor control and what's something else. By the time the dc gets in, she'll be 4, meaning the SLP will have not only the motor control tests (VMPAC, etc.) but also preschool skills assessments. So the answer to what's going on will be very obvious by the time they're done.

 

Sometimes people delay speech therapy and speech evals because of old information. PROMPT has only been around 10 years, so when you hear people saying their 3 or 4 yo is just getting treated, that's not how it is any more. They should be getting in by age *2* or even younger. It's readily identifiable even then with the newer techniques. She's waiting WAY too long unnecessarily, and she's in the golden window for treatment. That's not a technical term. Right now her dc is learning *incorrect* motor control, meaning the longer she waits the more there is to UN-learn and relearn correctly. The sooner she gets a good eval the better.

 

Don't go calling around nice local SLPs and asking them if they do PROMPT. There's "prompting" and then there's PROMPT. You want PROMPT if you think there's motor control involved. Btw, there is evidence of an apraxia gene. There have been some studies in England of families with whole chains of apraxia showing up and a genetic link. So there are different ways to get there. Someone might look at that family history and blow off evals, saying their dh was a late talker and did fine. Well the problem there is that kids VARY and degrees VARY. Just because your spouse or whatever didn't get treatment and is fine doesn't mean the dc is going to. Also there are treatments now that weren't around then. Good treatment can RADICALLY affect the dc's comfort with speech later and their ability to get out their thoughts. That was what finally pushed me, when I talked with a mom here on the board whose twin got ST but she didn't. Speech as an adult was MUCH easier for the twin who had gotten the therapy. Great therapies are out there now, and PROMPT is perfect for the involved mom who WANTS to be part of the process and participate.

 

Also suggest she watch the Deborah Hayden video on PROMPT. It's on youtube.

[MistyMountain]

That is definitely not normal at 4. At 4 the majority of what they say should be understandable.

[claluck]

I would mention it to her. As a good friend even if she takes offense it would be only for a couple days honestly. And you would be a better friend by asking. My husband is a speech pathologist and he see's kids all the time whose parents have put it off forever. We still see one little girl every week in church who still sounds like a toddler and she is 8. My husband wants to smack his forehead every time he hears her speak. And he has mentioned it to her parents but they keep saying she will grow out of it. Which is a huge disservice because like PP stated the longer they keep doing it the firmer those habits are ingrained. And long term kids have to face many difficulties. Most people judge whether they mean to or not a person with poor speech as being unintelligent. They could be the smarted person ever but they will be instantly labeled in someones mind. Whether for job interviews or anything else of importance.

 

Maybe the next time you are around just say something like "Hey I have been wondering for a while and didn't want to offend you, but as your friend and someone who cares about you and your family, have you ever thought about getting your daughter evaluated for speech services, I cannot understand much of what she says and I think by 4 I should be able to. I have heard the earlier you get help the easier it is to help kids and it makes learning to read and do good in school alot easier" (kids with speech troubles often have problems with reading, I think because when they sound out words or phonics rules it doesnt sound like it should (I dont know for sure).

 

I think emphasizing you are doing it out of concern and love as a friend and not judgmentally even if she is momentarily offended or thinks its none of your business she will get over it. And you might open her up to ask about what she has wondered about but never done anything for. Speech therapy is so different from drs and such, the things you work on are practice and motor and behavioral changes. There is no talk of medications and such.

 

Christina

[kerenlynne]

It's a toughie. I think if you are hesitating asking, you probably have a good feel for how it will be received. That being said, you probably won't be happy with yourself until you bring it up. Just be bold and ask if she has ever noticed the speech issues. Be kind, bring it up, let her digest it, make a decision, and then stay out of it unless she asks for more help or information. Maybe she doesn't even notice it. My mom told the story of how she couldn't believe it when the doctor told her my brother needed speech therapy. She had his older siblings who just translated for her and she was tired and busy and just didn't notice that she couldn't understand him. The other thing is that even if the kids are in the system, they often don't get flagged. We did well child check-ups, pre-school, etc. I always knew DS was hard to understand but no one seemed to be bothered about it but me. He made progress, but in 1st grade he ended up with speech therapy and a host of other help because he had an LD. The speech was a leading indicator of the other problems and I wish someone would have told me there were places I could have him checked out when he was younger.

[boscopup]

I agree that she needs to be evaluated. Also, even if she sees a ped, sometimes they blow speech off until school age. Grrr. I would have gotten my middle son into speech therapy much earlier if the ped hadn't said, "Oh, don't worry. If he's still not speaking well by age 5, you can get him evaluated." I finally decided on my own to get him evaluated with the public school. He qualified for services quite easily. I later changed doctors, and the new doctor was glad I had gotten the evaluation. She's a family doctor. I had actually had TWO pediatricians tell me to wait until age 5. :rolleyes:

 

Speech therapy has made a huge difference in my son's life. He is much happier because we can understand him now!

