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Speech therapy for the delayed talker: 101

Truman_purplesmile As many of you know, my 29-month-old, Truman, is greatly delayed in speech. Through the MESD, we had him assessed for early intervention at 20 months, then again in August. Because children are assessed for all aspects of development holistically until age three, we didn't qualify for services according to our score cutoffs either time -- but the women we were working with decided to use "judgment" to qualify us anyway at the second appointment. Maybe it was my persistence? Very few parents (I get the impression) make their own referrals for assessment. Or maybe it's just because Truman is so ridiculously cute.

Either way, we're now getting speech therapy once a week. And because you have to be so delayed to qualify, I thought I'd share my homework with you, so those of you with very mildly delayed talkers could join in the services!

Truman clearly understands most words but had a lot of trouble saying consonants that appear at the end of words, and stringing syllables together. So "mama" is "ahhh," "daddy" is "a-dah," "airplane" is "aarrr," "water" is "ahh-raarr." Our therapist sat with us and we found one of Truman's current favorite books, Richard Scarry's Best Word Book Ever. We started out with him on the floor, as usual, but soon she decided to put him in a chair with the book on his lap, and put me in front of him.

She took away all his distractions, even finding a pillow to put under his feet so his legs would hang comfortably. She encouraged me to wait to say the word for whatever he was pointing to until he looked at me (although not waiting so long that he would get frustrated or angry), and occasionally remind him to look up. Truman drools a lot when he's trying to talk, so she showed me how to press up gently on his lower lip and remind him to "swallow!" and do simple face massage -- rubbing his cheeks with my fingertips -- to inspire him to use his mouth correctly.

He loved the interaction, and we worked on it for more than 20 minutes, ending with the most syllables he's ever put together: a strange but obviously valiant effort at "police car"! (Something like "ppeessscckah", where before he might say "paahh" or "caaaahhrrrr" but not together. Wow!) I felt like a victor. Later that night, he used sign language to ask for "milk" "please" entirely without prompting. This is progress!

Our homework is this: just 10 minutes (or more) a day, to repeat the reading exercise with one of his favorite books, making sure Truman is looking at me when I answer his mostly-wordless questions. I've been working hard on "milk" and "please" and I think my new goal is to add a new word in sign language every day or too.

I'll keep posting every week or two, if you're interested, and I'd love to hear experiences from other mamas and papas who have been through speech therapy, or who have agonized over developmental delays. Can I just say that the bumper sticker I received as part of my package from the MESD -- "Disability is a natural part of the human experience" -- gives me no comfort at all? The thought though, the thought is much appreciated.

I'll also post at some point on the process of going through evaluation for early intervention, as it's a big process that took me a while to navigate.

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My first son had speech therapy starting at the same time as yours. He said "No", "Dada", "Dee" for Mama, "Dee Dee" for G'ma, and "vroom" for car, and finally my favorite "ka" for yes.

Six months later the therapist told us that he was speaking at the level of a four to five year old. We praised him for sounds that he made even if he didn't quite get the word out. He loved going, it was free, and it worked. I learned enough from those sessions that I can now help my youngest who is also a delayed talker. Good Luck. The trick now, which you know, is getting them to Hush up.

My niece (a picture of her swimming is on the Urban Mama Flickr page) was diagnosed with Verbal Dispraxia as a toddler and required speech therapy until she was 5, when she was declared to have developed speech normal for her age group. She had a great deal of difficulty with consenants as well, usually dropping the first one in a word. When I was visiting her, I said "I have to go to the potty" and she said, "I ah oh otty ooo." (I have to go potty too). It was very difficult to understand her, and frustrating to her, as she heard the words coming out of her mouth the way she thought they ought to sound. Now she is a very intellegent, well spoken young 9 year old with an attitude, and a love for all things Fergie! The one really cute thing she did was call her brother Adam "Ba."

We have had A LOT of experience with speech therapy and developmental assessments with our six year old son. He started receiving speech therapy twice a week when he was around three. At about four he qualified for services through the school district and started going once a week.

That has continued and will probably go on for at least the next year. He is now very understandable for his family and can often be understood by strangers too. The process has been very worthwhile for us and I would highly recommend that anyone else jump through all necessary hoops too. You would not believe the things my son can tell me now!

I've picked up some helpful tips along the way that I thought others might find useful. I was told that for kids who need help building awareness of their mouths, a great thing to give them is Talking Rain or something else bubbly without any sugar or other yucky stuff added. Popsicles are great too. Someone else told me that somehow the swallowing and mouth control muscles are engaged when you take kids horse-back riding too...

My nephew did not say a word that anyone could understand until he was three years old.Because his parents were young and uninsured,he never received speech therapy. Now, he is probably the most articulate, well spoken sixteen year old I know.
It seems that, in my family, the children are always very slow to develop in the areas where they excel later in life.

