2 year old- moderate speech delay

[cheekymonk]

Hi have asked about this before but not many replies. DD aged 25 months has seen SALT and been assessed as having moderate speech delay in Jan 2013. she had a hearing test in Dec and had glue ear in both ears. SALT felt it was down to glue ear and agreed next apt was may 2013 after additional hearing test. Hearing test again showed glue ear in both ears but hearing was better and they said speech probs were unrelated to hearing issues. Further hearing test booked for July and if glue ear again will refer to ENT. meanwhile, dd's speech improved 1st week after speech apt after they told us to focus on one word, lots of books etc and using makaton but no real progress since. she can't put 2 words together and says about 10 words. I have chased NHS but they said short staffed etc and it will be May. Considering going private, anyone else done this? friends have advised me to push/hassle NHS but I am crap at this and don't know what to say...

[gerbilsarefun]

My eldest dd had speech delay. She didn't say a word until nearly 3, then it was just gobbledegook, nothing recognisable. Eventually we got her into speech therapy (she was 5, we moved area and she had to go back to the bottom of a list). TBH I don't think the ST did much for her except to point out to us where she was having problems. Her time in reception did loads for her, learning to read and pronouncing words properly helped her a lot. She is 14 now and has a great vocab, she has a bit of a lisp but otherwise her speech is great. Just to add, her hearing was re-tested and they found no problems with it. She passed her 2 year check in every other area except the speech.

Hope this gives you hope, it can be overcome (but currently going through the grumpy teenage stage!!). And, it's a very common problem but worrying as a parent.

[Holfin]

Hi, I can't offer any advice but am in a similar situation. My DD is 25 months and has only about 5 words. We have been told she cannot be assessed until she is 27 months. It's so stressful waiting. Hearing tests have all been fine. Sorry I can't help but just wanted to tell you you're not alone.

[cheekymonk]

Thanks gerbils, yes it is worrying and I know it can seem like small fry but to us as a family it is causing stress. We haven't been told that holfin- its all such a postcode lottery!

[juneau]

DS2, 22 months, is also suspected to have a mild speech delay. He had some serious issues with one of his ears back in the autumn, requiring hospitalisation and an operation, and we've since had a hearing test that suggests mild glue ear, but the audiologist thinks he probably had reduced hearing for about three months in Oct, Nov, Dec, and that's why he's not saying very much and what he does say is not clear. We've got another appt for a hearing test in May, when he'll be two, and they're going to refer him for ST if no improvement. I've been using the Dorling Kindersley 'My First Words' book with him every day and I have noticed a slight improvement recently, but I can tell that he's hearing now, because he follows instructions and understands me and others perfectly well.

In your position I would go to my GP and say how worried I was and that checking her hearing every six months, but doing nothing to treat the glue ear or monitor it in between, isn't good enough. If GP repeats the excuses about low staffing, etc, I would then ask for a referral to a private practitioner. If you have BUPA or similar you can then ring them up and they'll sort it out for you. If you don't have private medical insurance, at least you'll have the name of a local specialist to approach.

[cheekymonk]

Thanks Juneau, that's kind of what my Mum suggested. half of me thinks oh, it will right itself etc and I kind of get brow beaten by them all and then the other half is more fiery and wants to fight for dd and thinks why should she suffer a minute longer than she has to?

[cheekymonk]

I have so far emailed 3 private practitioners but none have replied. I have left message for HV as cannot get through.

[yetanotherworry]

Its a worry isn't it. One of my children had speech delay - he ended up unable to say any consonants except d. When he was your dd's age we were advised to do lots of oral-motor exercises - use straws to blow ping pong balls, blow bubbles, look in mirror and pull funny faces (wide open mouth, narrow pointy mouth etc). We did lots of reading together and watched TV, basically anything which encourages talking. If he pointed at a bus, then I would say yes, its a big blue bus etc.

