When and if to start speech therapy?

[Gwenny]

I have a 2.5 yr old son (3 in May) who speaks very little. He probably has about 50 words and only puts together a few 2 word sentences. What he does say is not clear. I was planning on waiting to pursue speech therapy but he seems to be making little progress.

 

In my area, children under 3 get in-home therapy. A friend of mind has been through it and she said all they do is one-on-one playtime. My boy is very shy and would be unlikely to play with anyone until they have been over dozens of times. It seems like a waste of time to me. He gets tons of playtime (even one-on-one) already and I have done everything to help him speak. I read at least a dozen books a day to him, talk to him, sing to him, he listens to songs at nap time, audio books (his 5 yr old sister's) at night time - all the things that are supposed to produce early talkers. No results here. His sister, by the way, didn't say a single word until 17 mo. She caught up and now she won't stop.

 

I read an article once that suggested that much of the success of speech therapy in this age group is related to the fact that it is also the age when many kids naturally experience a speech explosion, with or without therapy.

 

Part of me thinks he will just talk in his own time. He passes or exceeds all other developmental milestones and understands everything that is said to him. The other part of me worries that he will be forever behind. Does anyone grow to age 30 and not talk?

 

I guess what I am wondering is what are other's experiences with speech therapy at this age and are there any resources out there that I can use to help at home. I have read several books on the subject and they always list the things I already do.

 

Thanks, and sorry for the rambling.

Gwen

[Melmc]

My son started therapy at age 2 and four months. He was fine developmentally except for speech. The kid's always been a math whiz. We pursued both private and county testing and both came up with the same treatment plan. He was diagnosed with verbal apraxia.

 

He's still in therapy at age 8 and will be for a few more years. It's not something I'd wait on if you feel there is a need. Testing isn't that expensive (could be worth it just to put your mind at ease and our insurance even covered it) and is even free through county early childhood resources. I'd say just get him tested and use the results to make a decision not what others say or have heard.

[sgmaddox]

My son is 4 and he has been going since September. I really struggled with this myself, I honestly felt like it was something that I had done or had not done. But his therapist can see a big change and we have only been going a couple of months(we were out the entire month of December). We actually go to the local university that has a speech clinic that the doctor's send their patients to. It is where seniors and individuals working on the master's get their clinic hours. It is supervised by the director from a one-way glass, and I get to watch also, and reinforce at home what they do in the clinic. If you are concerned about it, don't wait. If there is anything that I can help you with, simply pm me and we can talk further.

[4kiddies]

My son is 5 and has verbal apraxia. He was a late talker who turned into a big talker with an articulation problem. Everyone, including my ped, told me he would grow out of it and to wait it out. I regret it. He has been getting speech therapy for 1 1/2 years now and while there has been GREAT improvements I think it would have been better to start earlier. Also, while it looks like playing they are really working. Our original therapist played games with my son all the time but they were working on sounds and lip and tongue placement. Please do not assume it is just play!

[Aletheia Academy]

My son received about 1 year of in-home thereapy starting around age 18 months, and then he attended about 3 months in a special pre-school program at the local public school.

 

We were in a play group at the time, and I noticed that the other children, boys and girls, were much more verbal. Secondly, I read one of those milestone books that indicated he should be saying about 30 words at the time; he didn't even say 3. Third, he wouldn't say even very simple words that were part of his everyday life, like "milk" or "banana." He would make no attempt, not "mmm" or "bana"- nothing.

 

I had him evaluated by the county program. They said his receptive speech abilities were fine, but his expressive abilities were behind. They approved him for the in-home services. He received one year of the services, and it was completely free. A therapist came once a week to play with him and elicit talk. It is not mere play. The therapists are skilled at reaching the little ones. They understand the sort of "scope and sequence" of speech development, and they have really neat toys we didn't have at home. They also don't have the same emotional connection that we moms do; I feel that little bit of detachment helped them push a little harder than I might. They are less susceptible to the emotional aspect of the frustration than I was. Plus it was a special one hour for him (I had an infant daughter), and he appreciated the attention. We actually had two therapists during that time (the first one took a different job), and they both were wonderful. The county program lasted until he turned 3, and then we were referred into the school system.

