Speech problems in 2.5 year old.

[AndiMac]

Our son has been learning to talk but he is often very unclear, using a lot of "g" and "k" sounds for other consonant sounds. When I listen to other children his age and look at video of his sister at the same age, he is definitely not at the same level. He can make the noises and speech patterns, but understanding the words when he says more than a couple at a time is very difficult, if not impossible. Not just for others, but us as well.

For example, he will say "gikkle" for "little" and "geekp" for "sleep". Mister Tumble is "Gigga Gungle". He is very sociable, smart and easy-going (other than when he's tired, but hey, that's 2 year olds for you) so I don't think this is anything other than related to his speech. His hearing was tested when he was a baby and there weren't any issues, nor does anything now make me think he can't hear.

There is a drop-in speech therapy session where we live, so I took him in for an assessment and was told this is called backing. They asked if he could make all the other sounds individually, which for the most part he can. He can make "s" "m" "b" and will use them in some words such as "yes" "morning" and "baby" but not in general use.

The speech therapist suggested to just leave it until he's 3 and see if it clears up, with simply the suggestion to repeat the words back to him correctly. Well, we are already doing that and it doesn't seem to make a difference. I'm not sure if I should just sit on my heels about this for another 6 months, I feel like we're just being postponed. I would think that the best chance to correct his speech is while it's still developing, or am I totally off in this?

[NotSoSuperMa]

The trouble is, 2.5 year old boys often aren't very interested in developing their speech, and 'backing' is a completely normal process at this age. If he's still doing it when he's 3, that's just about the right age to make a change (with that particular speech process) and you can whisk him back to the SLT straight away (I'm amazed & impressed to hear that you have a drop-in service running, what county are you in?).
The advice sounds good to me: repeat back what he meant to say, slightly emphasise the sound he got wrong, don't turn it into a big issue. If you're feeling very keen, play some silly noise/expression games in the mirror - sit side by side, facing the mirror, and get him to copy you. Make funny faces (poking your tongue out, looking cross etc) and then try a few sounds eg. "sssssss" or "g-g-g-g". Then add in the sound he's producing incorrectly "t-t-t". The point is just to raise his awareness of the sound, and it's usually easier to do it on its own rather than in a word.
And don't even attempt to compare him to his sister, girls' speech & language is often way ahead of boys' at the same age

[EllenJaneisnotmyname]

Agree with above. I was always told never to correct them, if they say 'Gockle' you repeat back, 'Yes, that's right! Clever boy, bottle !'

[AndiMac]

Yes, I realise this and have always done this. But he's well past the stage of saying single words. One sentence will be "My gooter ouside 'ouse" which is clear enough to understand that his scooter is outside the house. The next sentence will be "Ga gee go gagga" and I have no idea what he's talking about because there's not enough clues to figure it out. He's not just pointing at things and naming them, he talks about things not in view and this is where not understanding what he's saying makes communicating with him difficult.

[EllenJaneisnotmyname]

Sorry, didn't mean to teach you suck eggs. My DS didn't talk at all until 3.5 so I can understand the frustration. Often more socialisation helps them to appreciate that they have to be clearer as a peer won't try to translate, they'll just ignore. Your other option is to find a private SALT.

[AndiMac]

Thanks, not trying to be snarky either, if I came across so. It's just quite frustrating currently. He does go to a childminder where there are kids his age or slightly older, but I'll try to remain patient until he has started preschool in a few months and see how things go from there.
NotSoSuperMa, I know we are lucky to have such a drop-in speech and language service. Not sure if it's county wide or more the borough, but we are in east Berkshire.

[Sassyfrassy]

You could look into cued articulation. It uses signs to help children understand how the sounds are made. You can play various games with the sounds and pictures to help them distinguish between the sounds as well as making them.

[NotSoSuperMa]

Oh, I thought they'd dropped those clinics - lucky you! I think you could go back and say that you're worried and would like some more ideas of what to because modelling doesn't seem to be working.
To reassure you though, he does sound like a normally developing boy and I'd expect to see his speech gradually improve over the next few months

[NotSoSuperMa]

And I should have said I'm a SLT!

