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Behaviour/development

Worried about speech delay

81 replies

WelshJoB · 05/08/2013 22:58

My lovely DS is nearly 25 months and is still not talking. He's been saying Mama and Dada for over a year, makes animal noises, brrrmmm, choochoo etc, but nothing more. He babbles constantly, and is very assertive when he does so. I'm sure he's convinced he's chatting! He also says "mama oh", "dada oh" a lot, as if getting our attention. I keep being told not to worry, but it's breaking my heart at the moment. He has great understanding, but answers all questions by pointing! Waiting for a SALT referral. DH didn't speak until 2.5yrs. Starting nursery for 1 day a week in Sept. Just need to know whats going on really so I can deal with it, and stop crying myself to sleep ...

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NigellaEllaElla · 05/08/2013 23:12

Hi there, I could have written this post about my ds3 who is 24 months. He is exactly the same. Chunters and babbles constantly but just baby noises and all he says is mama, fankoo and gone! When I try to encourage him to say more he clams up totally. I am starting to worry a little bit now BUT know someone will be along any minute to tell us not too and that they will do it in their own time etc. Who has suggested SALT? I would have thought way too early for that and the fact they are babbling etc shows good use of mouth/ tongue for word formation.

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confusedofengland · 06/08/2013 08:07

Just want to say that I think you are doing the right thing by getting SALT referral. They take ages to come through (4 months in my case) & if you don't need it as the appointment draws near, you can cancel. Have you also asked to be referred for a hearing test, to rule that out?

My DS2 is nearly 28 months & has his SALT assessment today (I am so nervous!). He has about 10 words & quite a few animal/vehicle/general sounds. He had his hearing tested & fluid was found leading to some hearing impairment, they believe, but he has to be tested again. I am glad that I have taken action early, I asked for both of these referrals at his 24 month check, because even though he may well progress on his own, if he doesn't I am giving him all the help I can. I liken it to a broken leg - you wouldn't leave that, so why leave a speech delay?

We also found that going to nursery 2 mornings per week has helped with DS2's language development greatly - not talking as such, but he now understands a lot more, does actions to songs more, points more - all of which, I believe, will help with talking eventually.

In the meantime, see if you can borrow 'It takes two to talk' by Hanen from your local library, it is very helpful.

Also, I have been given a few strategies from group speech therapy which are quite useful. Firstly, encourage any communication. If he points at a dog & says 'uh' say 'Yes, dog. Big dog. Do you see the dog' etc. Encourage him to make choices - eg hold up milk & water together & make him choose what he wants - this can be through pointing or touching his choice, the important thing is that he's communicating. Set up phrases for him to complete - eg with DS, when we're playing ball, before I throw the ball I'll say 'ready, steady' & won't throw till he attempts to say 'go'. Finally, singing really helps, maybe see if you have a singing group near you (most libraries run them in term times).

I know how worrying this is & I am right there, too, but I really believe we have to do everything we can to help our DC, plus it makes me feel more positive to think that I am doing something. Good luck!

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WelshJoB · 06/08/2013 19:45

Thanks both for posting - it's helped to not feel alone.
It was the HV who suggested a referral - we've been waiting for 4 months now. I think she suggested it because of the waiting time. I think our DS is very shy too - he often clams up when playing just with me and DH.
Confusedofengland - how did it all go today? Been thinking of you x Thanks also for the tips. We are doing much the same - constant questions (to which DS points or intonates), trying to get him to finish phrases etc. His words a lella (yellow) and purpa (purple) and rrr (red), so he answers a lot of the time with colours. Going to see if I can get the Hanen stuff as well. I read a bit about it lastnight. Have you tried any of the Sookie and Finn DVDs?
xx

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confusedofengland · 07/08/2013 09:26

It sounds like you're already doing a lot of the right things then!