My son is 16 months old and hasn't started speech therapy, but I'm sure it's in our future. He is hard of hearing (HOH) and receives services from Columbia Regional Program (contracted from MESD). He signs some words and says a few. He didn't get hearing aides until 8 months, so he missed some of the listening that newborns do. He's developing in most areas at the 9 to 12 month level (as far as communication is concerned).

We try to say and sign most words (it's hard since we didn't know any sign language before this started). He signs "dog", "more", "eat", and "milk" at a regular basis, but understands other signs such as "no", "stop", "banana" and "help". He doesn't understand that many spoken words but we are working on it. We use a lot of props and sounds that items. He now barks when he hears the dog bark.

There is a workshop coming up at the Tucker Maxon Oral School on Nov. 2 and Nov. 3 called "Learn to Talk Around the Clock". It's put on by Karen Rossi. It costs $25 per person with additional family members for $10. It says the program was originally designed for parents and professionals touse with parents of children who are deaf or hard of hearing, some professionals have found the strategies to be effective for children with language delays.

My son in three years old and is very delayed in speech. He has been in speech therapy privately and in Early intervention since he was 12 months old. Through Early Intervention I took a class called the Hanen method. It is an 8-10 week course where parents meet for two hours a week with a speech therapist during this time there is a workbook and several videos to watch. You take home the methods you learn and try them that week and the next week you meet again and talk about what worked and didn't ect. Early intervention also came out twice during the class and videotaped everyone in the class working on speech with their children and then sat down with us to help us. Sorry to run on but this class helped tremendously for me. I would suggest calling your early intervention to see when they have the classes. Ours was at Sabin Elementary in NE portland and I know SE IE has the classes also.

He's cute as a button!

My son(2/05) was a late talker but we were never worried because he understands EVERYTHING and has from a very young age. And he is and has always been a great communicator so his lack of words were not particularly problematic. At his 12 month check up the doc said let's really keep an eye on his lack of speech, we needed agreeably but passed it off. I have been in child care for a long time and many kids, especially boys, are late talkers.

At his 18 month check up, different doc, they said, he may just be a late talker but let's get his hearing tested just in case. Well, the fluid in his ears was preventing him from hearing normally. Though he had only had 2 ear infections, he had fluid in his ears almost constantly. Though he could understand everything, the differing levels of fluid in his ears at different times prevented him from having a good "base" with which to build words. In other words, the same word sounded different at different times.

We ended up getting tunes in his ears 11/06 at OHSU with Dr Henry Milczuk. After he had gotten the tubes, my husband heard a story on NPR that in studies down the road there is no difference in language skills between people who did and did not get tubes b/c of fluid in the ears. Luckily we did not have this information to start with so did not have to agonize over it. He was tested one and six months later and hears perfectly.

We started speech therapy in 2/07 with a WONDERFUL private practice speech therapist in Vancouver WA, Patty Ehlers. He LOVED her, they had a great rapport, he was always eager to go and would practice the things she showed him in on his own. She also told us to remind our son to close his mouth with a gentle push. When he started with her, he had said Ma for Mom, occasionally Ma for Dad, Pa for grandpa, Ba for ball, Ra for rock and had a few signs (more, all done, please, help, sometimes milk & water). He had a whole bunch of words he had said once or only a few times. In fact, early on he had a couple words that he said regularly but then stopped saying them all together. He was also excellent at gesturing. Between everything he had almost no trouble communicating what he wanted to say.

Patty's thoughts on him were that he was delayed (maybe b/c of fluid, maybe some other reason, hard to diagnosis in young kids) but that likely when he started turning the corner he would not need speech therapy anymore. In the time he saw her, through 8/07, he started getting more and more words and putting small sentences together with words and signs combined. It started with attempting more sounds, animal, vehicle, around the house, etc, and grew into trying more words and sounds of all kinds. He slowly crept out of his comfort zone of, ma, ba, wa & ra words.

In the past few weeks he says several new words almost daily. He puts small sentences together with words only regularly and uses the new words he tries over and over. He still has trouble with the ending consonants but is really blossoming. So he seems to be turning the corner, luckily because our new speech therapist(husband switched jobs & insurance, old therapist no longer covered) is not as experienced, does not have a good rapport with him, is too busy, sees adults and children so has to switch gears too often, and is not able to see him often enough (he saw Patty once a week for 1/2 hour, then switched to an hour for the last few sessions.)

So we are left with seeing the new therapist a few more times and seeing if things get better, trying a different therapist at the new insurance company or going back to Patty and paying cash. I also want to look into the program through the public schools but sounds like I may have trouble getting him in.

