Referal for speach and language terapy

[jenkins88]

Hi everyone.

My son who's 3yr 4mth old has been refered to a speach and language therapist. I received a copy of the letter that was sent to the clinic yesterday and I was a bit upset about what was written.

At the appointment where his speach problems were first raised I was a bit worried, but spoke to lots of other parents afterwards whose children had also seen a speach therapist. I started to think that it was just a slight hitch and would be fine after therapy.

The letter I got yesterday upset me because it seems as if they are saying that Liam is generally slow in everything. It mentions that he was a late walker (18 months), that he has single channel attention span and is very distracted. I don't know if I am being over-sensitive about this, but I'm so worried that this will lead to learning difficulties when he starts school.

I was aware that his speach was delayed and have previously asked his hv about whether it was a problem. She always reassured me that he was age appropriate and said she didn't think it was a problem.

He only ever pronounces the first part of a word. eg. dog - do, horse - hor. He can't say any words with the letter L in, which really upsets me because of his name. We have started calling him Lee all the time to make it easier for him but he pronounces it as Yee. He also has problems with vowels. Milk - mook, bye - bar. Has anyone else had any problems like this? Or does anyone have any experience of speach and language therapy for pre-schoolers.

Liam starts nursery in September and I'm really worried about it. I was told by the person who made the referral that it's important to get help immediately because otherwise the other children will exclude him from play. That broke my heart to hear that.

I'm also having problems with potty training and teaching counting and colours, hence why I'm worried about him having a whole host of other problems waiting for us. I keep thinking that the school are going to tell me that he's got problems when he starts at nursery.

Any advice or similar experiences would be great to hear. So sorry that it's such a long post.

Jennie

[soapbox]

Jenkins - have you had his hearing tested? It could be the root cause of some of the symptoms you mention.

My DS(now 5) has had speech problems from a young age.

The speech therapy does make a big difference and hopefully your referral will get you started soon. Although you should be aware that in some areas the wait for SALT is very long!

'L' is one of the later sounds to develop so Liam is not yet behind in that sound. It is a hidden sound - in that you cannot see it from looking and watching someone do it. Some of these hidden sounds take longer to learn for some than others!

Can your son poke his tongue out, point it towards his nose, point it down towards his chin?? SOme children have slight dyspraxia of the mouth meaning some motions are hard for them to do. It is worth practicing these movements if he cannot yet do them. Can he hold his tongue up on the roof of his mouth behind his front teeth? This is where teh L sound is initiated from, it is a downward flick from there. Again if he cannot do this then practice a bit with him.

When you are in speech therapy it will be crucial to practice lots and lots with your DS. AN hour a week is not going to cure the problem so you do need to be very committed to putting in teh hours at home!

Good luck - I hope you see a therapist soon and that they manage to put all this is perspective for you

[jenkins88]

He passed his hearing distraction test, but that was ages ago now. The person who made the referal doesn't think it is to do with his hearing because he could hear prople passing in the corridor outside and kept ignoring her to investigate. She was actually quite stroppy about it and was almost telling him off at some points.

I think one of the problems is that he does get distracted easily. We can't have the tv on when we eat dinner because he won't sit still if he see's something he likes. He's very exciteable as well and it's really hard to keep his attention for more than a few seconds. Teaching him right from wrong is a complete nightmare because he just won't listen and interupts constantly with bizarre sentances that either don't make sense or are irrelevant.

Today I got very angry with him. We've just had a new carpet laid in his room and we're trying to potty train him. He was only in there for a few minutes but laid on the floor and did a huge wee. When I went to get him out he was absolutely soaking. I tried to ask him why he didn't use the potty and tried to explain that he must not wee on the carpet but he wouldn't listen. I got to the end of my tether and put him in the naughty corner for 3 minutes until he was ready to say sorry. I felt really bad after because he probably thought I was punishing him for having an accident, but I was actually trying to get him to listen to me. When I went to get him he threw his arms round me and said sorry, but I know he didn't know what he was saying sorry for. He just said it because he knew I was cross with him. I tried to explain again, but then he started talking about cars and bears and balls. Sometimes he comes and finds me and talks for ages about kicking a ball, and I can only understand a tiny amount of what he is saying.