 

I was less thrilled with that program. I didn't particularly enjoy the environment of the school or the class, and the teacher was professional but not warm. Still, I felt the speech-focused stimulation he received was valuable. Because his birthday is in the spring, he only had a short time in that class, and we didn't re-enroll in the fall.

 

The bottom line is, my ds's speech did improve. One of the therapists told me herself that there is no way of knowing whether the improvement was due to the therapy or normal development. At one time, I was really worried my ds was going to have a long-term problem; now I wonder if he'll ever stop talking! He even is comfortable reciting poems in front of others. I have no regrets about availing ourselves of those services. They certainly didn't hurt, and they may well have helped.

 

I am quite certain your son will speak before he turns 30. I thought my son might be speechless and wearing diapers in high school, but now he talks constantly and manages his bathroom duties like a pro! Think of it as nothing more than a little help getting over this hurdle.

 

Blessings to you...

[tullyfamily]

Our ds will be 3 in March. A few months ago, we started therapy at Children's Hospital b/c the ped DR was concerned about his lack of speech. We only went to 3 sessions before quiting b/c they were threatening- they blamed it on his attachment to me & the fact that we homeschool. (Funny, I though 2 year olds were suppose to be attached to their parents! And we have 5 children- he gets plenty of "socialization!") Also, the sessions were 1/2 hour of playtime- he HATED it b/c it was in the middle of naptime. I hated spending money for him to play cars and say "car" or "vroom" over and over again. We can do that at home! We spent a LOT of time in prayer & decided to wait till he is older. A couple from our church had 2 boys go therapy also but it wasn't till there sons were older (age 4). Friends who are DR said the same thing- there child didn't start talking till almost four. For now, I am working with him- he has started to say so much more already!

 

So, I personally would not stress about it at this age! Keep requiring your child to use words, read aloud a ton & be patient.

Heather

[Sara in WA]

Your sons sounds similar to mine! My ds did not put two words together until he was 2 years and 4 months. I had a pediatrician ready to send him to speech therapy at age 2 for not having 2 words together. We moved and found a new dr with 6 kids of his own. That alone gives such great perspective! He encouraged us to keep a watchful ear open to ds's words, and to come back at age 2.5 if we were still concerned.

 

I also talked to many moms with older kids to get their experiences. Many told of early talkers (like my daughters) and late talkers who at age 3 finally opened their mouths and took off.

 

DS just turned 3yo and his vocabulary is increasing. It's still not the same level as his sisters, but that's ok. Our dr reminded us that all children develop differently, but to come back at 3.5 is 75% of his words are not understood by a stranger.

 

I have a feeling your ds is just fine. Yet, if you are worried, a visit to a dr may put your fears to rest or send you on a track for help.

[joannqn]

Right around 3 is a good age, in my opinion. It takes a while to get all of the testing done so start now. If he needs it, they'll tell you. They look at a whole host of factors including vocabulary, intelligibility, articulation, actual structure of his mouth, hearing, vision, etc.

 

My son was much further behind than yours is so there was no question of his need.

[SkateLeft]

My son started in-home speech therapy at 23 months. At that point, he was totally nonverbal. I had a lot of people tell me that speech therapy at that age was silly, that he was just going to be a late talker, and that he had three older siblings to talk for him, etc.

 

However, it ended up being one the BEST things we could have done and I am so glad that we ignored everyone's well-intentioned advice and pursued it.

 

Originally, I assumed that once he started talking, he'd progress normally. However, that wasn't the case. When he did start speaking, it was clear that there were some other things going on. His articulation was very poor, and he had very little spontaneous language. He'd repeat certain words over and over. After working with him for a while, the speech therapist noticed some "red flags" in what he was doing, and referred us to our pediatrician who sent us to a neurologist.

 

It turns out that my son has a very large cyst in his brain and is missing a significant portion of his temporal lobe. He also has a variety of other behavioral and developmental issues that are related to the cyst, but his speech was the first indication that we had that there was something not right. He turned 3 this month, and this week we had his last (rather tearful) sessions with the EI speech therapist and occupational therapist. Our speech therapist was WONDERFUL, and it was far more than just playtime in our house!! My son did not interact with other people at all when we started, and she worked hard to build a relationship with him. That was a huge benefit as well because forming attachments is one of the things he has issues with.

