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Behaviour/development

2yo, speech delay, hearing test, various referrals... just want some experiences please

35 replies

jauntynomates · 19/03/2015 19:10

Will keep it as brief as possible for now as I could probably witter on!

DS 2.3 has been under speech therapy for 2 months, mainly group therapy, simple strategies at home. Generally given the impression it was nothing to worry about and delays run in the family.

Things are changing a little and it's just got me a bit confused. Went for a hearing test but he couldn't settle, he doesn't settle immediately in new places and they wanted him on one spot, low lighting etc, when the sounds started he couldn't take it. Stopped then and there and doc said not to worry, they'll book us in for a longer test slot to give him time to settle.

Got letter today for new appointment but he has also been referred to the multi agency team to review his communication and development. CM has just done 2yo review and physical development is strong but everything else he is down as 8-20mo, with one or two 16-22mo (following EYFS). We went through it together and I agree with the evaluation against the benchmarks. Also recently had 27mo review with HV and he is being referred to a team to get help with his concentration skills.

Concerns seem to be over lack of speech (not just speaking but also understanding), he understands a few words like 'no' and 'shush' and his name but associates pretty much everything by sight (eg gives us his cup when thirsty but doesn't understand the word 'cup'). He also has a short attention span often and flits regularly between different activities (1 min here, 1 min there), but does sometimes settle in for 10-20 mins on an activity.

He's otherwise gorgeous and funny and sweet Smile no problems with sleeping or eating and behaviour is generally good, occasionally throws something if he is upset but calms down very quickly and follows our instructions to behave (eg quiet, away, get down). He is independent and whilst he likes playing with others he doesn't tend to engage in structured activities (eg group play at CM's), instead he watches and evaluates whether he likes it and then will do it later alone if he does. CM says he is wary of new people, which is true.

We've generally felt that he is just a bit strong willed and independent - always has been! - but that otherwise he is just a toddler and has his own quirks. But more and more HCPs, childcare professionals and sometimes just random strangers seem to be leaning towards him having behavioural issues.

Have you had anything similar? Maybe it is just toddlerhood coupled with speech delay? Or even hearing? Getting a bit tired of people expecting my 2yo to be different.

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Ineedacleaningfairy · 19/03/2015 20:04

My ds is the same age, I opened your thread as I have a close friend who's child is starting to go through the process if hearing tests for her dc due to lack of speach.

My son certainly has the same attention span as yours, I think that quite often toddlers tend to flit from one thing to another, I read somewhere that you should expect a minute for each year of their life, so 2 minutes at 2 years old.

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jaybirdsinginginthedeadofnight · 19/03/2015 20:07

I will give you my experience as briefly as I can Grin

DD failed her 2yr HV assessment, she wasn't speaking, was showing no signs of imaginative play or shared interest, just happy to explore by herself and spent a lot of time just gathering toys and moving them from one place to another. She did not have any behavioural issues though. HV referred her for developmental assessment, we were very worried and if I'm honest devastated Sad That was April time.

On referral to the developmental team they thought her main issue was speech and we should take a watch and wait approach all while encouraging her speech. I bought the Hanen book it takes two to talk and threw myself into being amateur speech therapist. She started to say 'no'

DD started nursery in the June and a few more words came by Aug/Sep she had 10-15 words. As her speech developed so did her social skills. We haven't really looked back from there she has come on leaps and bounds. At her latest SALT appt they said she was a few months ahead in her comprehension but still 3-4 months behind in expressive speech. She'll be three next month and is a happy, funny bright little girl who just has some issues with her speech. It all came together she is just taking a wee but longer than others Smile I cannot believe the difference a year has made.

It is a worrying time when your LO gets referred for anything. The professionals we saw were excellent and really put us at ease Smile

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HiawathaDidntBotherTooMuch · 19/03/2015 20:24

I think that having multi agencies involved at this early stage can only be a good thing. If he develops in line with what is typical (and every child progresses at different rates, and it is not a straight line but a curve), then you will not need their help and they will withdraw it. So all good. But if he doesn't, you have people on board early. Which is what you would want.

I have a child with developmental needs and I am fighting like mad for those agencies to make him a priority. I am being fobbed off yo the extreme, and my child is a year older than yours.

