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Speech delay in 2 year old...hearing loss/autism(24 Posts)
This May be long so please bare with me. Also may not be in the right place as DD hasn't been diagnosed with any special needs (yet)...
Our DD is 2.2 and is delayed in her speech. She has only a couple of words which she uses in context and unprompted. She has a few more which she will say when prompted by us. She has had maybe another ten words which she has said in the past in context but has never repeated. At around 15 months her speech seemed normal, she had developed a few words that she used often and in context but she just stopped using them one day and hasn't used them since.
She has certain sounds which only we understand. She is good at pointing at things that she wants and can make her needs known well. I would say she has ok eye contact although sometimes it isn't particularly prolonged. She is cuddly with her parents and one set of grandparents who care for her regularly and will accept kisses, she rarely gives out kisses. She has a newborn sibling who she will bring bottles and dummies to when crying.
She is very shy around other people and can appear whingy and clingy, this includes with people she sees weekly. However when she is with people she knows well she is generally quite happy. Often when she plays with other children it is like she has blinkers on and only focuses on what she is doing and doesn't generally like to interact with other children her age. She does ignore us a lot of the time when we call her name but in general does follow verbal commands well.
She likes to watch television and would watch all day if allowed, she prefers to stand very close to the TV but will move when asked, through usually will move back to right in front of the telly. She does do imaginative play, will make pretend cups of tea and play with her toy kitchen for example. I wouldn't say she has any obsessions or obsessive behaviour. She does sometimes walk on tip toes, particularly when pottering in the living room, the rest of the time she walks normally.
She is not keen on toddler groups or singing type activities. Often demands snacks part way through sessions, sometimes I think as a comfort then always demands to leave early by giving me our coats and pointing to the door! If we don't leave early she gets quite upset and often tantrums.
She has very good focus for activities which she wants to do. However with drawing skills she only ever scribbles, does not like me to show or help her with new craft skills such as drawing balls or glueing. She is at her happiest when she has lots of open space to run like at the park or soft play.
We have had her hearing tested and the audiologist thought she might have a high frequency hearing loss. However she said this was unlikely to effect speech development. I find it very odd that hearing loss wouldn't affect speech development though??? They wanted her to have a repeat hearing test in 6 months time but to me that isn't good enough so she is having the test repeated this month instead. If they still think she has a high frequency hearing loss what will be the likely treatment for this?
Obviously I am concerned that she might have mild autism as well but I really don't know. I have no experience with special needs so I don't even know if I'm just reading too much into things. I'm just fed up of everyone telling me there is nothing wrong with her and that she will catch up. I feel like we're being ignored and the system is letting my beautiful girl down. I'm so stressed and exhausted with it all. Why aren't we being helped?
She is supposed to be having NHS speech therapy which is once every 12 weeks (yes, really!!). She has had one session so far and we haven't heard anything else since. I have been trying to chase this up today and it has been a nightmare. We have started private speech therapy for her in our home which will be weekly although we've only had one session so far.
On a daily basis we do flash cards, reading, modelling language, sabotage etc. We've been teaching her some makaton. We are a dual language home, she seems to understand some of DHs language but does not speak it.
If you've read this far then thank you! I'm am just so tired and fed up of being fobed off. I just want to help my little girl but don't know how really.
Any experiences or thoughts would be much appreciated.
Oh and just to add as a toddler now she is a fantastic sleeper. Usually get her twelve hours a night plus a two or three hour nap in the afternoon. I know children with SN can have sleep issues so thought I would add that. Feeding wise she is a typical, pedantic, fussy toddler
Whether or not a high frequency loss would affect speech development would depend on the degree of hearing loss and the frequencies affected.
A mild to moderate hearing loss above 2000Hz definitely has implications for discriminating between some consonants, and hence for understanding speech.
here for a diagram of the "speech banana" showing approximately what sounds can be heard at different frequencies and volumes.