 

We are indebted to both our speech therapist and our OT for the tremendous amount of help and support they've provided. Starting next week, he'll attend special education preschool three afternoons a week for a couple of hours. In April, we find out if he'll need surgery.

 

Early intervention dramatically improved our son's prognosis, and we're hopeful that by the time he's 5 or 6, his delays will have been resolved and he'll be caught up.

 

If you feel your child would benefit from speech therapy, I would absolutely not let other people tell you that it's not worth pursuing. Sure... your child might just be a late talker and might just catch up on their own. But there could be other things going on too. Having your child evaluated is worth it, imho.

[4kiddies]

----His family can understand him but I can't , and I am use to kids with speech issues! ------

 

 

This is a great point from the pp. JUst because YOU and the people who are around him the most can understand him can others? Will not getting him therapy hinder him the rest of his life? Why would you subject your child to that. Speech therapy is never going to hurt.

 

 

I'll be honest with you. In my particular situation, with my son, I would borrow the money for speech therapy before I would stop taking him to a private therapist.

[CookieMonster]

If you would like a been-there-done-that story, you can read what I wrote on my blog:

 

Our Journey through Speech Therapy

 

In short, my advice to you would be to get an evaluation and pursue speech therapy if advised. Speech therapy success is dependent upon the therapist and the parent. Some therapists are not great. Most care and are good. Parental involvement in the process is a must. (You only get out of something what you put into it applies here.)

[CookieMonster]

1. It doesn't hurt to get the evaluation but it may hurt to wait too long.

 

2. It looks like just playing with the therapist but she should be able to tell you her specific goals for each session and why she is doing what she is doing.

 

3. You should have homework to do with him daily and you will be able to see how the games relate to the speech work. All therapy has to be surrounded by play at this age.

 

4. If appropriate the therapist can also teach your son to sign and this will lessen his fustration. It is easier to talk so don't worry, he will drop the signs as the speech comes.

 

 

 

yes and amen!

 

or

 

:iagree:

 

About #2 - What you see is play because through play the therapist is able to encourage the child to perform prescribed babysteps. These babysteps leads to measurable progress over time. For my son, the first babystep - one that would be incredibly easy as a parent to never see the therapist doing - was eye-contact. Without consistent, appropriate eye-contact the child cannot progress onto practicing other things with the therapist.

 

About #3 - I'm not sure if I would have gotten much homework from my therapist if I had not asked, every single session, what I could or should be doing with my son on my own. I also gave the therapist a summary of what I had observed at home during the last week: encouragements or discouragements.

[Gwenny]

Thank you all for your replies! I am certain now that I will at least get him evaluated and also do the hearing screening. Does anyone know of any books or videos that I can use with him while waiting for the evaluations? We watch one the Signing Time videos every day and he already knows well over 100 signs. This helps alleviate some of the frustration but I'd like to know exactly what kinds of things I can do with him at home in the meantime. The sort of things that speech pathologists would do with him. All I can seem to find are the blowing bubbles and licking peanut butter off the lips sort of thing. He already happily blows bubbles all the time.

Gwenny

[Aletheia Academy]

A few things I remember...

 

Blowing cotton balls across the table by blowing through a straw.

 

Using a straw to drink, in general- all different colorful, fun ones.

 

Sitting next to him and looking into a mirror amd having him try to emulate your faces (like ah, oh, ooo shapes with your mouth); showing him how the mouth looks for different sounds like m, b, d, g, th

 

Requiring some type of verbal response for everything he wants, even if it's not a complete word, e.g. "mmm" for milk, "nana" or "bana" for banana; while playing games, the same thing...require a specific sound for every game piece or next step.

 

 

My son's issues were related to oral motor development. NOW I understand why he was not a good nurser!

[Mandamom]

who advocates for early speech. My ds2 has been in speech therapy for several months and I've seen improvements already. He enjoys the speech therapists (he has two that come to our house because he' so far behind) even though he' extremely shy.

 

I undesrtand shyness. I was one who wouldn't talk to anyone outside of my family until I was 5 years old (I spoke very well at home but to no one else). My kids take after me. My now 6 year old would refuse to get on playground equipment when she was 2-5 if there was an adult near or on the equpiment. when she entered speech therapy before he was 2 I was really worried it would be useless because it would be a waste of time. It turned out really well and although she wasn't a prolific talker she was able to play with the therapist enough to make significant progress and eventually was done with speech. She currently attends the local elementary school and her teacher still comments she doesn't talk enough :tongue_smilie: but at least she can now.