I'm not really sure how DS's assessment went yesterday, TBH. The SALT said he definitely has a fairly severe language delay & that he may have some delay in his play skills as well. But she did say that as he has been on the late side doing everything else, he could just be a child that does things late & will catch up, as he has in other areas. We are having further assessments (4/5 sessions) in September/October, to determine whether this is the case or whether he has other delays too Sad

What happened was that she talked to me about a sheet of questions I had filled in about his general health, development & family history etc. Then she played a wooden peg puzzle with him - she had the pieces in a bag & he had to 'ask' for the next one, so this was assessing language & also eye contact when asking (DS looked at the bag about half the time when asking & half the time at her). Then she asked him to find some pieces from the puzzle board eg where's the dog, but DS couldn't do that. Next she had some play food & dolly & teddy & was asking him to give eg teddy an apple. DS knew where the apple was, but tried to feed it to the SALT/me rather than teddy, which apparently shows delayed play skills. However, we have never really played these kind of games at home as both my DSes like lego, trains, cars etc. When we got home I had dolly in a highchair & he was happy to feed her, put her to bed etc when prompted.

I am happy that he's having further sessions to assess, as I felt that he was not quite 'himself' in the session & he will do things at home that he didn't so much in the session- eg more eye contact, more pretend playing etc. I think I am just worried that he won't perform properly the next times, either, so I have started making a list of things he is doing that maybe the SALT didn't see him doing yesterday.

Anyway, sorry to ramble & I hope that has helped!

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Amiee · 07/08/2013 09:35

(This is a copy from a prev post of mine) I work as a SALT, and these are the kind of tips we give parents to encourage language in little ones.
-Offer choices. Milk or juice for example. Even if he just points you can use the opportunity to label the options. 'You want the milk' .
-use short simple sentences to provide a clear language model. (Think one word more than your child uses in a sentence) so if he is still at the one word level use 1 or 2.

  • sabotage. It may seem cruel but some kids wont speak if they dont feel the need so don't automatically open the toy box for him or you could leave a piece out if his puzzle on purpose. if he wants juice give him a tiny bit so he has to ask for more. Same thing works with biscuits, playdoh, bubbles etc. (if he doesn't actually say it but points or something say more or open or whatever yourself before giving it to him)
  • repeat yourself a million times. 'You want juice, here's the juice, pouring juice, mmm yummy juice'
  • don't ask many questions. It doesn't provide a good language model and it can be a bit testy for some kids. Comment instead 'Look a car' 'wow big tower'
  • speak for him when you know what he wants. eg when he is struggling to be put down say 'get down'.
  • pauses, young children can sometimes take a long time to process. Count to 5 in your head when your expecting him to say something to give him lots of time to give it a go. Look at him expectantly while you wait. For example after offering him a choice or at a key point in a book or song 'silly old fox doesn't he know there's no such thing as a ............. Wait..... look expectantly......(if he doesn't say it say it for him ...Gruffalo)' this also helps to build anticipation and auditory intrest.


You probably do most of this anyway but actively thinking about these things and doing them more can encourage 'reluctant talkers' to get to the next stage.

Hope it helps.
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Amiee · 07/08/2013 09:57

confusedofengland
Making a list of things he does well as well as things he doesn't its a great idea.

I also thought yoh might like some game ideas-
-Teddy bears/dolls picnic is a great game for early talkers. Lots of repetition. (Lets give some cake to dolly. Lets give some cake to teddy. Lets give some cake to cat.)
Plus the visual support is provided with the object. Great for the verbs eating and drinking.
-Bathing dolly in a bath with water in the garden (washing up bowl works fine too) get a flannel for a towl and you can wash and then dry dollys hands, feet, head etc lots of repetition again. Great for learing body parts and verbs washing and drying. This can then be repeated at bath time on him/her.
-ready steady ..... Go games (as described above) click clack cars or bubbles work well for this.
-making face biscuits. Get a big flat biscuit and spred icing on it then make eyes and nose etc out of raisins/Choc buttons.
-mr potato head.
-books, but instead of reading them just talk about the pictures pointing at them as you do it. The board books with photos like '100 first words' are good for this.

Sorry getting a bit carried away...... Hope these suggestions help.

