Speech therapy?

sarah42sarah42 Posts: 4,034Registered Users
I've posted about this before, but I'll start a new thread. Connor just turned 3 a week ago. We had him evaluated by Early Intervention back in April or May for developmental delays, and our real concern was speech. He was rarely putting words together (just single words and pointing) and was hard to understand. He was tested to have a 15% delay in communication, also 15% delay in fine motor/adaptive skills, but that wasn't enough to qualify for services. They require a 50% delay in one area or 33% in two or more areas. The speech pathologist who evaluated him said or gave me the impression that they weren't concerned about poor articulation before age 3.

Since then, his speech has really developed as far as vocabulary (which has always been age-appropriate, I think) and speaking in sentences. I haven't tried to list all the words he says, but it's in the hundreds, and he says sentences of 5-8 words all the time. But his pronunciation is not great and he doesn't enunciate well all the time. He can't says R, L, TH sounds, and sometimes he mixes up T and K. I don't know what to call this, but he also sort of stutters sometimes. He'll say something like, "I...da...da...da...ice cream." If I prompt him to say it clearly, he will: "I want ice cream please." (Or more like "I want ice ceam pease.")

I took him to the pediatrician yesterday for an unrelated issue, and she commented that she thought his speech was not where it should be. She said he should be more understandable at his age, and wanted me to get him evaluated again. At age 3, special services are done through the school district, which have different criteria to qualify. The doctor acted like she thought he would definitely qualify for speech therapy. My feeling is, if he was 15% delayed eight months ago, and I know how well he talks and how he compares to the age milestones, I would be very surprised if he were much more than 15% now. But I'd rather be safe than sorry, especially since the doctor brought it up out of the blue. She said it would be better to get him speech therapy now and he would be able to be completely caught up by kindergarten.

I called today and scheduled the evaluation, so we'll see what they say. They can't see get him in for another month, so I'll update when I know anything more.
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Comments

  • deezee02deezee02 Posts: 1,509Registered Users
    Speech varies a lot during these ages and should increase rapidly. I did not realize HOW delayed Steven was until I heard his peers speaking so clearing. I am so used to his speech that I can understand him even when others cannot.

    He also does the da da da thing, I think it is when he speaks too fast and cannot keep up so his words run together. Something else I noticed was when he has huge advances in words he learns, he does not prononciate well, thus his words seem jumbled.

    His main issue is confusing letters, T's for C's are a main one, he calles Callie Tallie for example.

    I am a huge supporter of getting kids evaluated and help if needed. I think by helping them and being proactive early when they are able to learn faster, it will definitally be an advantage later on.

    Please feel free to PM me with any questions, I have been doing OT, PT and speech with Steven since he was 2 months old and we just transitioned from EI into the school system (which is a PITA to work with)
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  • sarah42sarah42 Posts: 4,034Registered Users
    I don't want to sound skeptical that needs speech therapy, because I do trust our pediatrician and her opinion. And I did make the decision to have him evaluated before based on my own concerns about his speech. I guess I didn't think that he would have a not significant enough delay a few months ago, but could be eligible now. I'll see how it goes.

    I hope the school district won't be a PITA to work with, but I'm not too optimistic yet. Their first available appointment was in February, which I took, but it conflicts with my work schedule. If I'd tried to wait for an afternoon appointment, they couldn't see him until May. Ugh. I guess the schools and everyone are facing budget crises.
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  • SigiSigi Posts: 2,379Registered Users
    Preston was in speech therapy when he was 2, and received services through early intervention until age 3. Right before they turn 3 they go to be evaluated by the school district. His speech therapist and the leader of his EI playgroup met at the appt to discuss his behavior more than his speech at that point. He didn't qualify for services with the school district because his speech was where it should be, but where we had behavioral concerns the psychiatrist said he was exhibiting normal behavior that he'd grow out of. I wish I had pushed a little harder because he's 5 now and he's uh, a very interesting little boy.

    You are your child's best advocate, so if you're feeling iffy on his speech then really push for it at the evaluation with the school district. If he turns out to be within normal range, see if you can bring him back at age 4 for reevaluation.
  • kathymackkathymack Posts: 9,999Registered Users Curl Neophyte
    It's in everyone's best interest to remediate issues earlier, rather then later. That being said, most speech articulation problems correct themselves, which is why they don't provide therapy unless the communication skills are delayed by so much. In my former district (and I believe most), kindergarten students were referred by teachers (a parent could also refer) if their speech was below what they considered the norm for incoming students. Everyone was screened in first grade because that's the time that most of the sounds should be intact. I've been retired for almost six years, so forget the last ones to come in--I know that "r" is one.
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  • cosmicflycosmicfly Posts: 1,814Registered Users
    The criteria to qualify for speech therapy in the 3 to 5 program are different than for early intervention- in New York, their score needs to be below the 10th percentile in any one area of speech or language- receptive, expressive, articulation, etc. If the score is, say, in the 11th percentile and the evaluator is concerned, she can also make a recommendation for therapy, but the comittee can deny the service.

    Many of the sounds you said Connor has trouble with are sounds that are later developing. Errors on th for example, can be present until 6 or 7. Some kids, however, make errors on lots of sounds and even if they are later developing, it makes them hard to understand.

    Even if he doesn't qualify again, the evaluator should be able to make specific recommendations for things you can do to help his speech sound development.
  • mad scientistmad scientist Posts: 3,530Registered Users
    I don't have any advice, but I'm following this thread because we're about a year behind you on this issue. Sandhya is 2 and has a couple of words. We are in the process of having her hearing tested - which is really hard to do with a 2 year old since they are notorious for selective hearing anyways. There is a decent probability that she will be getting ear tubes.