 

My d2 is exactly like his older sister and although when exposed to new place and people he hides, he has done well working/playing with the therapist. The therapist has been amazing in getting him to say sounds he was unable to do before. He enjoys the time and considers it playtime even though I can see why she is doing what she's doing.

 

BTW, he is ahead in receptive language just severely behind in expressive language.

[sgmaddox]

Excellent about the therapist playing/interracting with the child; they actually use this to see how the child interracts with various toys, if they know the object and whether they can pronounce the object while playing with it. Check your local university and see if they have a speech clinic, we pay, but they have a pay scale according to finances.

[ElizabethB]

My son's speech improved a lot after a month of daily watching leapfrog's talking letter factory. Hearing the speech sounds in isolation was very helpful to him. He watched it when he was 2. The first few weeks, he had just learned a few sounds. When he had learned almost all the sounds, his speech became markedly clearer. (I wasn't expecting that, my daughter watched it at the same age and got no speech benefit--of course, before watching the movie, she was already speaking very clearly, even strangers could understand most of what she said.)

 

Here's a good website for seeing how the mouth and lips move together with the sound of each letter. You could watch a letter or two a day with him, working on the letters that are the least clear first.

 

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

[Gwenny]

My son's speech improved a lot after a month of daily watching leapfrog's talking letter factory. Hearing the speech sounds in isolation was very helpful to him. He watched it when he was 2. The first few weeks, he had just learned a few sounds. When he had learned almost all the sounds, his speech became markedly clearer. (I wasn't expecting that, my daughter watched it at the same age and got no speech benefit--of course, before watching the movie, she was already speaking very clearly, even strangers could understand most of what she said.)

 

I'll definately try the video. It seems everyone recommends that one anyway (even for speaking kids). When I taught my daughter the sounds of the letters at age 3, I also noticed an improvement in the clarity of her speech. I guess I never thought of teaching him the sounds since he can't say them back to me and because he is a bit younger. He tries to say the alphabet (it is at the end of every signing time video), but is unable to say many letters. He just grunts along with most letters!

Gwenny

[ElizabethB]

He tries to say the alphabet (it is at the end of every signing time video), but is unable to say many letters. He just grunts along with most letters!

Gwenny

 

Well, it looks like he can say the sound of g at least!

[joannqn]

My son's speech improved a lot after a month of daily watching leapfrog's talking letter factory. Hearing the speech sounds in isolation was very helpful to him. He watched it when he was 2. The first few weeks, he had just learned a few sounds. When he had learned almost all the sounds, his speech became markedly clearer.

 

Two of our speech therapists recommended Leap Frog videos. Unfortunately, we got them too late to help much but I can see how they'd help.

[The Governess]

My dd is 30 months and has benefited so much from her therapy. She wasn't very far behind on her number of words, but her pronunciation was poor (and still is, although she is doing MUCH better than she was even a couple months ago). Also, she had a very large gap between her language understanding and her ability to communicate. So, she knew what we were asking her/telling her, but she couldn't formulate a response. This was incredibly frustrating for her and was causing a lot of behavioral issues. Giving her the skills to communicate has helped in so many ways!

 

The one-on-one really does seem like just play, but you will pick up ideas from the therapist and it will change the way you communicate with your son at home.

 

It sounds like you are doing great things so far! Based on what my dd's therapist has done with her, here are some additional ideas:

 

1) use action words: push, pull, jump, sit, hug, squeeze, up, down, roll, slide, etc. Perform the action with him over and over (pushing cars across the floor, lifting him up and putting him down, etc.) and say the word and encourage him to repeat it. These are great because when you combine the action with the word it means double input.

 

2) Foods that stimulate oral awareness: my dds therapist has given her spicy foods, sour foods, even pop rocks :001_huh: to encourage her to pay attention to what's happening in her mouth. She's also used a vibrating tool, if you have a vibrating toothbrush you could use it to "paint" some yogurt or something onto his tongue, cheeks, roof of mouth, etc.