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daytoday · 07/08/2013 10:57

Just wanted to say, I have a lovely 11 year old with a speech delay (a sequencing issue). He is an absolute joy. Because he found speaking difficult he has really developed his receptive skills (as in listening and understanding).

He is an understanding and thoughtful child and a really great friend. He is doing really well at school (so no worries there). I couldn't want a more balanced happy child. I put a lot of this down to having speech difficulties and speech therapy - he is very aware of what he says and how he says it -

I just wanted to give you some emotional support.

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confusedofengland · 07/08/2013 11:28

Thanks Amiee, it's good to have some advice from a professional. A lot of these things I do already, having been to a speech therapy group where we were given some tips, but I will certainly do the ones realting to pretend playing a lot, it is not something we'd done before really Blush

In your experience, do speech delay & delayed play skills go hand in hand? Or is it likely to mean something else? I honestly thought I'd come away from yesterday reassured, but I just feel more confused than ever Sad

PS Welsh sorry for hijacking your OP!

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LeBFG · 07/08/2013 13:49

Marking spot out of interest.

SOunds like my DS (28mo). Lots of words are just the first letter or an approximate noise - he puts them together now into two/three word strings. He understands very well. He doesn't seem to be very vocal iyswim. He's not very fustrated about his lack of communication.

Very encouraged by your post daytoday Smile.

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NigellaEllaElla · 07/08/2013 17:59

Just checking back in.

Spoke to my HV today cause this thread made me panic a bit and before this I wasn't and she said that they would not consider referring until 2yrs 4 months and usually only then if they aren't even making the sounds that form words (if they can make the sounds and babble a lot then that is a big positive). However she is coming out to see us in a couple of weeks. Then remembered my lovely friend was coming round today who is a SALT (forgot this as she is currently a stay at home mummy!) and she said her 1st DS didn't speak a word til 2yrs 4 months when her 2nd DS was born, that was almost what spurred him on to make himself heard. She was unconcerned about my ds3 as he is saying some words (about 5 I reckon!) and makes lots of sounds so I feel a lot better.

One great bit of advice though is that you do not have to be referred to SALT, you can refer yourself just by calling them up. She said not many people know this, I didn't.

Hope that helps!

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Amiee · 07/08/2013 18:51

confusedofengland
Yes delayed play skills and delayed language skills very often go together.
while there are many ways to stimulate play and language skills, and you will be helping him a great deal by taking the advice you've had from the salt, you should not worry about the lack of pretend play so far. It would be like the mother of a dyslexic child worring they hadn't taught them to spell enough. The child would still be dyslexic either way.

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WelshJoB · 07/08/2013 21:36

Hello all,
Great to hear from you all! Daytoday, thanks for your lovely post. Wonderfully reassuring and heart warming too. My DS is sensitive, caring and warm, and whether this is speech related or not it contributes to making him a very special little boy that I'm very proud of.
Amiee - great tips, thanks! As you said, we do a lot of these things already, but its helped focus me and DH again. My DS has really good understanding and sounds like your DC. LeBFG - lots of first syllables with us too (rrr for red etc), and is rarely frustrated by lack of speech.
I spoke to our HV today in an attempt to find out how long the wait is for SALT referral, and she's coming out to visit us tomorrow (apparently I'm known as an "anxious" parent!!!). She said that she knows from his 18month check that DS has good understanding and eye contact, so that reassures her. In her words a lack of understanding is more worrying than the lack of speech. Anyway, we'll see what tomorrow brings. DH is, by chance, around tomorrow, so will be good for him to meet HV and hear her thoughts.
BTW - went to library to try and get copy of "It takes two to talk", only to be told there's no copies left in the city, and its been assumed they've all been stolen. Nice, eh??

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SimLondon · 07/08/2013 22:52
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LeBFG · 08/08/2013 09:52

To the SALT lady - is it worth introducing signs at this age to reinforce the words they can't say yet?