Sometimes I feel like he isn't progressing at all and just doesn't listen to anyone. I'm dreading him starting school because I can't imagine him doing what the teachers tell him to.

Thanks for the advice on the L sound. I'm not really worried about that now. We have tried to show him how to use his tongue to make the sound and if he tries really hard he can make a kind of L sound. I think I will leave that one to the speach therapist now that I know it's one of the last sounds to be learnt anyway.

I'm not sure how much of this is normal 3 year old boy boisterous behavour. Sometimes I think he has ADHD or something. I think if he would just listen then he'd learn so much. Do other's feel this way too?

The other issue raised was the way he constructs sentances. Like he will say 'you ope me' instead of 'you open it for me'. Part of me feels that she is expecting a bit much from a child who is not yet 3 and a half, but I know from listening to other children that Liam does have some catching up to do.

I'm so sorry that these posts are so long, but I'm so worried and really need to hear what other people think. I have tried talking to family and friends but I think they find it hard to give an honest opinion. They tend to just brush it all under the carpet and say things like 'He'l get there in the end'. I just think that I would probably make the same comments to someone who came to me with something like this without really thinking about it.

Thanks for reading
Jennie

[jenkins88]

Sorry, one more thing.

Soapbox - I am trying to help Liam at home but apart from what I just described below about him not really listening to me, I'm a bit worried that I'm overdoing it with him and making him feel self conscious. How much home practise did you do with your little one? How is he doing by the way? Thanks so much for replying. Maybe it's just me but in real life it seems like everyone just wants to boast about their perfect kids. It makes me feel really low to hear about kids who walk before a year and can count to 20 by their second birthday. We have friends who phone us and get their kids to sing nursery rhymes. Then I spend the next week trying to get Liam to learn them too. Everytime I sing now Liam puts his hands to his ears and says 'No sing'. I think I push him too hard sometimes, but I just don't want him to get left behind.

Jennie

[baka]

does he point?

Have you tried fiish oils? Very good for attention problems. I'd avoid mini-iQ though as they seem able to make any hyperactivity worse; efalex or eskimo kids are good though.

[mizmiz]

Jenkins,sorry that you are so worried.
i am a speech and language therapist,also the mother of a daughter with communication difficulties,so have a foot in both camps.

We deal with two issues. The ability to make sounds and form words correctly (speech) and the ability to construct clear and logical sentences and to understand what is said (language)

This is a simplified version of our work,but for your purpose it is all you need to grasp at present. It sounds like your little lad has some difficulties in both these areas. Firstly,don't panic!! One in ten children (and they are usually boys) have some sort of communication issue.) it is good that he has been referred and your salt will help you. Not sure about the pereson telling you that other children will exclude him from play,very insensitive of her,and certainly not necessarily the case.

The things you are doing,like not having the tv on when you eat,are great.At the moment,the most important thing you can do with him is give him a great deal of attention and to play,play,play,play,whether it is walking in the park,messing about with teddies and teaparties,playing with paints,or reading books. Forget about ctrying to teach colours or numbers for now. People do get fixated on these but at the moment there are more important things to worry about.

If you search the archves,you will find more tips from me (Mizmiz),also Mogwai (another speech and language therapist). There is also loads of good advice from the very well informed people on this thread.