[MistyMountain]

My son's therapist says that the preschoolers she works with make much better progress than the elementary age kids she works with and she enjoys working with them because she can see the progress. It is harder to fix the problem when they get older. 4 is a good age to get them in.

[Tracy]

Here is a chart showing what sounds a child should be able to make and at what ages. From my experience with speech therapy with my ds, I know that they generally look for about 80% intelligibility. My ds could say all the sounds in isolation, but he was almost completely unintelligible, and this is what qualified him for therapy. I was very suspicious of the whole speech therapy system, after some experience, I think there are a lot of good reasons to be concerned about getting speech therapy. In our case, we started with a therapist who was fairly incompetent. She had worked in the school system and was trying to apply techniques she had used there to therapy with a 2yo. We were very wise to ditch her quickly and very fortunate that we ended up with a superb therapist next. You need to do your research and know what you are doing when you get into it. And at 4yo, they would likely end up with the school district, at least for the evaluation, unless they have insurance (or cash) that will pay for a private evaluation.

[tld]

I was just talking with a speech therapist today about my 3 1/2 year old and she mentioned that she has dealt with some 5 year olds who only use vowels. That's a bad deal, but it can be worked through. As it is, my 3 1/2 year old is labeled as having a "severe" speech issue. He does use consonants, but not blends and about 50% of the time leaves off the beginning or ending consonant of a word. I'm sure your friend's daughter would then be labeled at the next level as having a "profound" speech issue.

 

The speech therapist was saying that 3 1/2 is the perfect age to get children help for there speech issues because progress can be made so much more quickly than if you wait until kindergarten to try to address the problems. Plus, early intervention helps eliminate social and emotional delays that can result as the child gets discouraged from not being understood. Where we live there is something called Prairieview Services. They go around to all the public schools and provide free speech therapy and other special ed. helps. If the schools in your area offer preschool screening, that's a good place for her to get referred to these kinds of services. Also she needs to get her hearing tested too in order to make sure that's not the problem.

[happypamama]

I asked our speech therapist about a 4yo, because she was doing so well working with DS1 that I wanted to see if DS2, who had just turned 4, should start seeing her as well. She said by 4, a child should be 75% intelligible to a non-family member. (In DS2's case, it's a phonological issue, not a physical one like it is with DS1 -- DS2 makes all the correct sounds but needs some help to make his brain put them in the right place. But DS1 wasn't saying some sounds correctly and needed help to train his tongue to make them. They did check DS1's hearing first to make sure it was okay, and that's a good plan.)

 

We went through our health insurance/family doctor and tried the facility they recommended. We happen to adore the speech therapist there and are really happy with her, but our other choice would have been the public school. I've heard that Easter Seals may help as well. I know our therapist does do school screenings, so it's possible the child's school might have someone to come in and do screenings.

[happypamama]

Also, our therapist said that earlier is better than later for getting kids into therapy. I didn't start DS1 until he was 7, because I wasn't sure what he'd outgrow and what he wouldn't, and he's pretty quiet anyway, but he's done amazingly well in a year. People could understand him just fine, but it just became apparent that he wasn't outgrowing some childish mispronunciations. Otoh, DS2 was harder to understand, and he's made a lot of progress very quickly (but is highly motivated because he loves having homework to do, LOL), so I can see why earlier is better.

[Tracy]

One of the reasons that it is better to get therapy earlier rather than later is that as the child ages, he continues to practice saying those words wrong. The longer they say the words wrong, the longer it takes for them to learn to say them correctly. My therapist warned us that our ds would make the most improvement on the most recently learned words, and the oldest, most basic words would take a lot more time to work out. She was absolutely right.

[prairiewindmomma]

Everyone above has written about how it's not normal, how important early intervention is, etc. I completely agree with them.

 

I'll address the my-friend-isn't-going-to-like-hearing-this issue. We've bumped into this a few times IRL. For those who are looking to solve the issue, they will be so happy to chat about things with you. For those who are clueless that there's an issue, or even worse, aware that there is an issue and trying to repress the little voice in their heads telling them something is off....they may not be so happy that you bring it up. They may become angry, or push you away, or tell you that they know all kinds of kids who had similar issues and their parents did nothing and it all worked out. Tell her anyway. It plants the seed that help is out there and that you can help her get the help that her kid needs. Eventually she will open her eyes and look around and realize that something really is off and be ready to do something....but sometimes parents take a long time to become ready to do something. (They also typically have a harder grief/adjustment period, at least in my experience here with friends and family.)

[Hwin]

It's very possible that she's brought it up to others and they wanted to be nice and suggested he would grow out of it. That happened quite a bit to me! If you can't bring yourself to suggest the child be evaluated, then a subtle way to talk about it would be to notice when you CAN understand the child. I remember when a children's church ministry perkily said to me that my 3yo had a "first" when he sat for circle time for a whole minute that day. I was like, wait, he never normally sits for circle time? :/