My son will be getting his tonsils and adanoids out next week, this may help his speech b/c he is a bit of a mouth breather. So this apparently may help him hold his mouth correctly to get the right sounds out.

I've tried to be as brief as possible, it's all a lot more in depth,of course, than I have written here. Feel free to email me with any questions. Good luck to all! Love- A

Just wanted to say that all of these comments are so helpful - we are in the process of determining whether our son's speech delays require intervention and where to begin after receiving mixed feedback from our ped (have a temporary one while ours is on maternity). Thank you for such thorough and thoughtful summaries.

This posting is quite interesting to me. My 19m old has been diagnosed with sensory processing disorder and is still not verbal...he babbles uncontrollably, but also drools uncontrollably and has no intelligible words, not even mama or dada. We have had him assessed through EI and have a therapist/teacher in our home once a week, she does a lot with him but no direct speech. He also sees a private OT who has said he needs to start speech therapy...but MESD is saying they are "incorporating it into his general therapy"....as his mom i am beginning to worry he needs more direct speech instruction but the EI program doesn't seem to want to set it up for us and we can't afford it privately....he has private OT through Providence but his OHP insurance covers it...we just aren't in a position to pay out of pocket. So, any tips on getting MESD to help us with speech? at 19 mo he is SO frustrated all the time and signs a lot but his mouth can't form words yet....and we need all the help we can get!!!! thanks....

Debra, you may likely be eligible for some private speech and language visits through OHP. I am an SLP and see many children under that plan.

Debra-
Under IDEA (individuals with disabilities in education act), your child's IFSP should have any interventions he needs written into it. You have the right to have an IFSP meeting at any time that you want (usually they are twice a year for kids under 3, but you can always call one). You can request that a speech therapist be present at the meeting and you can voice your concerns about him needing individual speech therapy. They must provide him with a free and appropriate education (because he has special needs this counts even before he's school aged). If appropriate means he needs a speech therapist, they should provide one. This means that if they think his speech is behind, they should provide speech therapy.

thank you guys for this, i am pursuing this further w/MESD and OHP. I appreciate all the good feedback....:)

Another place to consider looking into is Oregon Scottish Rite - www.scottishritekids.org. Just as Shriners helps kids who are burn victims, Scottish Rite helps kids with speech delays, for free or significantly reduced rates. They don't advertise too readily because they don't have the staff to serve everyone but they take who they can. My twin sons have been going there for over a year and it has been invaluable. We had EI through MESD as well, and did the Hanen program, and my sons currently have speech therapy through their preschool program, but Scottish Rite has been where we go for weekly speech therapy. It might be worth calling to see if you can at least get on the waiting list for an evaluation. They are top-notch therapists and it's an incredible organization.

Can anyone make a recommendation for a speech therapist in Portland? I don't know that our child is delayed but I'm concerned because her vocabulary isn't very large and there are many sounds she won't or can't say at all.

My closest friend on the East Coast has a son who qualified for early intervention due to speech delays and social and emotional concerns. She had been an OT in the schools and realized quite early something was not right. She got him services starting at 19 months and he is almost 4 now. The difference in him is astonishing-he has beyond age appropriate vocabulary although the social and emotional issues are still present. She has been a tireless and loving and stoic advocate for him. She is smart and so knowledgable about the different programs. She swears by the Hanen (Hannen? not sure of spelling) program. Thought that might help. Also, the whole idea of just waiting to see if it passes, and Einstein being a late talker, etc, should not be put into practice when there really are concerns. Research has shown that there is a critical period of brain development in the early years and it is important to get services as soon as you can. The developmental pediatrician my friend takes her son to credits his "recovery" and progress to the fact that they got him services so early. People may want to go through CDRC at OHSU as opposed to MESD. I have heard they have a more thorough and critical assessment process. Don't know if any of this helps but thought I would share.

Thanks for this post. My son is almost 17 months and not really starting to talk yet. He makes lots of noises & says, "mamama" and "da" and "no, no, no." There are a few other words he has said occasionally, but nothing with any regularity. He has been slow learning to walk too, still just taking a few steps, which had been my greater concern until this week. MESD assessed him this week and thought he would benefit from arch supports. Three months ago I expressed concern about the outsides of his feet not touching the ground and his doctor was not concerned. Anyhow, it looks like I was right & I'm hoping the arch supports allow him to start walking when he gets them next week. In the meanwhile we will also be starting speech therapy. I go back and forth between feeling hopeful that he just needs a little help right now and will soon be catching up and feeling this knot of dread in my stomach that things will not be OK (and of course that would be my fault... oh mama guilt). His problem solving skills and fine motor development are good and his social development is normal as well, so I'm trying to let this comfort me. Anyhow, it was good to read these posts and hear other peoples stories.
Cafemama, how is Truman doing now?

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