[clary]

Oh jenkins I was so sad to read your posts and felt my heart go out to you and your ds, so I wanted to reply tho I?m not sure I can be much help.
Firstly you are right to try to push for some action and help for your ds. I feel very strongly that guidelines of what a child should be doing when are there for a reason and children who don?t achieve them should be given help, if appropriate. Saying ?oh, he?ll get there in the end? is often just not helpful (not saying of course that every late developer should be rushing to the GP).
My ds has delayed speech in some ways and has been having SALT, agree that you will need to do lots of practice but it does help. MY ds?s delays are to do with C and G sounds and some blends, but I had to fight against therapists saying his delays were normal etc, so good luck with what you are tryign to do.
Don?t worry about SALT marking him out, it will really help and if he can communicate and be understood by others he will get on much better.
IKWYM about perfect kids, my ds1 is at school and it sometimes seems liek everyone else?s kids are reading geniuses etc, but hey! we all have our strengths. MY ds1 is a fab eater and loves fruit and veg (as do my other 2) and all 3 are good sleepers. I count my blessigns every day.
Is your ds yr only one?
I would follow others? advice here about checking his hearing, also look at his diet. Does he eat well, or a lot of processed foods, as that can affect behaviour too.
Good luck and keep posting here if it helps.
Cx

[clary]

sorry my post was a bit hard to follow, jumping around from one notion to another. What I was trying to say was that although your ds sounds like he has some difficulties, I am sure he is good at lost of things too. Mizmiz is right about lots of varied play for him, what does he like doing best?

[soapbox]

Jenkins - we do a little practice every night. Even at 5 this shouldn't last for longer than 5 minutes and is often much shorter.

We also use his reading practice as another way of getting some speech practice in. Pointing out the blends in the words, so that play is not pronounces as pay, for example or truck as tuck.

The trick I have found is to be ever so subtle! Instead of correcting him in everyday speech I will often just say, sorry I didn't catch that word and he will say it back to me properly.

I think the most important thing is to be extremely low key about it all Easier said than done, I know. Children with speech problems get incredibly frustrated at their inability to communicate at times, and I don't think its fair to add parental pressure to their list of worries!

[coppertop]

Hi Jenkins,

I have 2 boys. My eldest started speech therapy at around 3yrs old . Each child is different of course but he went from having no words at all until around his 3rd birthday to being at a similar level to his peers by the time he started school a year later. I can honestly say that in all his time at pre-school he was never excluded from play by other children. If anything they seemed even more keen to try to play with him.

My youngest son is 2.3yrs and is having speech therapy at the moment as his language development is disordered. He now has quite a few words but a lot of these are unclear or he says only the second half of a word, eg "crocodile" = "dile". We see the speech therapist once a month and she gives us advice about games to play for the rest of the month. It is very reassuring to have someone to talk to each month about ds2's progress and also a good indicator of how much he has learned over the month since the last appointment.

My eldest used to hate people singing to him and stuck his hands over his ears. I found that it helped if the person sang in a deeper voice as that seemed to be so much easier on his ears. Ds1 is still very sensitive to noise and will block out other sounds/voices when the television is on. Another tip is to say your son's name at the beginning of each sentence rather than the end. That way he will realise that you are speaking to him and may be more likely to listen to you.

[mizmiz]

jenkins,would agree with soapbox on being very lowkey. You can model the sort of things you think he should be saying by talking to him in clear simple lively language-keeping up a copmmentary on what is going on around you for example,how ever dull it seems to you.

eg 'Ooh ,look an aeroplane! Isn't it big? See how fast it goes!!! Up and up and up.Now it's gone!'

Generally speaking,inability to make 'correct' speech sounds (particularly at a very early age) are far less of an issue than whether or not the child appears to be understanding you,or is able to concentrate or focus attention for short periods of time.
Different sounds will appear at different ages.Massive amounts of research have been done on this,and salts have all this info. to hand.
Clary,of courseI dont know your personal circumstances,but no salt would be telling you that your son's speech delay was normal unless that was the case.often therapy is unneeded or inappropriate,and we have al ot of dealings with parents who don't want to accept this. Hard I know,but if this is the case,try to listen calmly to why they believe this is so.