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Jellyandjam · 19/03/2015 20:35

That's lovely to hear jaybird as I remember your posts last year on the speech thread. So pleased she has made such good progress.

OP- my DS had SALT and can only agree that early involvement is a good thing.

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jaybirdsinginginthedeadofnight · 19/03/2015 20:46

jelly thank you, hope your DS doing well too Smile

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Jellyandjam · 19/03/2015 21:00

He's come hem today with a speaking bit for his class assembly next week! Grin didn't think that would be possible a year ago.

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Jellyandjam · 19/03/2015 21:01

*home

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jauntynomates · 19/03/2015 21:24

Thank you all so much for your input. I agree about early involvement, I'm very grateful that we've been readily given referrals and appointments and such, if there's nothing they'll just discharge him but we're in there if need be. It's just the comments of 'he's very active, isn't he, he doesn't focus for very long' make me want to shout 'HE'S TWO!'. Hearing so often started to make me worry that maybe I'm not appreciating how 'behind' he is - to which DH promptly says 'nonsense! He's fine'. Grin

jaybird That's great to hear! DS has only been with the CM a short while but he has come on a great deal since he started, I think he's just going to be a bit of a late starter and catch up in time. Likewise with the SLTs, they're also working with his CM which is great.

Feeling a bit better reading the comments, I needed to know I wasn't crazy for thinking he is a fairly normal toddler! He has a speech delay which I've known for a while, CM thinks the lack of understanding and expression is why he grades lower on the other EYFS areas and I'm inclined to agree, my instinct is that he doesn't have behavioural problems although it's always possible there could be some hearing issues.

I should stop before this turns into an advert for our CM! She is rather good.

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Orangeisthenewbanana · 19/03/2015 21:52

Read your OP and it really hit home to me. My DD is 2.2 and like your DS is generally very well behaved, good eater and sleeper but I have been a bit concerned about her speech for a while. She understands a lot of words/instructions, will recognise objects/animals/colours but doesn't speak much at all. She babbles away in nonsense speak all the time but doesn't use a lot of recognisable words and doesn't put more than one word together.

She is also quite independent and shows no real interest in going and seeking out other children to play with, though she's more than happy if they come to her. Physically she scores highly on the EYFS and nursery haven't highlighted any concerns but I just see how a lot of the other kids her age are, and can't shake a nagging feeling. We're still waiting to hear from the hv about her 2 year check but now wondering if I should chase this?

She's just so much fun and gorgeous and we spend so much time interacting with her and reading to her, it just upsets me that she might be struggling Sad

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jauntynomates · 20/03/2015 14:22

Orange "I just see how a lot of the other kids her age are" This is it! I keep seeing 2 year olds who play in groups, are relatively calm and quiet, sit and listen to a story, but DS just isn't like that. So it can start to be worrying when you feel like your child is the odd one out! But I think it is just him, his personality, and he'll catch up eventually. We'll see how everything goes with the various referrals and I'll try to remember to update Smile

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DeeWe · 20/03/2015 14:47

He isn't the odd one out in reality. More perhaps that people with parents that have the calm quiet ones tend to take them to such places.

I have 3 dc. All aprented roughly the same.

Dd1 would sit happily through something like a wedding with a colouring book/lift the flap book from 15 months. Never a peep out of her if we explained before hand. And she was quite happy to play with a book.

Dd2 wouldn't have sat at 15 months, but would have by 2yo, although perhaps not as long even then.

Ds would have thrown the book on the floor at gone off to find something more fun (ie active and preferably noisy) at 4yo. I didn't take him to a lot of the places I took dd1 and dd2 simply because it was agony for him trying to sit still and he didn't enjoy it-and agony for me knowing that I would spend most of the time either trying to keep him quiet or chasing him to come back. Grin

Ds does have hearing issues, he's done hearing tests from about 3yo-they tried before that but weren't too worried that he did one or two sounds then decided a more entertaining use of the bricks he was meant to be putting into the box was the build them into a tower and knock it down. They said that was fairly normal.
In fact it wasn't really until he was about 5yo and they decided to use the button to press he's really done them properly. They told him he was a pilot and pressing the button dropped a bomb... and he loves that so does it very enthusiastically. (this was after they'd asked him what he was interested in and he talked about WWII and planes)

He's 7yo, and it's only in the last year that I;ve been able to relax at things where he needs to be quiet and sit still.
I make sure I explain beforehand what is expected-because once he's there he can be too excited to listen. I have a treat that he was have while he's being quiet-and if it's very important to keep him quiet, also one he gts at the end if he's been good.
If he is noisy, I remove him, as once his concentration has gone, it's hard to get back.