    So can I ask some questions here, rather than starting another speech-related thread:

    Is anyone familiar with the "Hanen: It takes two to talk" program? Its offered through our EI program and on our consellor's recommendation DH and I are going to be taking it starting next week.

    Has anyone's kids had ear tubes? How was that experience?
  • cymprenicympreni Posts: 9,609Registered Users Curl Neophyte
    I think the school might be easier to get then EI. It's in their best interest that kids be able to communicate clearly.

    Kade's pronunication and sentencing is up to par, vocabulary above average. yet, the school has not even considered dropping ST services yet. His communication, understanding and social skills are still not age appropriate. Talking to him is like talking to the intelligent articulate toddler. He still has difficulty responding to questions. and as far as having a conversation, forget it. He talks about what he wants no matter what. You ask about school, he talks about transformers. So they help him with that. They take a few kids in with him just to help him with social stuff.

    They didn't take this stuff as seriously before autism awareness and i had ST in school until the 5th grade until my pronunciation was perfect. And my school district wasn't that great.


    mad scientist: There is another hearing test they can do that circumvents their selective hearing. It requires sedation and special equipment, so they try easier ways first. What they do is pretty much give them something to drink that makes them sleepy. Then put things in their ears that makes the noise and measures the vibrations in their ear drums. it requires no participation of them then to take a nice nap on your lap. Oh and of course the food restriction for the sedative, but places usually schedule kids early for that. The only discomfort would probably be your own from holding a sleeping toddler for so long if you don't get the right position. The whole thing only takes an hour or two depending on how long they sleep. We spent more time in the waiting room.

    They loved Kade. He stayed asleep the longest they ever had and they were able to do test they never had the chance to do before. They were very excited and everyone was bragging on him and telling how great he was. he looked so confused. I could just see him thinking all I did was take a nap???
  • kathymackkathymack Posts: 9,999Registered Users Curl Neophyte
    Actually, it's easier to get EI services then school aged services--at least in my experience (over 25 years as a Sup of Special Ed and Elementary Principal.)

    Once a student is eligible, they won't exit them from services until they feel they can't progress further. They wouldn't have to meet the qualification for eligibility at this point. For school aged services, the service is supposed to be "educationally relevant." In the past, services were given for any student that had just about any issue. Now that the $$$ are tighter, I think they are enforcing the "educationally relevant" a little more.
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  • elitaelita Posts: 402Registered Users Curl Neophyte
    I work in EI (not in speech, but at this age the areas all overlap :)). Unfortunately not every child that has a delay is eligible for services through the program. Birth to 5 programs are federally mandated and every state has a different interpretation of the law and who qualifies. These are programs funded by the government and there is just not enough money to service every child who is referred. And yes usually the requirements change once you move from the birth-3 to the 3-5 program.

    If he does not qualify for school services and you're still concerned I would recommend looking into private outpatient speech therapy. This is medically based and so any delay would qualify. If your pediatrician recommends it, there should be no reason why your health insurance would not pay for it.

    It sounds like your area has a very strict eligibility requirement and unfortunately it means a lot of children are not getting the help they need. A 50% delay is actually quite significant as a child gets older. A 50% delay at age 4 months means a child would qualify if skills were at or below a 2 month level, but a 50% delay at age 3 means a child would only qualify if skills were at or below an 18 month level. :cry:

    @mad scientist, the Hanen program is a parent training program and should give you some great ideas to encourage speech. We use it a lot for families when a child has a mild delay & doesn't qualify for services. My own kids have not had tubes but from experience with my little ones at work, I can tell you that when needed tubes can work very well for all areas of development. The recover is only a few days and speech, balance, bahavior and ability to focus usually improve very quickly.
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  • cosmicflycosmicfly Posts: 1,814Registered Users
    kathymack wrote: »
    Actually, it's easier to get EI services then school aged services--at least in my experience (over 25 years as a Sup of Special Ed and Elementary Principal.)

    Once a student is eligible, they won't exit them from services until they feel they can't progress further. They wouldn't have to meet the qualification for eligibility at this point. For school aged services, the service is supposed to be "educationally relevant." In the past, services were given for any student that had just about any issue. Now that the $$$ are tighter, I think they are enforcing the "educationally relevant" a little more.

    I think this used to be the case; however, EI criteria have become quite strict. In NY, the child has to demonstrate a 25% delay in 2 developmental areas or a 33% / 2SD/ 12 month delay in 1 area to qualify, and Sarah posted that in her state the numbers are 33%/ 50%. Also, to qualify for speech under EI, the child now has to demonstrate delays in both receptive and expressive language, whereas the school district will provide speech for just articulation or just an expressive delay, for example. It's true that they are pushing the educationally relevant thing more, but for a preschool child, not being abe to communicate effectively for whatever reason generally qualifies as educationally relevant IME.

    @MadScientist- I like the Hanen program- I think it does a good job of showing parents how to encourage the development of their children's communication skills. It's great even if you're abe to work with a speech pathologist- your therapist will only spend an hour or two a week with your daughter, but you're with her all the time. I see significantly more gains in the communication skills of my kids who have parents/ caregivers who ask for and use my suggestions on a regular basis.
  • deezee02deezee02 Posts: 1,509Registered Users
    MadScientist- Steven had o have his hearing tested every 6 months for 3 years due to being on life support for a few days. He was never allowed to be sedated for it (due to his heart), so we went right into the big kids room.

    He would sit on my lap and they would play the sounds in the room, when they looked the right way, a light would flash (they had a mickey mouse and pooh in one of the rooms for example). At one point they would have to put plugs into his ears for a minute or so, and ear phones for a bit but they had toys for him to play with.

    We never had a problem, they were all really good and used to working with kids.
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