I had a couple of years dealing with the mother of a young man with Down's Syndrome with very disorderd speech. She was unable to accept that the amount of work we and he could put in was not worth the miniscule improvement he would make. It wasn't actually that much of an issue-he is confident,sociable and very independent.Inthe end I actually had to put the poor lad through a bout of intensive therapy (which he hated) in order to prove to his mother that I wasn't making the decision to kepp him off my waiting list,rather I had made a clinical decision with his best interests at heart,after weighing up all the factors.
Hope I haven't offended.

[jenkins88]

Hi everyone

Thanks so much for your help. It's great when people take an interest. It really makes me feel better to hear how common speach problems are. Not that I like to hear of other children having problems, but just hearing about how perfect other people's children are makes me feel excluded.

Liam does point at things or says 'I show', and leads us to the item. This worry's me a bit because I don't want him to get used to gesturing rather than speaking. I think he does it because he finds talking so frustrating as we only understand him half the time.

Is having speach and language problems an indication of low intelligence or attention disorders? I suppose it's this thought that is bothering me the most at the moment. I have found that the best time for learning with Liam is when we are out walking. He seems to be very interested in things that he see's and more willing to talk. At home he talks alot, but I'm not sure that he is even making sense to himself. He babbles all the time even when he's alone. I hear him talking to the tv and to his toys. He talks to himself a lot as well, but I'm not sure if he's just making sounds or actually talking.

Liam is an only child and we don't have a very good diet at home. I do put vegetables on his plate but he always leaves them. Sometimes he will try a bit but he turns his nose up and say's 'yuk'. Does anyone have any tips on improving his diet.

I will check previous threads for info on speach therapy. At the moment I want to know everything about it so I am prepared for what is to come. Does anyone have any idea how successful it usually is, and how long it might take to sort out his problem?

Thanks for reading
Jennie

[littlerach]

DD1 was referred at 2.9yrs, she had disjointed speech, and couldn't pronounce many sounds, incomprehensible to most people. It has helped her immensly, she is now 4.2 yrs and almost on a par with her peers. She is still disjoinred in speech but has most of the sounds fine.

When we first went I was so concerned about her socially as I too felt she would be left out - so not true! Children communicate with each other in many ways, not just speech. And at pre school the staff have never had a problem, they may not always have understood her, but they have managed to communicate fine.

Our SALT has actually said that when DD1 starts school, she shouldn't need any more help, something I never thought!!

You do have to put in a lot of work at home, usually your SALT will give you games to play.

I am not aware of a speech problem pointing to lower intelligence, I guess it can come with other problems and disorders, but each child is different in their needs. DD1 couldn't sing any nursery rhymes a year ago, now she can do most of them. She can count and knows her colours, and do it so we can understand!!

*It is worrying, but at least you are in the process of resolving it now, you'll get there!!

[mizmiz]

Glad you're feeling better, jenkins. Your walks sound really lovely, just the sort of thing to be encouraged.
Speech and language issues often occur separate to 'low intelligence' and attention disorders. They can of course occur in concurrence,but this is not necessarily the case. What I do know is that more and more salts are seeing children with attention and concentration problems which affect their ability to learn.

The causes of this are complex and not fully understood but there are two areas that are being considered.

First is the 'information overload' of today's lifestyle-tvs,computer games,radios,mobile phones (next time you're out,note how many parents are phoning texting when they are supposedly taking their kids to the park/out for a walk.) which, it is felt just engulfs a child so that they don't even know where to begin chanelling their attention as there is just too much going on.

This is where 'quiet time' can really help-turning tvs off for large parts of the day,cutting back on the all singing all dancing toys we are tempted to buy for our children,having a bedtime story and so on.

Secondly,as we are all aware,more and more people are realising that the junk a lot of our kids are eating isn't good for them,and in many cases is positively harmful. There is loads on this on MN. Try the 'Food' threrads. Hard to do if you don't eat such great stuff yourself,but as an salt,I would advise you to really think about changing the diet of your whole family if you feel it's not too good.