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jauntynomates · 20/03/2015 15:46

Thank you DeeWe, you're right about the type of activity attracting certain types of children, I hadn't thought of it like that. We don't take DS to the library story time because he just doesn't do sitting and listening, but the CM takes her group every week (she has a set timetable of activities for every day), and she has noticed that he is just not keen on it. However he will wander around the children's section, look at books, and do his own thing without running or being destructive. Occasionally he tries to climb so she has to bring him down! But he's otherwise fine, just doesn't want to sit with the others quietly and listen to the story.

On the other hand, he can do sitting quietly in the pram with a book in certain contexts. Weddings and similar, yes. Out and about, nope, he needs to be out too! So for us we think he's very good because he will be calm and quiet in appropriate situations the vast majority of the time, but when he's in new and interesting places or surrounded by other children then he wants to play and explore. That seems reasonable to me but the local HVs and HCPs have this idea that he is in the minority. I don't tend to pay much mind to them Blush admittedly, but, now that he is being referred by SLTs and paediatricians I am more trusting of them and wonder what they see in him that means they want to do more tests and observations.

We had a home visit today and DS was really unsettled for the first 10mins and then was fine. He knows the person very well, but he has these associations that I'm noticing - certain people or things are for certain places or activities. They've never been here before and that just kind of threw him off and made him upset. After he got used to it he was fine, saw them off at the door and waved goodbye (big step for us! He only recently started waving bye), and when he sees them in their setting he is always fine and happy.

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Orangeisthenewbanana · 20/03/2015 18:04

DD loves books luckily and will happily sit at home for 20-30 minutes or so, reading together. She'll also just go and grab a book at nursery, sit by herself and mutter away while turning the pages as if she's reading to herself Grin. She sounds the same as your DS when out and about jaunty. At library rhyme time she'd rather be pottering around exploring, but isn't badly behaved. She just always seems to be totally focused on what she's interested in at the time, and doesn't really care what's going on around her. Same when out with other friends with kids. She doesn't give a hoot what they're up to most of the time, and just heads off on her own to what interests her.

It's funny isn't it that traits like independence, which would be admired in a adult seems to be something that HV's worry about with toddlers! Confused

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chocgalore · 21/03/2015 20:04

OP, my DC was like that at two. For us the big red flag was at that stage the lack of understanding. Speech delay is apparently pretty common but most children with delayed speech have usually still good understanding. My DC had only little understanding. We have now a dx of autism. Not saying this is the case with your little man but this was our outcome of similar referrals at that age.

good that you have all the referrals in place. Hopefully all is we but if not then an early dx and early intervention can make such a difference.

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howtodrainyourflagon · 21/03/2015 20:29

My dc was like that at 2. He had severe glue ear plus scarred eardrums from repeated infections. He's now in y4 and fine. He made a lot of progress very quickly once he'd had grommets put in.

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jauntynomates · 22/03/2015 00:25

Thanks for the recent responses, it's helpful to see the wide variety of possibilities and experiences, it is keeping my mind open. I am glad that we are getting all of these appointments and referrals now, so that we can make sure how DS is doing and find out if there is a delay, a physiological problem or if there are any other possible factors, rather than just waiting and seeing or hoping that things will change.

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jauntynomates · 27/03/2015 00:17

Just updating in case it may also be of use to others, input still welcome of course Smile

Had follow up with SLT today. DS has a couple of words which he is starting to use more regularly so that's some improvement, generally context reactions/expressions - eg 'oops', 'oh no'. He is also starting to display greater frustration when he can't do something or communicate effectively. Our CM is great and had the SLT at her setting to observe DS and give tips on what she can do, SLT has given us some extra tips too based on her observation and is giving a plan to the CM. DS is being transferred to one-on-one therapy as previously he was in group speech therapy and made a little bit of progress but isn't where they would want him to be so that will start in a few weeks.