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Amiee · 08/08/2013 16:53

LeBFG
I'm a BIG fan of sign to support early language development and IMO most kids will benefit. Obviously always use the language when you do it and give the language if they do it. The only time I'd say don't do it is if they are saying a word incorrectly and your deliberately giving them the correct pronunciation. If they say 'tat' and you say 'yes it's a cat' don't sign as it may distract from your lip pattern.

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Ellen7 · 08/08/2013 19:54

My daughter is 25 months not talking much and sounds very much like your DS with the hv checking back in in a few months. To be honest I'd never even thought about it being a problem til reading these kinds of threads. It's obviously not a problem for now if you still have to wait longer for any speech therapy as clearly there's no need yet, it's just a deadline that gets set. At the two year review the hv really didn't seem to think it's any panic yet, in fact I hate it when you get made to feel like you should panic about it x

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NapaCab · 09/08/2013 02:05

Great advice Amiee, thanks! My DS is 22 months and has about 20 regular words he uses unprompted and maybe 50 more words that he can half-say if prompted e.g. 'shah' for 'shark' on his T-shirt etc. It worries me though because most kids I know his age are saying words clearly, not babbling and some are even saying sentences like 'I give back' or 'I can do'.

It doesn't worry me hugely as he still has a good 6 months before it would be a developmental concern but I am just desperate to encourage his speech to relieve his frustration - and mine! Thanks so much for the advice.

Hope you get a SALT appointment or at least some reassurance from your HV, Welsh. I was also told by our pediatrician that if they are understanding well and can follow instructions that is more important than their active speech at this age. I'm clinging to that more and more!

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MaMattoo · 09/08/2013 02:24

I just saw this...if it helps at all my child did not say much at 2. Laughed like a maniac and clearly understood everything but chose not to speak much. 6 months down the line..he became a proper talker..and now at 3, I use neurofen to cope with the incessant chatting!!! Long sentences and crazy imagination.
I got good advice from the nursery (he's been there since he was 1yo). They said he is absorbing and processing and a lot if children do that. We also speak quite a few languages at home which so did not help him start talking early. And he used to talk/communicate a lot more at nursery as they did not predict what he wanted to say...which I constantly do did. Hth.

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LeBFG · 09/08/2013 13:30

Thanks Amiee. DS mispronouces most words however. I have taught him some signs (and Mr Tumble has taught him a few more). But I find he prefers to use the signs rather than say the word.

For example, he can say 'yes' but 9 times out of 10 he'll sign it. He's used the 'more' sign since about 10mo - and now at nearly 29m he uses it exclusively and doesn't even attempt to make a sound to say 'more', not a grunt or any sort of syllable (apart from a whine/cry or sometimes the colour of the drink if that's what he wants more of).

DH says DS is lazy relies on the signs and that I shouldn't encourage him to sign Confused.

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Amiee · 10/08/2013 08:06

NapaCab yes there is such a difference between normal kids at this age it's hard not to compare. Your right to encourage these skills but try not to worry. It tends to be when kids get to 50-100 words that they start to put them together so he may be on the brink of this.
leBFG have you had a SALT and hearing assessment? It so hard to comment without seeing the child. Things I would worry about - words pronounced differently each time they try to say it. Only using a limited amount of speech sounds. Using a lot of back sounds (k and g). Getting the vowels wrong. Some areas offer drop in's so some one can have a listen to him. His language sounds fine (you said he's putting little sentences together) but you can get help just for the speech sounds side if he is very unintelligible but its common for young ones so I'd have to hear him. I understand his DH not wanting him to sign but i think at this stage is important to encourage his language and communication using all methods available to him (Not all salts agree with this).

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LeBFG · 10/08/2013 13:54

Thanks again for the reply Amiee. Very kind of you.

We're not living in the UK. At his 2 year check the paed. wasn't too worried as she thinks the second language will slow him down but to contact her if I had any worries in the year (will see her again at 36mo). Some of my worries are: how can he be properly assessed in English and any intervention will be in his second language. I also worry they will keep putting off intervention under the guise the two languages are slowing him down. I will phone her next week and see what she says.

