Does this speech issue need fixing?

[Jenn in CA]

I'm so guilty of being overly worried about things with my adoptive children, things that my birth children did not do.

 

My 7yo, who also seems to have auditory issues and definitely is struggling with reading, has always had speech struggles too. You could call it "sloppy speech". She was evaluated by a Kaiser speech therapist at age 5, who said she was fine, and won't see her again now that she's school age.

 

She says things like "bofe" for "both", "bafroom" for "bathroom". "fought" for "thought." She often can't keep the "shr" sound and "str" sound straight, so she says "strimp" for "shrimp" and "stred" for shred." Another one that seems "sloppy" is "poe-mobil" for "playmobil".

 

I can see why these sounds are hard to keep straight. But the other day she said "thinger" for "finger", and didn't bat an eye. She can make the correct sounds, she just seems sloppy when she talks.

 

She has no trouble connecting the correct sound with the letter.  I was wondering if flash cards or some visual practice would help her keep those sounds straight.

 

Or is it better to not make a big deal out of it, and assume she'll grow out of it?

The fact that she's got auditory issues (auditory memory, poor phonemic awareness but it's improved with Barton and practice) makes me wonder if I should be actively helping her pronounce these words correctly.

 

 

 

 

 

[PeterPan]

Any other symptoms?  Low tone, fatigue with chewing (or conversely, eating like a bird and constantly hungry), cherub cheeks, difficulty doing age-appropriate oral motor tasks, difficulty blowing...  

 

It would be helpful to you if you inventoried her speech more precisely.  Go through ALL the Barton phonograms (vowels, multi-letter phonograms, etc.), one by one.  You didn't mention ch/j, so I'd be interested in knowing where those are.  Right now your difficulties you list are th, sh, l, r, and then blends using those.  Those *are* the later sounds to come in.  How is she with discriminating vowels?  Can she clap multi-syllable words?

 

I'm not sure about the standards for 7.  At 6, in general they'll still consider those sounds formative and not give therapy in the public school.  For private, it's what you're willing to pay for.  I don't know what Kaiser is (hospital? insurance?) but it doesn't sound like they were LISTENING.  An SLP can run more thorough language testing, like the CELF, an APD screening, and other things that might give a fuller picture.  My ds has verbal apraxia, which means his motor planning isn't there naturally to support the acquisition of these sounds.  Therefore the ps put ST into his IEP, even though in general they might not have given therapy yet for those sounds.  But at *7* I think you might have crossed that line, even for the ps.

 

The real curiosity is to know why she's having the trouble, whether she's not hearing them, not motor planning them, not yet ready to say them, or what.  Have you had her hearing checked?  In our area the state univ. can do a full hearing eval *and* run an APD screening tool for $35.  Always reasonable when you can get it for that price.  (It would have been $380 private in our area, ouch.)  

 

I don't buy the lazy speech thing, so to me I'd intervene.  I know sometimes this stuff feels like a train wreck in slow motion, where you're begging people to stop the train, change tracks, don't let it keep going.  The trick is to figure out what's going on so you can choose the right WAY to intervene.

 

When you started with Barton, did you do LIPS?  And when you did LIPS, did you use the face pictures?  Where is she in Barton?  Do you still use the faces?  When you used the faces, how complex of words did you build?  Barton seems to expect people just to build 3-4 level simple words (cvc, ccvc) and then transfer over to just using the colored tiles and then barton tiles.  In our case, because ds has serious speech issues, we used the LIPS faces to build MUCH more complex words.  Like 5 letter words, multi-syllable words.  That would probably be my first move, that and a speech inventory.  That way you can figure out whether she can say the words when she HEARS the sounds.  For my ds, he was absolutely leaving out sounds because he wasn't hearing and noticing them.  You have to do enough work with the face tiles and slowing that process down that he begins to hear the sounds in the words (meta-linguistics).  So if you want her to be able to say shrimp, build that with the face tiles together.  Can she tap all the sounds?  Can she pull down the faces?  Can she trade the faces for colored tiles?  Can she trade the colored tiles for letters?  

 

I'd like to say there have been swankier things to help my ds hear sounds and have the skill carry over to his speech, but there haven't been, at least not for my ds.  For him, LIPS was where it was at.  We skipped th/TH because he doesn't have his two front teeth to pronounce it properly, and we skipped f/v because they are exceptionally problematic for kids with apraxia.  If you build words with the LIPS and do the trades (to colored tiles to letters) and then put those words into quizlet, she's going to get to practice saying those words with the support of the visual.  Where is she at in Barton?  Can she read those words yet?  I put my ds' words into Quizlet to let him drill to fluency.  For him, absolutely the difficulty of the motor planning is part of the process and reading the words aloud gives him practice in a good way.  

 

There are picture card sets you can buy, yes.  Super Duper Inc sells them or you can google the sounds you need and find discrimination pairs, minimal difference pairs, whatever online.  

 

Your sig says physics prof.  Does the local uni have a speech department you could take her to for a fresh eval?

[PeterPan]

http://www.speechandlanguagekids.com/what-speech-and-language-skills-should-my-7-year-old-have/

 

That's a link on what's expected at 7.  

[Crimson Wife]

Kaiser will give speech therapy to school aged kids so I would push the pediatrician for a referral if she doesn't have age-appropriate articulation.

 

Not to sound like a broken record, but has she had a full audiology exam recently?

[gingersmom]

Please take her for another evaluation.