My DD has high frequency hearing loss and it does impact her hearing and she wears hearing aids. Her first hearing test was when she was 17 months old and they did another two after that resulting in her getting the hearing aids at 20 months old. We are a year on now and there have been lots of hearing tests and the results always vary slightly but they are difficult to test when they are so young. Her speech is also delayed (but she is also has PMG so likely impacts it also) so we do Makaton with her. We have seen an NHS SALT twice in the last twelve months and each time it has been from us prompting it (they come out, give us some tips and then go away again). We are seeing a private SALT too.
I think you are doing the right thing in demanding she be tested again and if they conclude there is hearing loss then they will want to find out why so will likely test you for CMV/Rubella etc. I would also suggest that you push for an MRI if there is hearing loss as it can take ages for those appointments to come through and they would probably suggest it further down the line anyway.
In regards to the speech banana, my DD is by the dog barking for one ear and just above the vacuum for the other and wears the aids in both ears.
Thank you both for your help and for reading...didn't quite realise how long my post was until I read it back! Anyway...
I'm not sure where DD would be on the speech banana as I can't remember what DDs numbers were from her test (was in shock TBH when they said there might be a problem so didn't take it all in) but I will save that to refer to after her next hearing test in a couple of weeks.
Ladykookoo I have a few questions if you don't mind
1) what would the testing for CMV/rubella involve?
2) why would an MRI be needed and at what stage should I push for one?
3) how difficult is it to get your DD to wear her aids?
4) has anyone mentioned about when your DD goes to school and what might happen then? Can DC with high frequency hearing loss go to mainstream?
5) did your DDs speech improve much after getting her aids?
Hi Ask as many questions as you want.
1) Blood test for you.
2) In my experience if there is a negative result for CMV/rubella and there is no hearing loss (other than age related) in the family then they will want to get to the bottom of the reason for the hearing loss. This will result in the mri. Appointments can take months to come through so if they tell you at the next appointment that she definitely has hearing loss mention it then just to get the ball rolling.
3) No problem at all but I think that is because she realises that they are helping her. We only take them out for bath/swimming and bed time. They had a habit of flopping off from behind her ears which she found annoying but we found some stickers which help them stay in place and they don't bother her at all any more.
4) There is no reason whatsoever that she could not go to a mainstream school with moderate hearing loss. They would appoint you a hearing support worker to liaise with the school as well.
5) DD's speech has not improved greatly but she has other issues associated with the mouth/vocalising due to her PMG. However, her understanding has come such a long long way and understanding comes before speech.
Ahhhh brilliant, thank you for answering. That has put my mind at rest somewhat especially about schooling. Really pleased to hear your DD gets on well with her hearing aids and had made some improvements, you must be so proud of her . I'm sure I'll have a lot more questions after her next test so I'll come back to update after. It's been such a confusing time for us all, I think it will be a relief if she gets a diagnosis.
Sorry one more question!
Do children with high frquency hearing loss generally need to learn BSL or does this just depend on the severity of the loss?
Would really depend on the severity. We do makaton so that she could communicate her needs to us but bsl would be for children who have severe or profound loss. Good luck x
How is her joint attention? Does she point things out? If you point something out will she look? Is she engaged with you and responsive?
Yes she does point things out. If I point to something sometimes she will look, other times she will point at something else instead over and over until I look at what she wants instead, she can be quite stubborn.
She is currently sat watching a cartoon on the TV and copying every action and even the emotions of the characters. This is something she does daily. This is after two hours of her whinging and tantruming whilst I tried to get her to read, do play dough, draw, dance etc. she did do most of these for a few mins but then nagged for the TV again. She is my first so I've no idea of this is normal two year old behaviour or not.
I haven't had an NT two year old so not much help there. I hope you get some answers.
My ds has hearing issues and they are more pronounced at higher frequencies. It was detected because I was concerned about his speech.
You might want to look at the NDCS website, they do a really good guide to understanding your child's hearing test results. There's also some info on glue ear
Did the audiologist mention glue ear at all? Did they do a tympanogram? (this is a test that measures how well the ear drum is moving) Did they test her underlying hearing - this is where they bypass the eardrum? Sorry lots of questions!