I am sure that a regular poster, Blossomhill won't mind me telling you that she has made some big changes to her family's eating habits which she says have really helped her (very bright) daughter who has a communication disorder.

[clary]

mizmiz yes of course you are right. Not really moaning about the SALT, but just I was sort of relieved a year later when he had made no progress to be told yes, there is a problem.
But also a bit annoyed as by then he was 5 and I haev read that SALT is more effective before that age! (sigh)
I'm not offended at what you say at all btw, alwyas glad to have any professional input and I take yr point absolutley.

[mizmiz]

clary,see why you were cross,of course.
Unfortunately, with the scarcity of salts around,we quite often have to take a 'wait and see' approach,known more formally as monitoring.
Usually,nature takes its course and a problem does resolve itself.

Your salt was probably able to discharge a lot of children similar in age to your ds at that time for this very reason.

Hope things are better now.

[assumedname]

My first dd had to have speech therapy. She was late sitting up, late crawling, late walking and late talking. And late potty training.

She missed the ends off her words and couldn't manage l and k.

I was advised (as mizmiz says) to limit TV (didn't watch a lot anyway) and we played table-top games, jigsaws say, so that she could hear me and see my lips clearly. When she was having therapy we did the homework every day according to the therapist's recommendations (just a few minutes).

She had no problems making friends at nursery and was discharged from the service within a couple of years.

[coppertop]

Language disorders are not necessarily related to low intelligence. My ds1 is a very bright little boy who is in the top group at school despite being one of the youngest in the class. Ds2 was assessed just after his 2nd birthday and according to the psychologist is at the level of a 3.5yr-old for non-verbal skills. It's not a boast but will hopefully reassure you a little that speech problems don't necessarily indicate low intelligence.

[jenkins88]

Hi, thanks again for all your positive messages.

Not sure if I've got this right. Parents with children who have been through speech and language therapy, have your children been discharged because they have caught up and are now communicating at a level approriate to their age? I keep thinking that the salt will be at the end of their tether after the first appointment and say something like 'There's nothing we can do for him'. I wish I could stop thinking like this and get it in perspective.

Assumedname - your dd sounds so much like Liam. He was late with everything too. I'm not sure how late your little one was but with Liam up until now he's done everything at the very last minute. It's such a wind up really because I worry myself sick that he's not going to do something like walking or potty training, so I try so hard to get him to do it. Infact the harder I try to get him to do something the more he seems to resist. Then just at the stage when I start to think he's never going to get it, he just does it with no problem at all. It's so great to hear that your dd has been discharged from the services now and is popular with her peers. I really, really want that for Liam. How old is she now, btw?

Jennie

[jenkins88]

Oh and coppertop, of course you're not boasting. I was just being bitter when I made those comments earlier on in this thread. Sometimes when I feel low I think that people are being deliberately cruel when they praise their children. I know really that they are just being proud parents, and I suppose that makes me jealous. Having said that though I do it too. I am so proud of Liams manners. Maybe that sounds like a stupid thing to be proud of but it makes my day when he always remembers to say hello and goodbye and never forgets his please and thank you's. When people comment on what a pleasant child he is I feel like my hearts gonna burst with pride. It is so reassuring to read all these posts. It makes me realise that this is not so bad after all. Thank you

[clary]

Actually mizmiz, we have seen some progress. He had SALT for most of this school year and seemed to be getting nowhere, but just in the last few weeks he has started saying sw (as in swap) rather than fwap, and string not fring; also the C sound is certainly coming (cl and gl are there so maybe we are nearly there!
Actually the SALT has now discharged him so she must be happy with his progress.
He so needs to concentrate on what he is saying tho.
And yes, you are right, a lot of ?problems? will have gone by 6 months later or whatever.
I think you SALTs do a wonderful job.
BTW on the friends thing, DS1 has plenty of friends even if they can?t always understand everything he says, so don?t worry about that, jenkins.
WRT to SALT yr ds might have, they will be able to do lots for him I?m sure. I wouldn?t say ds1 is now speaking as clearly as anybody (not as clearly as his younger sister, for example) but he has made progress and he will get there, I can see that. Have faith in yr ds, he sounds like a really sweet little boy.
On the food thing, I do think it is worth lookign at the archive threads under food, lots of good ideas for gettign children to eat veg. And all the family will benefit from a healthier diet.