Wrt the specifics, DS says a lot of sounds on front of his mouth 'green', 'shoe' and 'down' are ones he prounounces well. ALthough he says 'green' and 'go' there are very few g words and no k words at all. He gets vowels wrong though - 'dado' for red Confused and 'da' for stairs for example. Once he's fixed on a way of prouncing a word he sticks with it (it took forever for him to drop 'wawa' and say 'daa' for duck).

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Amiee · 10/08/2013 19:09

Two languages and two sound systems can take a while for some kids to organise.
Using lots of front sounds is normal and many typically developing children do it. Not using k does not worry me in the slightest. Being consistent is better than giving lots of different attempts but some inconsistency is normal.
It's really tricky to really give you and idea without hearing him and even then I'd probably need to input form a therapist who knows his other language because he may just be getting things muddled up.
However you do sound worried so, if it was me, I would ask for him to be assessed. If he has a disorder (I'm definitely NOT saying he has) then it would present in all his languages and they may offer therapy straight away. If he is just delayed in this sounds then they may just say 'wait and see' but give you some tips. Where I work we try to always assess both languages but in practice sometimes this can't be done. If there is no problem then great, you won't be wasting anyone's time even if it just puts your mind at rest.

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captainbarnacle · 10/08/2013 19:19

My DS2 was referred to SALT at 2.5yrs. He only went twice. DS3 is also 25m old and HV will see him again at 2.5yrs as he only had 2 words at 2yr check. He can now say Mama and uh oh and oooose (shoes) and rrrrar and oose (juice). I'm not worried. He understands most things, is not frustrated, he babbles and points and joins in and tries. It will come.

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WelshJoB · 10/08/2013 20:21

Hello all, sorry for absence. So, HV came yesterday, as I'm an "anxious" parent! She was very non-committal, but repeated that DS has excellent eye contact and understanding, so she is not concerned about autism etc. But, he is painfully shy, and she wonders if this could be a factor. She also said that there is a 7 month waiting list for SALT referrals!! We're 4 months in, so will get a letter in Nov asking if we still want an appointment, so it looks like I'm just going to have to be patient. She did say that she's going to try and speak directly to a SALT about DS and try and get some more advice. Her only advice was to ask more open questions, although she recognises that DS has developed quite sophisticated non-verbal mechanisms for communication.
Captainbarnacle, thanks for post. I'm trying really hard to be positive like you! I think as DS is my first I've nothing to compare to and are led by the "norm", although I'm beginning to believe more and more that there's no such thing as a norm!!

I suppose perhaps the most important thing I should say is that I've had a fab couple of days with my wonderful DS who has been happy and laughing on a family outing and singing all day - I'm a little teapot, twinkle twinkle, old macdonald! He brings us all so much joy and is warm, loving, funny and clever - I'm thankful for being blessed with such a son, regardless of what happens with his speech!! xx

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captainbarnacle · 10/08/2013 21:11

Aw! He sounds delightful. I know how tricky it is to compare - DS3's friends are 2.5 and talking in full sentences very clearly. My 25m old seems like such a baby in comparison. However I know there is nothing seriously wrong - eye contact, babbling, understanding and communicating in his own way are all evident. He's definitely in our social world. He's just slower to talk. DS2 was the same - he's now nearly 5ys and has a fabulous vocabulary and has taught himself to read 3 letter words. Slow to talk is not related to intellect!

So me advice though - when Ds2 was referred to SALT, at the first meeting he asked if I had concerns about his hearing. I hadn't, but he suggested a hearing test would at least rule out that as a root cause of the speech delay. Maybe your HV could refer you to audiology in advance? Then when you got to SALT they knew hearing wasn't an issue? Am 'lucky' as DS3 was 2m prem, so automatically in the hearing programme as in NIcU for 3weeks. Initially they said he had congestion in his ears, but that had cleared up last month. So he's been discharged. But maybe the congestion was something to do with his delay. Who knows.

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