 

3) Take pictures of your son's favorite things and make a photo album. Family, household items, toys, playground equipment, etc. Read it with him and encourage him to name these familiar items.

 

4) Work on words that start with easy consonant sounds first: /p/ /m/ /h/ /w/ /b/

 

5) If you have the Cranium Cariboo game this is a great tool. My therapist replaces all of the little cards with her own cards that she's made that have pictures of objects on them (ball, baby, dog, etc, whatever words we are working on). The object of the game is to open the little doors and find the hidden balls. But she won't let dd open a door until she's said the name of the word on the card covering it. It is very motivating for her.

 

6) You could try starfall.com - they have phonics instruction on their website that is GREAT. I've used it with dd - she has to say the name of the picture (apple, etc.) before I will click on it (when you click it does a song or animation, etc.). Same idea as the Cranium game, it's something that encourages her to try to say it. It's ok at first if he is just repeating after you.

 

7) If you have a plastic doll and some accessories, you can use it to have your son act out some action words: brush hair, wash face, wash hands, get dressed, take nap, wake up, drink bottle, etc. DD's therapist has had her cover a doll in shaving cream to "wash" it, and then use a hand towel to "wipe." There are so many words/actions you can use.

 

Here in CA, they have a great early intervention program. I believe dd's therapy started less than a month after her evaluation appointment. I've been very impressed with all of the services she's received. I hope you have a great experience as well!

[TraceyS/FL]

My DD started at 3 thru the school/county. Only because i was able to self-refer at that point. Her ENT wanted her in speech, but the ped was holding back the referral. I guess for the under 3 set you have to have the doctor involved. At the ENT appointment he said wait a minute, she's 3 - call this number.

 

None of us could understand her, but she had words..... she made great strides last year, but summer did us in and it was like starting over. I'm going to have to work on that this summer more.

 

But i agree with the "it can't hurt" camp!

[siloam]

Gwen,

 

We waited till my ds was 5. My 3rd dd was also delayed, and she grew out of it, so we expected him to as well. He didn't.

 

When he turned 5 I bought Straight Talk. As it turned out it was similar to a lot of things that I had already started doing with SWR, and there were huge parts I didn't get at first. Mostly I made use of the evaluation sheets and figured out the sounds he had the most problems with and started working with those more. But I could tell *I* still needed more help.

 

Just before his 6th birthday I picked up a program called LiPS which is used by professional therapists. The full title is something like The Lindamood-Bell Auditory Discrimination and Phonomical Awareness program. Too long! It runs $500 but can be found for $350. Not cheap but the manual is partially scripted (sometimes expects you to apply the same process to multiple items), and has lots of hands on tools. It begins with helping the child to hear better, then moves to awareness of the mouth, then working on finding sound combination based on the movement of the mount and labeling them. For example did you ever realize that both F and V are made in the same way just one is vocalized and one is not? LiPS will discuss F and how the mouth moves to make F, it includes pictures of the mouth and helps. Then you have the child try to find the vocalized partner on their own. I game my ds a group of letters to choose from and he had so much fun going through them and looking in the mirror at how is mouth moved and finding the partner to each movement. His speech has improved a lot though we have only begun to use the program. If you are looking at an at home option, then I would highly recommend LiPS.

 

Heather

 

Edited January 30, 2009 by siloam

[Sara in WA]

The full title is something like The Lindamood-Bell Auditory Discrimination and Phonomical Awareness program.

 

Interesting that you found this! When my dh was in seminary, he worked as a tutor for Lindamood-Bell in San Diego. Almost 8 years later, I still hear him use those same techniques and helps to remind our kids of the different phonics sounds.

[prairiegirl]

My ds started speech therapy when he was 3. He had severe articulation problems. I am glad that we went. Even though, it looks like playing, the speech path. is doing a lot of work through those games. We would see the s.p. once a month and then I would have to work with ds for the remainder of the time. I learned alot.

 

My ds is now 8. There was two years when he couldn't get speech (our area does not offer speech to children who are not in the school system.) Through a miracle, he was picked up by a s.p. last year and he has made amazing progress, not just in his sounds but also in his sentence make-up.

 

It may seem like the s.p. isn't doing much or that there isn't much progress but that is deceiving. The progress may be slow but it is there.