ST Question

[MicheleB]

My ds (7) has been in ST since he was four. We see improvements and while we can usually figure out at least the gist of what he's saying, sometimes I have to ask several times. I typically try to use the context of what he's talking about or pointing to, etc., to really understand what he's saying (IOW, I can't just understand him based on his speech alone).

 

We were out today on a field trip and I was noticing that most of the other kids and their parents could not understand him very well. I knew what he was saying for the most part, but it just made me realize others outside our immediate family are not understanding him.

 

He is currently working on /th/, /f/, /s/ in ST. (He's also the one with the suspected APD.)

 

I'm guessing you all might say his speech difficulties are probably a part of the possible APD? Part of his issue is he talks very fast as well.

 

He goes for speech once a week for 45 minutes. I work with him at home. Of course he gets irritated after a while. It's really hard work for him.

 

If you have any other suggestions for me, or for what I should be looking to the therapist for, I'd like to know. I am going to pursue the APD, esp. if you think the poor speech is related to that.

[Claire]

If he has APD, that could indeed be contributing to his poor speech. However, after being in speech therapy for 3 years I would expect him to be better than what you describe. Has he been with the same speech therapist all of that time? He may need different techniques.

 

My dd was evaluated at 1st percentile for her age at 5yo. At that time my dh and I could understand her pretty easily because we had become accustomed to her unique articulations. We "translated" for other people. After two years of speech therapy everyone could understand her, although she needed more years of ST to correct a few remaining problems. However, she did not have APD.

 

Since you mention you and your dh still have difficulty understanding your son at 7yo, I am wondering if articulation is his only problem? You mentioned talking fast. What about his grammar and vocabulary?

[MicheleB]

His grammar isn't the best. In fact, now that you mention it, he still uses some pronouns improperly. Such as: Her went to the store. I guess we've gotten so used to it we don't notice it. I was trying to pay particular attention to his speech last night to hear it from "other's" perspective. He is probably not finishing some words completely and perhaps even not articulating middle of words clearly. I will pay close attention today to see what I can hear. If you have ideas for what to listen for specifically I'd be glad to hear them.

 

Both of my boys have what I guess is called syntax problems. Not horrendous but probably not typical for children their ages.

[MicheleB]

Quick note here: Ds just came in and said "actually" (which he uses a lot) and he says it: "Ack-oo-ly". If that helps any. I asked him if he could pronounce it the way I said it and he got out: "Act-oo-ly".

[Claire]

The "act-oo-ly" seems as if he isn't hearing properly along with not being able to articular certain sounds. The grammatical mistakes indicate an expressive language problem. How often has he been re-evaluated? Have you gotten any written reports for his evaluations? Has he been with the same speech therapist all three years?

 

If you can afford it, I think he would be a good candidate for FastForWord in terms of improving his ability to process the sounds of speech accurately and with speed.

 

You should probably make an appointment with the speech therapist to discuss the problems you are observing. You want to find out if she is noticing the same problems and find out what she is doing to address them.

 

You might also want to consider some oral-motor training for him. This type of therapy works on developing the underlying infrastructure of speech -- fine muscle strength and coordination of the lips, mouth and tongue. Developing the infrastructure first can make teaching the production of sounds easier. I used to have the book from this website and it is laid out in a way that a parent could do it if motivated. The book explains each exercise very carefully, including what it works on, and the exercise includes benchmarks so you know when to move to the next level of difficulty. Just be aware that, once you have the book and have decided which exercises you want to work on, you will need to purchase straws and horns from the company (an additional expense). Many of the exercises involve drinking through straws or blowing on horns, and these come in graduated sets.

 

Most speech therapists do not incorporate oral-motor training into their practice, but some will do it if you provide the book and equipment. You might want to ask your speech therapist about it.

 

You might also want to consider doing Straight Talk at home with your son. You could do that independently of the speech therapy he is getting now. The first volume works primarily on articulation. The second works more on expressive language. You would probably want to do both.

 

In your situation, I would not be satisfied with the progress your son has made in three years and would look for ways to speed up the process. The older a child gets, the longer it takes to remediate a speech problem and the less likely it is that full remediation will be achieved.

[MicheleB]

He has had two therapists. When he first started, he qualified for our IU program and the therapist came to our home for one hour each week. She provided me with evaluations periodically. She also went over with me what she was working on, how he was doing, etc.

 

We then moved and have had a new therapist for about six months now (?). He was out of therapy for several months because there was a long waiting list. She initially evaluated him but as far as I know, I have nothing written. I sit in on the sessions each time because ds wants me to and also because I want to know what he's working on and how she teaches him so I can help him better at home.

 

It is interesting to me because my ds *barely* qualified for the IU program. I was told he was just at the cut-off for the 75% to receive services.

 

I read about other children who obviously have severe speech delays and I see how my ds isn't that severe. Yet, I am very concerned that at age 7 (he'll be 8 in June) it is still difficult for others to understand him.

 

How often should his current therapist do an evaluation? I like her; ds likes her; she *seems* to get him to work very hard on articulation issues (but I have to say, they've been working /th/ for a long time now). Perhaps I need to spend a lot more time at home with him. He just gets so frustrated because it is hard for him and also, he's at the age where he realizes not everyone goes to ST.

[Claire]

Since you like the therapist, I would ask her about adding oral-motor therapy. The fact that he's been working on /th/ for a long time without getting it would be a good indication, I think, that oral-motor therapy could be helpful. Express to her your frustration (and his) at the slow progress and ask her if there are ways to speed it up.

 

I'm not sure what 75th means in terms of a cut-off. At the time my dd was tested, the district's cut-off for articulation services was 3rd percentile! I remember this clearly because the ST told me there was good news and bad news. The good news was that my dd qualified for therapy because she scored in the 1st percentile. The bad news was that my dd scored in the 1st percentile!

 

It does sound as if your son's problems are more complex than my dd's. My dd did not have APD and also had no problems with grammar. Her sole problem was with speech articulation.

[MicheleB]

Thanks Claire. About the %, I was told if ds scored in the 75% or less, he would qualify for services. He just barely made the cut-off. We of course were surprised because at that time, no one could understand him without a lot of effort.

 

When ds really slows down, thinks hard about his tongue position and is prompted, he can say /th/ but it is still a lot of effort. In "normal" conversation he typically does not remember (though he's a bit better at it).

 

I was just listening to him playing with his brother and I noticed he said, "'Tend we're doing...." Instead of "pretend." I guess he's probably at the age where he shouldn't be saying that anymore???

[Claire]

I was just listening to him playing with his brother and I noticed he said, "'Tend we're doing...." Instead of "pretend." I guess he's probably at the age where he shouldn't be saying that anymore???

 

That incident by itself isn't of concern; rather, it's the cluster of problems you are seeing -- especially since you and your dh have difficulty understanding him.