[assumedname]

jenkins88 - my dd had about 4 words at 2.5 and then a few more at 3. She didn't really say a great deal when she went to nursery. The one thing that stopped me tearing my hair out was that I could see she understood what I was saying.

She didn't sit up until 9 months with support; 10 months without support; 11 months for crawling and 1 year for walking. Potty training was still not reliable in the day at 3.5 years. That was probably ok within 6 months of starting nursery, barring the odd accident. I think it helps, being with the other children.

When dd was discharged they said her speech was age appropriate and her vocabulary was above average. She is now 11 and doing well.

HTH.

[mizmiz]

jenkins,just want to make it absolutely clear that there is NO WAY that the salt witll be saying there is nothing she can do for your little boy!! He sounds as if he has acquired plenty of skills (his grasp of manners alone would make many parents green with jealousy) already,and it will be a case of working on acquiring more.

Goodness,he sounds a doddle to work with. In my particular field at least,I don't turn a hair even when I am slapped,scratched or pinched! (I work at the more challenging end of the spectrum-out of choice because I like a challenge! )

And yes,most children are discharged from thr salt service as thier skills are acquired.it is a very happy day indeed for us when a family no longer need our help.

[jenkins88]

HI everyone

I think the reason I'm so paranoid about what the salt will say is because the person who made the initial referal was a 'senior specialist speech and language therapist', and she seemed so negative about Liam's speech. Perhaps I should explain how all this came about.

Liam was born with plagiocephaly, which means that his head is not as round as most childrens. He has quite a large flat spot at the back and his head skews to the left. It's improved a lot since birth and now that he's got hair it's really difficult to see unless you see him in the mirror. His head will continue to improve and hopefully by the time he reaches adulthood it will be unnoticeable.

Liam was going to a craniofacial unit yearly to be assessed by a team, to make sure he was progressing in all areas. This is not the usual course of action with plagiocephaly but I was very worried about it and pushed for him to be refered. Lots of health professionals are present at his appointment including a pshychologist and salt. For the past 2 assessments the salt has shown concern over his speech and language skills. The first time she wrote to my GP recommending speech and language therapy, but my GP just sent the health visitor round who said it wasn't bad enough for a referal. The last time he was assessed his speech was raised again but this time I think the salt bypassed my GP and made a direct referal to services in our area. At least this is how I have understood it.

I am really worried about Liam because she really made it out to be something that was a BIG problem. Liam is always very exciteable at his assessments. More than he normal is at home. He wants to talk to everyone and I think this was why his attention span seemed so bad on the day. She saw him privately after the assessment, to make some notes on what was going on with his speech. She was showing him items and asking what they were, and I thought he did quite well, but she didn't. He did seem to lose interest at the end but I think it was partly becuase she was being so negative to him. The whole thing was really upsetting to watch. I know he finds it hard to say alot of words so when he gets them right I make a really big fuss of him. Is this the wrong thing to do?

She gave Liam a doll and told him to call it Wendy. Liam dropped it on the floor and said 'Oh, Wendy dead'. He didn't do it on purpose it was an accident. I don't like him saying that word, and I didn't teach it to him, but kids always seem to pick up the words you don't want them to say so easily. He knows this word because he was bought a buzz lightyear gun at christmas and he pointed it at someone and they said 'You got me, I'm dead'. She made a big deal out of it and said he was obviously frustrated because he can't communicate what he wants. She was frowning and scowling like as if he had used a really, really bad word. Please tell me if you think I'm over-reacting about this. I know I have a tendancy to be highly strung, esecially about anyone critisising Liam.