If her speech is unclear then you have to change the focus from her to you, so instead of saying I don't understand you, you can say my silly ears didn't hear that properly, please can you say it again. Also model correct sounds so if she says dat instead of cat, don't sat it snot day, instead you correct by saying I see the cat, its a big cat, the cat is orange.

[cheekymonk]

Thanks yetanotherworry, interesting...

[gourd]

We just went private having waited nearly 6 months on NHS. Our child is 2 and a half. SALT did home visit and after various tests (that seemed pretty intensive but luckily DD was happy enough to do them all) said speech is delayed but language comprehension and other things such as role play and concentration are 12-18 months ahead at least, so the expressive language delay is becoming very apparent and also very frustrating for our daughter. She has already started to recognise letters in books and on signs, but uses animal noises ? makes Owl noise for O, ?Aaaaa? for S (sheep), ?Boo? (Moo) for C (Cow) and says Mama for M, Dada for D and Teddy for T etc rather than sounding out the letters. We now worry she will start to actually learn to read before she can talk meaning she cannot even tell us aloud what she is reading which would be a disaster! SALT said that age 2 and a half (even with good concentration) is too young formal speech therapy but will do two further home visits (at £65 a time) to give us techniques to use informally with DD. Next home visit is this Friday. I do hope it is useful and not just repeating things we already do and have been doing with her since around 9 or 10 months, when she originally said her first word - "Teddy" (we always repeat her words, but model the correct words/sounds when our daughter talks to us etc). She has favourite sounds she uses for a lot of different words that usually we do understand due to the context (despite purple, paper, butter, baby and bubble all sounding essentially the same ? she says "ba-ba" for them all) . I really hope the therapist will do more than just confirm what we already know and will help us to help DD to catch up with her language.

[cestlavielife]

contact ICAN in case of any local services/group sessions/playgroups -
www.ican.org.uk/ and maybe get some of their resources
www.ican.org.uk/en/Book-shop.aspx

see if there any group sessions in your area like this one
www.wales.nhs.uk/sitesplus/documents/866/Speech%20%26%20Language%20Therapy%20-%20It%20Takes%20Two%20to%20Talk%20-%20The%20Hanen%20Program%20for%20Parents.pdf

what did SALT assessment say - is it only a problem n speech (producing speech) or is it a general delay in understanding as well? that is very important to know. you need ot get a copy of SALT reprot and find out if this is just about expressive delay producing speech issue or also receptive language.

you are no crap - you do need to learn how to politely and firmly request the reports and information and ask what strategies they offering and where you can get more help.

[cestlavielife]

also try signs - something special makaton signs -

and get an ipad and download some communication apps and try those -= so she has to use it to say ask for a drink or toy if she wont speak it
see communciation apps here (scroll down some are free)
www.netbuddy.org.uk/info-packs/apps-ipad/

[cheekymonk]

Thanks gourd and cestlavie. at the one appointment we had it was very informal and the report was also informal, just stating moderate speech delay and criticism of dd's personality really! We have not undergone the rigorous tests you talk of. Will that not happen until dd is 2 and a half?
Will look at those links cestlavie. thank you.

[cestlavielife]

There is formal testing
Like Bayley scale of infant development
Griffiths test
Specific speech testing which wil even at this age tell you if child is delayed only in speech expressive production of speech or also receptive.

If you go for private slt ask them to do a proper assessment . It is v important you now if this is just a expressive speech delay or broader communication issue.m

[cestlavielife]

Or ask them to do the reynell assessment so you k ow how much delay and what form

reynell.gl-assessment.co.uk/

[cheekymonk]

cestlavie you have been so helpful, thank you. Have finally got 5 mins to catch up and do some research. Plan at the moment is chasing NHS to bring forward appt. SALT rang today but at work and no answer when I rang back but I will keep on tomorrow. Have got docs appointment booked as suggested by yetanotherworry. No reply from HV so give up on that front. Speech therapists have replied, 2 very helpful. one linked to ican website and said they do free advice over phone to start with. other one was quite reasonably priced and looks good www.listenandtalk.co.uk so feeling positive. Really grateful for all your advice everybody x