We are going to try his hearing test again next week and waiting on the multi-agency follow up within the next few weeks. Feels very much like all professionals involved are on the borderline, that it could just be speech delay, or there could be something more to it, all very nice and friendly and supportive so that we don't worry, but I'm not concerned for him, I just want to make sure we support him effectively especially to try and overcome frustration (as that has now led screeching rather loudly Confused).

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MiaowTheCat · 29/03/2015 12:09

This reply has been deleted

Message withdrawn at poster's request.

DimpleHands · 29/03/2015 20:25

My DS (2.4) sounds very similar and he has a diagnosis of autism. I knew something was "off" though from about 12 months and I would say the huge majority of time parents do have this gut instinct if something is wrong. So if you feel he is just a little behind and that there isn't anything really wrong, then that probably counts for a lot!

Might be worth doing the MCHAT test online though (you can Google it). I imagine that ASD is what the specialists might be considering in the assessments so might help to be prepared.

I don't want to worry you though! There's every chance he is just taking his own sweet time and even if it is ASD, it is an incredibly broad spectrum.

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jauntynomates · 29/03/2015 23:08

Thanks again, that's the thing Dimple, my instinct is delay as opposed to anything longer term, although I won't be stubborn and say it is if I'm wrong! I didn't know about the MCHAT so I've just done it online, thanks, it gave a result of 'Risk for Autism', the questions it followed up on after my initial answers were all ones relating to communicating with DS (eg if he understands words without gestures or showing him something).

I've just discovered that our appointment this week isn't just for hearing but is also with the developmental paediatrician, I think that must be part of the multi-agency referral, the letter says it could last up to 3 hours so it's really good to know that we'll have a good opportunity to find out more. Our CM also feels like with greater communication ability he will catch up on other things, having had him a few months and observing and assessing him, so with his new speech therapy plan in place this should help to continue the improvement. We'll see how things go Smile

He has also started to more consistently wave goodbye and say 'hi' (yay!).

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Pomegranatemolasses · 30/03/2015 18:53

He sounds like Ds2 who had severe speech and language delay and was wry frustrated. He did catch up by age 4, and came on in leaps and bounds. He continued to have a very hyper and easily distracted personality, and has just now at age 12,been diagnosed with adhd.

Not sure if this has any relevance to his earlier speech delay.

Best of luck with Appointment.


















stros

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Pomegranatemolasses · 30/03/2015 18:55

Sorry phone temperamental!

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jauntynomates · 31/03/2015 10:56

Thank you Pomegranate, that's interesting to know, a lot of our tasks with SLT are around maintaining his focus. They said in basic terms it goes attention > understanding > expression (there were actually 4 but can't remember the 4th! Blush ). So I guess it wouldn't be surprising if there is a link between ADHD and speech delay, certainly in DS' case they feel that when he starts to focus he picks up a lot more so all of our strategies are geared toward maintaining focus, eg 5mins at a time.

Spoke with the centre that manages additional needs and disability in children here, that is where all of his appointments are, and we will be seeing the development paediatrician first and then going for a hearing test. Hoping DS will manage with the long appointments and new people Confused but looking forward to getting some feedback from them.

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jauntynomates · 31/03/2015 11:00

Also just wanted to say thanks to you all for sharing your experiences, it is good to know that with similar sounding traits there have been a variety of reasons but all seemingly with positive outcomes Smile I don't know anyone who has gone through these channels or worked in this area so it is very helpful to be able to hear from people that have.

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Pomegranatemolasses · 31/03/2015 14:06

Yes jaunty, DS2 is doing really well now - bright and very sociable. The adhd diagnosis has been really helpful. He's just started taking medication for it and I can really see an improvement in his concentration and focus.

Not sure why it took us until he was 12 to realise adhd could be in the mix - I think we just kept putting his behaviour down to immaturity, and the fact that he had had such a rocky start to life. I feel a bit Blush about our lack of awareness now!

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