I asked her what we could do to help him before his first appointment but she didn't have any ideas, apart from talking, which we do all the time anyway.

I don't know whether she included a copy of her notes on Liam to the salt she has refered him to, but I think she must have, because I phoned them yesterday to get some idea of the waiting time. The said they may not have anyone appropriate to give therapy to Liam as his needs are 'specialised'.

Sorry if this has all been irrelevant. I just needed to get it all off my chest. DP is really reluctant to discuss this. He gets so upset when he thinks that Liam's having problems with things.

Thanks for reading another of my really long posts.
Jennie

[mizmiz]

jenkins,these sorts of multidisciplinary assessments are common when there are cranio-facial issues. The salt at this one obviously noted things that she wanted to follow up. THERE IS NO RIGHT OR WRONG WAY FOR A CHILD TO BEHAVE AT AN ASSESSMENT.He did what he did and she observed which is what she is trained to do. The 'dead' thing is rather clever and appropriate actually!

Your positive reinforcement of him when he says/does what you want is perfectly appropriate.
You are doing a good job,and to emphasie the point again,the most useful thing for him at this stage is lots of love and fun and playing with his close family and friends.

I know it is worrying when children are referred,but see it from a different angle.We should be glad when our children's needs are noted and followed up.

I'm not sure if I understand your point about him needing 'specialised' therapy. Who told you this? A salt or a secretary? it needs to be explained in person,not over the phone. Phone again and say that you are not clear on what this means and would appreciate a phone call (at least ) from a salt to explain more fully. If you're not happy,get onto your HV again. They can 'hassle' the salts directly.

I'm not surprised that you are a bit worked up. The plagiocephaly alone must have been a bit of a worry (my nephew was in the smae situation-happily like your little boy's it is now resolved.)

Oh,and don't worry about the 'senior specialist' thing. So what? That's what I am officially too.
Means you know about a particular field. Hope I don't frown and scowl when I'm with parents! Maybe she'd just had a rough day? She was NOT scowling about your little fellow.

[jenkins88]

mizmiz - The person who said that Liam's needs are 'specialised' was the 'speech and language therapy serices manager', at the hospital where Liam was refered. When I spoke to her yesterday she told me that Liam wouldn't be seen at this hospital as it is purely an administration unit now, and that he would probably be seen at our local health centre. Then she said that as Liam's needs were quite 'specialised', they may not have a salt who can take him on at the centre, but until he had been assessed she couldn't say for sure. I'm not sure if I heard her wrongly or I misunderstood what she said, but I was gutted when I heard that.

I am getting used to the idea that it's good that Liam has been refered as he will now have access to the right services to help him. I have to keep reminding myself that if speech and language problems couldn't be solved there would be no salt's because there wouldn't be any point in them. That thought is helping me a bit.

How old is your nephew? Did he have any communication problems? I often email other parents with plagio kids, and it seems that speech therapy is quite common amongst them. We all seem to have a hard time teaching numbers and colours too, although I've given up on that until I get his referal to the salt through.

The salt's specialist area was craniofacial anomalies such as cleft palette. My dad was born with this and she was very interested in his speech - which is absolutely fine.

Hope you don't mind me asking all these questions. Do speech and language problems fall into different categories. e.g. delays, disorganisation and mispronounciation, or something. If so, would all salt's be able to deal with all issue's or do you specialise in one area. If Liam has trouble paying attention at his ppoinments will he need to see a salt who specialises in children with behavioural problems. Sorry to be so ignorant about this. I'm just trying to understand what was meant by specialised needs. The comments that the specialist made were 'He has an interesting way of constructing sentances' and 'delayed speech and language skills', 'many sound production immaturities' regarding speech and language.

Sorry if this is a bit inappropriate. I have phoned our local health centre but they say they will contact me when they hear something. I tried to phone the services manager again but I can't get through. She did say that they were moving locations this week, so to expect a dlay with anymore contact.

Thanks
Jennie