[doodledee]

I've just found this post as I'm in a similar situation. DD turned 2 last week and says 4 words, all other areas of development appears normal. Starting to really worry about it now, have got her 2 year assessment with HV Friday (had to ask for it as 3 month delay). For so long I told myself not to compare her with 5 year old sibling, to not worry but now I'm feeling so guilty for not chasing it up earlier, although in fairness discussed it with close friend who is HV and she advised waiting till 2 year check. Hope I don't get fobbed off and get referred for a formal speech therapist assessment.

[juneau]

Be pushy doodle, if you have to be. My DS has had glue ear since Dec (and a serious ear problem for two months before that), and I've found that being firm and persistent, but always polite, obviously, has got us the referrals we were looking for (SALT and back to the ENT surgeon, in our case). If HV fobs you off go to your GP and ask for a referral to whatever s/he thinks is necessary, whether that's an audiologist, SALT, whatever. Don't be fobbed off. Persist!

[cheekymonk]

Agree with Juneau! Thanks to Dh making a call in addition to me, SALT apt booked for 29th april!!! yeay!!! Don't feel guilty doodledee its easy to feel overwhelmed and/or hope it will right itself. Its hard to know what to do sometimes!

[doodledee]

Well just back from HV and she's not worried. Says it's not unusual and she will catch up, seemed to indicate her being 4 weeks premature is significant. She will reassess in 4 months. She also said that they are unable to refer to SALT until the age of 3 due to shortage of therapists! Also that many children start school without talking well (really??) Told her I was willing to pay and she said not necessary that it would be a waste of money and they would probably refuse to see me, even privately. She paid for SALT for her own daughter (now 14) so I guess she knows a bit about it. So while i'm a little reassured i'm still worried, just hope she's right.

[cestlavielife]

doodledee - look at the ican website and speak to their helpline - if she literally only says four words at age two then this is a delay and you would be right to ignore the hv and get her assessed now. assessing receptive and epxressive and also play skills etc.

if she then catches up wihtout intervention and all is fine -well you spent 120£ or whatever but you will know...

if she IS in fact delayed then early intervention now could make a big difference and you wont have wasted a year waiting.


call ican www.ican.org.uk/en/What-we-do/I%20CAN%20Help/Enquiry%20Service.aspx Call 020 7843 2544 to arrange a free phone call from one of our speech and language therapists through the I CAN Help Enquiry Service or you can email your questions to [email protected]

We can help explain any aspect of children's talking and communication development that you may be concerned about. We can also talk you through ages and stages and what you can do to help your child and get the right support.

[cestlavielife]

how does your child communciate at the moment? how does sh choose between cake or cookie when they offered?
how do you know what dvd she wants or whether she wants to go on the slide or the swing?

the reality is that communication is the most important skill a child a person can have - (ref stephen hawkins) whatever their physical abilities or not.

poor communcaition skillls leads to behaviour and frustration and poor learning

[cestlavielife]

look at the talking poitn website for comparison - if she is not using more than four words there is an issue ...

www.talkingpoint.org.uk/en/Parent/My%20Child%20Is/2-3-years.aspx

[cestlavielife]

and watch the video

www.talkingpoint.org.uk/Parent/Speech%20and%20Language/Communication-is-vital.aspx

it is bad that SLT is bieng left til 3 if that is the case...but call ican get whatever free advice you can and if things ahvne cahnged in four months inisst on referral - bu frankly given the shortages etc i would beg or borrow money for private assessment now..

[cheekymonk]

Update on our situation, have got SALT appt 29/04/13

[doodledee]

Thanks cestlavie that's really helpful, will definitely call the helpline for advice. Money isn't an issue I would happily pay for treatment if she needs it, HV made out I would be wasting my money and suggested they would refuse to see me, felt a little surprised that she wasn't concerned to be honest.