Apparently extra "speech therapy" isn't what I need for DS2's receptive language delay

[lingle]

I thought this might be interesting for some of you, especially those at the early stages of helping your child with understanding language, and those of you who are on waiting lists for speech therapy.

DS2 is 3.6 with receptive language delay and the professionals have question marks about ASD. He has progressed tremendously over recent months and can now understand both choices and sequences of events and can say and combine 500+ words including nearly 100 verbs.
Recently, I'd emailed my NHS therapist with some questions and she replied apologising and saying she had no desk time and would respond in person in two months' time at our next meeting. Frustrated, I went to the "helpwithtalking" website to try to find a private speech therapist in my area. I spoke to one yesterday and what she said was interesting.

The therapist informed me that she specialises in prononciation problems and so was not suitable for me. She then said however that one-to-one sessions with a speech therapist are not what a child with fairly "pure" receptive delay needs. What he needs is a language-rich environment, full of communication at the level he happens to be on at that time. If anyone would benefit from one-to-one training sessions, it would be the parent not the child because it can be tricky for parents to learn to modify their language to bring the child on.

It was very interesting to hear this "from the horse's mouth". A part of me had still felt that I was using mumsnet and Hanen because I wasn't getting "actual therapy". But in fact, implementing the tips from mumsnet and the Hanen book (and now my visual communication aids book) turn out to be the speech therapy, not a substitute for it. Good to know I've been getting the best help for the last 9 months, not a substitute for it .

Despite all my posts decrying the "medical model" jargon used in relation to language delay, a part of me would still have liked to think I could somehow hand these problems over to the speech therapist to "solve" for me. Aint gonna happen .

I just want to add that none of this applies for children with other kinds of language issues in addition to receptive language problems. And that you still need to get your child assessed.....

[cyberseraphim]

It is good to hear an honest explanation. It does not surprise me though. I had a childhood friend who trained to be a speech therapist and her thoughts were completely focussed on stammering/pronunciation problems, not working with children like DS1 who has a serious language disorder. I think some SALTS do the best they can but yes I do think it is mainly down to the parents to bring on a child whose problems are not easily 'fixed'

[paranoid2]

My Dt2 who has dyspraxic and ADD traits was also deemed to have information processing problems/ receptive speech delay. I was also told that he didnt need speech therapy because his expressive speech was very good and that the rest was just part of who he is. I have always thought that he would have benefited from some therapy but not sure what. He was referred for physio a year ago and had a number of sessions as it was deemed that the effort that he was putting into his motor regulation was having an impact on his processing of information (not enough space in his brain to do both). I had always been sceptical of this and had always felt that OT and SLT would have been better. His motor skills are now age appropriate (they were never really a major issue) but I think he is still somewhat behind in his language processing . Difficult to know how much his inattentiveness has to do with it though. Anyway he is now in a unit attached to mainstream and there is a new service there where a SLT comes in regularly. She asssessed each child. Still waiting to see if he is going to get some therapy. Sorry for the ramble

[morningsun]

paranoid2 could i be cheeky and ask how old yourdt2 is?

[paranoid2]

He is 7 and ur not cheeky at all. Can I be cheeky and ask why you are asking?

[morningsun]

oh Hi!
I've been dithering about whether to get a slt assessment for my ds age 7.
He had very good early speech apart from a stammer and not pronouncing "TH" but the last couple of years often doesn't seem to hear me or if he does hear he says"what do you mean" or "i don't get it".
I got his hearing tested it was perfect on the day but is not perfect during colds.

For the life of me i now can't work out if this is habit,lack of interest in what i'm saying or me speaking in a confusing way!
It didn't used to happen and i'm not clear on why these communication difficulties seem to have arisen.
He also has unclear pronunciation now which could be his teeth growing down and spends a lot of time "finding words".He is learning bilingually and i don't know if this is the reason.

[lingle]

morningsun, sounds like it could be good to talk to someone about this....

[morningsun]

lingle are you a salt?

[lingle]

gracious no, I'm the OP!

[morningsun]

sorry!

[TotalChaos]

interesting but I would also want to confirm that with a SALT who was more expert in receptive language delay. I strongly feel that yes, the parents need to do a great deal of the work, and the sessions with SALT are the tip of the iceberg,BUT regularish SALT sessions are vital - as you need skilled professional input to help find areas of weakness, set realistic goals for your child and tell you precisely how to achieve these. Without (private) SALT advice I would never have bothered using PECs with a verbal child, and use of PECs was hugely beneficial to get DS talking in sentences.

Most people are not as able as you lingle in finding the correct material, understanding it and applying it.

[lingle]

true total, it was the NHS speech therapist who forced me to "get visual" which is crucial I think.

[lingle]

Hmm, ok T. I'm certainly open to this....but there doesn't seem to be anyone from the helpwithtalking site in my area with the right specialism.....

do you think ICANN could help me at all? wouldn't they just refer me back to the same site?

[TotalChaos]

if you look for therapists who are used to dealing with kids with ASD, they should also be able to advise on receptive language difficulties.

[RaggedRobin]

interesting points all round. i'm currently putting some pressure on our salt to visit ds in nursery now that he has settled in, though not particulary to establish regular therapy. i just feel that she is best placed to assess how well he is reponding to that environment and whether the staff need additional strategies to help him make progress.

i do think that her area may be pronunciation rather than asd, as she does put a little more emphasis on this than our last salt, who seemed far more focussed on asd issues. i would feel far more confident if i thought the salt was an asd specialist, but i do think that she is a good therapist.

[lingle]

I think it's defining "language-rich environment" that's the tricky thing here.

For most kids, that just means talking to them from time to time.

For DS2 it means an awful lot more, as many of you know, and yes some of it is not obvious - witness the bemused reactions of our partners!

The "big thing" for me just now is the visual aids book. There's no way I'd think up or realise any of this stuff by myself plus it doesn't suit my own language style.
So I need to do some pretty strange-seeming stuff to create that "language-rich" environment. Comes back to training the parent again though I think....

[RaggedRobin]

what's the visual aids book, lingle?

[TotalChaos]

Completely agree lingle. A barrage of language without any consideration for the level of receptive language a child is at is IME with DS and private nursery worse than useless.

[lingle]

Ragged,

"Visual Strategies for Improving Communication". Practical supports for school and home
By Linda Hodgdon.

Published by Quirk Roberts. Am very impressed with style and positive attitude.

It's given me inspiration to start explaining things like how buying and wrapping cards and presents are connected to particular parties the next day.....

It has a great idea on home-school communication by the way. Calls it "visual bridges" and considers it as an alternative, not addition, to hasty daily notes and chats between parent and school. The idea is that the child has responsibility for indicating in some way what activities they have done at school. For our level, they show standardised pictures of nursery activities where child has drawn a ring around the ones done that day. The picture goes home with the child. So the parent knows what happened because child has "told" her. Can tell you more if interested as it would help me consolidate.

Suppose a good specialist speech therapist would be better than these books - but one only interested in expressive speech would be less good.

[RaggedRobin]

sounds good, thanks!

[kettlechip]

just ordered the book, feel a bit stuck at the moment so definitely need some inspiration to help me boost ds on again.