 

Kids don't outgrow speech issues, they become adults that no one can understand.

[mellifera33]

My 7 y/o still fronts the /th/ sounds, especially in medial and final positions. LiPS has been very helpful for him--he still can't discriminate between th and f aurally, but he can use visual cues to see the difference.

[RootAnn]

This blog has a lot of helpful things for do-it-yourself, but please do get an audiological eval & possibly another speech eval. You can do your own speech eval with the Mommy Speech Therapy blog.

 

One thing is to see if your child can tell the difference between sounds when she hears them. Some kids can't - which makes it difficult for them to be able to say them correctly!

[PeterPan]

Just to diatribe, that link (which is probably otherwise fine) has incorrect info on apraxia and shows a picture of a child who clearly does NOT have apraxia.  That's all. Rant over.

[PeterPan]

Jenn, just backing up here a minute, when you say she has auditory issues, what's going on?  You've had her in for a full eval?  Like at a place that can do an APD screening in a booth?  She has hearing loss?  Issues with background noise?  

 

My ds failed half the APD screening tool from the SLP, but it was stuff you'd expect a dyslexic to miss.  When I took him to the univ, they weren't really seeing any concerns for APD for him.  Dd is *so close* to failing the screening and just barely passes.  They said at that point they call it a relative weakness and tell her to compensate.  Ironically, her Left Ear Advantage is indicative of bilateral brain issues, something we did OT for.  Turns out she has a *slight amount* of at least one primitive/neonatal reflex still retained (ATNR).  (Retained reflexes are strongly correlated to ADHD, SLDs, ASD, etc.)

 

So when people are saying get other evals, it's not that they're blowing off your concerns so much as you can have these situations where symptoms are coming out as auditory, coming out as this or that, you really REALLY DO have a freaky list growing with your Mom Radar going off over and over, and the common root is something you're not expecting (or a combo you're not expecting).  

 

This child has a real advantage, with you having raised more neurotypical children.  You're SEEING it in a way that people who only have raised less neurologically typical kids don't catch so easily.  You're catching things earlier.  I would totally listen to your gut and keep asking questions.  The trick is, because these practitioners are all so pigeonholed, you have to KEEP asking questions to find all the facets and get to the root.  So it can seem crazy for a while, because you're needing so many evals to piece things together. Things don't just go away, so you're wise to pursue the stuff you're seeing.

[imagine.more]

 She often can't keep the "shr" sound and "str" sound straight, so she says "strimp" for "shrimp" and "stred" for shred." 

 

I can see why these sounds are hard to keep straight. But the other day she said "thinger" for "finger", and didn't bat an eye. She can make the correct sounds, she just seems sloppy when she talks.

 

 

 

These are the types of mistakes my adoptive daughter makes too, but she has moderate-profound hearing loss in both ears. So yes I'd definitely get a full hearing evaluation (DD wasn't diagnosed until age 7.5, apparently she lost hearing sometime between age 1 and 5).

 

DD can make the correct sounds too, but it takes mental effort and frankly she doesn't see the difference enough to be motivated to fix it. We've had to get kinda blunt and when she blows us off for correcting her say, "look, 3 year olds say that....not 13 year olds, if you want to talk like a 13 year old and have everyone understand you I suggest you slow down and say it correctly." Of course if she *couldn't* we wouldn't be that blunt, but when it's a lack of motivation because to her it sounds pretty much the same and always will due to hearing loss we felt we needed to lay it out for her the consequences of continuing with lazy speech patterns. I tell her all the time that people will never judge her for saying a word slowly, they can see she has hearing aids, but they will be confused or judge her poorly if she goes too fast and outright says the wrong word because she messed up the sounds. Especially because once or twice she's said an inappropriate word accidentally by switching a sound, lol!

 

I'd say at 7 she's just crossed that line of "she'll grow out of it". My 4 year old sometimes makes these types of mistakes but we correct like crazy because we're so hypersensitive to speech issues now that we've experienced what happens down the road with DD. I bet because of her age she might qualify for speech therapy. And if she doesn't qualify through the school go elsewhere because the school's standards are really low! They were even going to drop my DD with a known HUGE language delay and hearing impairment from speech therapy in the public school. They said she'd made progress and no longer needed it. 

[Jenn in CA]

Thanks to everyone. So you're saying she'll grow out of it.

 

Just kidding!! She is on the waiting list at Scottish Rites for eval, it may take up to a year... I haven't thought about the APD eval in a while. Her auditory issues are weak auditory memory and comprehension. It's improved a lot, but mainly because of me accommodating, come to think of it.

 

The one factor that makes me think she may grow out of it, is that English is her 3rd language. Her birth language was Swahili, until age 2.5. Then for about 4 months she spoke French while in the orphanage. Then she joined us. By this point, she didn't use any more Swahili, and she had quite good French for a preschooler; she only had one word she regularly mispronounced, otherwise she had perfect articulation.

 

The thing with Swahili is that there are no blends, and blends are what she struggles most with. So I do wonder if her brain has been hard-wired for the Swahili phonetic system and it will just take longer for her.

 

Articulation-wise, she picked up the English R in just a couple weeks (after having a perfect French R... which she no longer has). She can produce all the other sounds. If you met her you would not think she has an accent. 

 

W/Barton, she can't always distinguish between short E and short U.

 

I started LiPS with her a couple weeks ago. I think it will help a lot, and I'm glad to hear that confirmed by some of you.

 

I have more thoughts and want to answer your questions... I will do so later.