[bdaonion]

We are the same county AndiMac, and perhaps the same borough . My DD (5.6) has specific language impairment and we started the process through our local drop-in clinic too. We were very fortunate in that we assessed/diagnosed with language disorder very quickly but she was just over three when we attended and it was clearly language related as opposed to speech.

I don't know how close you are to Maidenhead but there is an absolutely brilliant school there with a speech and language resource attached and they take children from nursery age (3 and up). It might be worth taking a visit to see whether that would be an appropriate pre-school setting for him to give him intensive speech therapy before he goes into reception. PM if you want any more information.

[working9while5]

NotsoSuperMe, backing is NOT a normal developmental process!

[dolfrog]

you find this new CiteULike research paper sharing group may have some ideas
CiteULike Group: Speech and Language Pathology - library 298 articles
and may be the MNs SLTs can add some more research papers.

[AndiMac]

Thanks for the link dolfrog, although I'm not sure what I should be looking for? A simple search for backing doesn't bring anything up and I'm not familiar enough with the topic yet to know what else to look for. However, I have read a bit on other sites about backing and it's interesting to read differing opinions about backing. I have read that backing isn't usual and does usually require speech therapy. The ST we saw doesn't seem to think it's worth worrying about now, nor does NotSoSuperMa. Not convinced, but willing to wait a bit, plus read more, if I can be pointed in the right direction.

[Maryellenwalton]

Working: Exactly what I was thinking

And I also think its pretty disingenuous to say that 2.5 year old boys 'often aren't interested in developing their speech'. It's comments like that that really could stopped me getting help for ds1 if I'd listened to them. Ds2 is 2.5 (NT) and he is just as keen to develop his speech, if not more, than his sister was at the same age, as are most of the NT toddler boys I've ever come across.

Boys and girls should both be at the absolute apex of their language acquisition and desire to communicate at around 2.5

[NotSoSuperMa]

Umm, working9while5, backing is not an unusual process in children until the age of 3. And at this age, in combination with consonant reduplication..?
Don't have enough information here, but I don't think AndiMac needs to panic yet, and it's great that she's keeping a careful eye on his speech already.

[dolfrog]

AndiMac
if you scroll through the list of papers over the 6 web pages you will find quite a few which cover early development, and pre-school issues.
Speech and Language Pathology covers a wide range of inter related issues, you will need to identify the issues which relate to your DS, which is not always easy.

[working9while5]

I should say before I freak out the poor OP that backing does occur in children aged 2-3 without it being a sign of anything more serious, but it is still not a "typical" process as some others are (e.g. knocking sounds off the ends of words in very early speech development, or saying e.g. pin instead of spin or cooter instead of scooter).

However, particularly where it is systemic and replacing many different signs, it IS a red flag that warrants watching. It is certainly an indicator that a child needs a hearing test. AndiMac, does your son have any signs of persistent/ongoing ear infections e.g. ongoing colds/coughs/effusion from the ear/not responding to certain sounds in the environment/needing repetition etc? www.audiology.org.nz/prof/pdfs/Flags%20Bowen.pdf

Intelligibility is always a key consideration. At 2;6 a child can be very normally 50-75% unintelligible, so it's worth really thinking about how frequently sentences are of the goo gaa gee gee variety. I am always concerned when I hear a parent is really struggling to understand at all what their child is referring to, although of course it is encouraging to hear that he does seem to be intelligible in some contexts and certainly if he is using a range of syllable types that is good.. but I wouldn't be comfortable to give specific advice about how he's doing based on what you've said.

A good speech assessment looks at
ALL SOUNDS
in
ALL CONTEXTS e.g. beginning/middle/end of words
AND
SYLLABLE USE
and how sounds fit into syllables
AND
in connected speech as well as single items.

There's also an argument for differentiating between spontaneously produced and elicited words.

For older children, assessing how they perceive words is also important (hard to do at this age).

A definitive diagnosis of any speech difficulty can be hard before 3 and there is a very wide range of "normal" which is why on the NHS under 3's are really not a priority and seen as low risk. Do you have any risk factors e.g. speech/literacy impairment in the family?

However, this is NOT the same as saying therapy is never indicated. There are approaches such as this for example, which can be done with this age range (although it won't always be successful) and other types of "auditory approaches" where you really increase exposure to the sounds you want your child to use more of, but in a low-pressure environment.