Ds had glue ear and as he has grown his hearing has improved lots, although he may not regain full hearing thanks to scarring on his eardrums. His speech has improved massively and he is doing really well at school now (he had a slow start but the school has supported him really well) He has been brilliant about wearing his hearing aid and his friends and classmates are totally accepting of it, I was quite worried about it but it has honestly been a non-issue. He has support from a Teacher for the Deaf once a half term - she gives advice to his teachers and checks his hearing aid.
Signing is brilliant for some children but not appropriate in all cases - our audiologist said not to sign with ds as we want him to focus on our faces, lipread and use the hearing he does have. (ToD thought the same) Obviously this varies from child to child.
Happy to chat more if you have more questions.
I would ask for an assessment by a developmental paediatrician, to at least set your mind at rest.
What's NT stand for? Would I get the referral for a pead from the GP or HV? I'm wary about labelling her at only two but I'm also worried that if I leave it too long she might miss out on therapies or interventions...
Thank you shoewhore, I'll have a look at that guide tonight for some bedtime reading. That is great news that your DSs hearing and speech have improved so much. The audiologist didn't mention glue ear although she didn't mention much of anything to be honest and I left feeling very brushed off. I'm not sure if she did a tympanogram, she had a look in DDs ears and placed a block like thing in her ear to record the amount of fluid (I think, sorry not sure how to explain it very well), apparently it showed more congestion in one ear.
We went to rhyme time today and for the first time ever she actually joined in with the dancing and instrument plying. Normally she would just whinge until we leave. I could have cried from happiness watching her. Last week she had double ear infections and has been on a course of antibiotics. I have been wandering if the two might be related, could the antibiotics have cleared up a part of her ear problem? Clutching at straws maybe but it was literally the first time ever that she has participated like that.
Dont be worried about labels. If she gets one..and it is not easy to get one unless its deserved..if you feel its wrong later you can get it removed.
NT is neurotypical ie without neurological SN.
I think GP or HV can refer you.
I am in no way diagnosing anything but is always best to get checked out if you have concerns
Yes the fluid/congestion in the ear thing is glue ear. It's really common in children and can come and go. Has she had a lot of ear infections? This can cause glue ear as well.
Ds was quite similar to how you describe your dd when his hearing was really bad. Very very shy with strange people. Played on his own a lot and seemed in his own little world when playing. Hated Rhythm Time class.
Glue ear often goes away on its own, hence they like to retest. You may be offered grommets (again read up on NDCS) - ds had these and it was brilliant but unfortunately they don't stay in forever, hence he ended up with the hearing aid.
Ahhhh well glue ear would explain a lot of her behaviour I think. She hadn't actually had that many ear infections, just this one last week and one at 15 months which didn't require antibiotics, just saline drops. The strange thing is though prior to that infection at 15 months she had a few words which she could say but thinking about it it was around that time she stopped using those words.
Am I right then in thinking that grommets are temporary whereas aids are a more long term approach? Are there benefits to grommets over aids? I'm assuming there must be since they're put in surgically?
She does sometimes have periods of rubbing ears and whinging a bit but I've put it down to teething as no temp. Oh man I wonder if that's actually been ear infections. Rubbish mummy!
Whether grommets or hearing aids are recommended for Glue ear depends very much on the surgeon. Some prefer to avoid surgery (and possible complications/infections) and advise the use of hearing aids.
Hearing aids can be brilliant - but can also be difficult with glue ear as some children don't like wearing ear moulds (they make your ear feel blocked) and as glue ear tends to be a fluctuating condition, hearing aids can be ok one day and too loud (or not loud enough) a week later.
The NDCS website is brilliant.
The Ear Foundation is also very good - espcially if you are near their base near Nottingham.
You can also have a private hearing test with specialist audiologist such CHEAR.
It is worth asking about soft band BAHA as well. Some people have found them very helpful.
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