This is what has been suggested above BUT what often isn't emphasised is a very systematic approach to this and/or dosage effects e.g. how MUCH you should do this. Stimulability therapy is about 50 mins twice a week for 12 weeks for example (but again, not enough evidence to suggest that this is the "right dose"). The more the better is not a truism though...

[working9while5]

Sounds, not signs. Good grief.

[AndiMac]

He also has final consonant deletion, but this I know is still fairly regular up to three. That I'm willing to accept is normal, it's the backing I'm more concerned about, at least at this stage.

There's no hearing problems for anyone under 65 on either side of the family. We are speak English at home, all as native speakers. He doesn't have persistent ear infections at all, just the normal run of colds. His hearing, as far as I can observe is normal. He sometimes ignores me, but again, that's being 2 and wanting to keep building his tower. He certainly can hear what's going on and will answer me from another room.

I'm just uploading a little video of him so people can see what I'm talking about. I'll put the link up once it's complete.

[working9while5]

"Don't have enough information here" - yes, NotSoSuperMe, that's the key point really.

We don't know anything about this child's developing linguistic system and neither of us have heard him say a single word.

That alone is a reason to suggest that backing should be viewed with caution.

How you define backing is a major issue here. If a young child says, say, "kaka" or "gak" for tractor, there is a point at which that is a phonological simplification process and there is no issue whatsoever with it, and it is typical. However, judging whether that is typical or atypical is dependent on a full analysis of a child's sound system (phonetic and inventory constraints) in the context of viewing their speech, language and communication.

Apart entirely from the fact that AndiMac's little boy is 2;5 and so much changes between 2-3, I really couldn't say one way or the other whether her child's backing is or should be low, medium or high priority. I don't have enough information here.

What I do know is that backing can be a red flag for speech delay and impairment, AndiMac is concerned as she can't always understand her child and that I do not know enough to say if he "sounds" normally developing.

[working9while5]

Sorry for some reason I posted the red flag link twice above, cut and paste issue.

The therapy approach I intended to link to is here.

[incywincyspideragain]

I've not read the whole thread in detail so sorry if I am repeating someone else but can I just ask, have you ruled out hearing difficulties?

All of mine have had cronic glue ear and the littlest (2.5 years) has speech and language delay and has just had grommits fitted - I've noticed a huge difference. All of them had the ability to speak but the 'feedback' of speech wasn't there so words would be shorted or jumbled and some days just unrecognisable but they could follow a clear instruction with ease.

All 3 had clear newborn hearing tests - glue ear is something that develops over time. Apart from speech (and ds1 and ds2 got by fine - its only with hindsight I can see the extra improvement and how they have started singing more songs) they had all been fine in small quieter environments and well behaved, sociable - it was when ds1 went to School he struggled as it really highlighted the problem, School is incredibly noisy, up to that point I had no concerns about his hearing and only did it because my mum suggested it as the School raised concerns about his behaviours and she said do a sight and hearing test and rule them out (he also has glasses now )

HV referred ds's for hearing tests based on speech delay - this might not be the case for your lo but worth ruling out imo, glue ear had a huge impact for my ds1 in particular as his wasn't sorted until towards the end of his first year in School.

[AndiMac]

I suppose it could be some unknown hearing issue like glue ear. That's something to look into.

I've put a video of him singing "Twinkle twinkle" [[http://vimeo.com/34861056 here] so people can see what I mean. This is a good example of him not being easy to understand, other than you can obviously follow him along in the tune. He's not always like this, lots of what he says is decipherable, but a good deal is like this, especially longer sentences.

[AndiMac]

Argh, I wish I could edit. For simplicity, the link again here.

[working9while5]

He is very gorgeous!

It's hard to tell with singing, because language wise some of this might be beyond him at this age e.g. "how I wonder what you are" is not really a typical sentence construction.

When you say it's a good example of him not being easy to understand, would you say there was a LOT of this gigga gagga and lots of open vowels when he TALKS to you that you are unable to follow? How does he react if you don't understand him?

Is Mr. Tumble more like Gigga Gugga and little gigga or giku or can you hear other sounds in there? How many sounds is he using that aren't "g" or "k"? You say there is "s", "b" and "m" in some words? Any others?

[working9while5]

typical sentence construction at 2.5. I wish I could edit too!