To get a referral to a speech therapist

[professorsnape]

My Dtwin boys (identical) are 22 months and I feel have a language delay. So many people have said to take the 'wait and see' approach, saying they'll be fine, etc, etc, that twins have own language and it's normal for twins to be delayed, etc, etc.

They understand almost everything - 'go and get a book from the bookshelf', 'give your brother a biscuit', etc, etc.

They have about 10 words - 'more' (which they say all the time, for more food, more kisses, more hugs, more songs if I'm singing to them), 'baw' for 'ball' 'ba' for 'bob (the builder), and 'ba' lots of other things. They have 'bay' for bear. Yesterday, one of the twins said 'bub bub' for bubbles in the bath.

If they want to communicate, they babble lots of 'b' syllable sounds 'ba ba ba ba' if pointing to their cup/packet of breadsticks/bowl of grapes and I say 'Do you want a grape?' They shake their head if not and so it's process of elimination - 'Do you want a breadstick?' If so, they nod and say 'ah ba' which is their affirmative word, or their word for 'yes'.

They are just much more placid/quiet/less verbal than my 4 and half year old older DD and I can't help compare them. She had SO many more words, sentences at this age (I remember as I kept a record as have a background in linguistics), just a richer knowledge of language; loads of nouns, a good few verbs, some adjectives even.

The boys seem to be at the level she was at about 14 months.

I feel a bit guilty too as I didn't do enough talking/reading to them in the first year, there was a lot of sitting them on chairs while I was cooking/cleaning other ones nappy or pulling my older toddler away from the climbing frame. I feel now I should have got a nanny/more help as I feel this is a price they are paying.

I do as much talking/reading to them as I can. They're in a creche in the mornings only and afternoons are spent with all 3 children, often they hear a lot of background chat as my older toddler tends to dominate the conversation so don't talk as directly to them as I'd like. I feel now I might consider taking time off work to focus on their language.

Are they too young to get a referral to a speech therapist?
Would love some advice from other mothers and any possible speech therapists out there. I've posted about this before in other forum on mumsnet so don't flame me if I sound a bit repetitive! Offering in advance

I think 2 is the average age for a referral. See your doctor or HV. They may just be late talkers but a bit of support doesn't hurt.

Sorry - no kind of an expert but my son was referred to a speech therapist at slightly older than yours because he would only communicate via a series of differently toned grunts. We always knew what he wanted - so it took them telling us to stop understanding him to motivate him to speak. It worked, and very quickly!

Ask for a referral and to have their hearing tested, their hearing may be good enough for them to understand but not perfect enough for them to be finding it easy to hear the sounds they need to make for speech.

The referrals take time - once they come through they may have come on in leaps and bounds and you can cancel.

They are not quite 2 yet, and I have a few friends who have twins. Every set of twins were late talkers, definately older than 2 before they were talking at all.

My youngest stepdaughter barely spoke until she was 3 either, as she was so used to her elder sister anticipating what she wanted that she got whatever she wanted by grunting and pointing.. ... she made up for it as she got older and certainly has no speech difficulties other than the ability to stay quiet.

One of my DCs was referred at about 2, but he had no words. What he needed was a hearing test, it turned out - he didn't have much receptive communication either.

Dd2 was referred at 2 years for speech therapy and still has it now she's 4. Hers is slightly different as she lost language (she was dx with autism later), but I'm sure any speech referral would be considered at 2.

Other lessons I learnt was to model back to them the correct word.

"bub bub"

You want bubbles!

So not correcting them but modelling the use of the correct word, confirming that you've understood them.

No harm in asking for a referral, but I don't think you need to worry just yet as it sounds as though they are doing fine. I find it sad that you feel guilty and that they are paying a price for what sounds to me like happy normal family life.

No they're not too young IMO. TBH they will probably be over 2 by the time they get seen anyway. (My apologies if policies have recently changed in your area and you get a letter saying 'we don't see anyone before 2.6'). I would agree with the people you talk to that there's probably no need to worry, but why worry when you could take some action which will certainly do no harm, and may help? Trust your own instincts.

You may not get a great deal of input from the SLT at this age, more general advice that you could work out yourself, but IMO it's worth going and talking to someone now. Apart from anything else, they should show you everything you are doing right.

I will give you a couple of basic ideas but please don't feel patronised, I am sure you do all of this already. www.talkingpoint.org.uk is useful.

• Offer them choices, so 'Do you want a grape or a raisin?' so they are more likely to make efforts to differentiate the noises. Don't rush to understand them.
• Match what they say and add one word - so 'bub-bub' - 'big bubbles!', 'more' - 'more songs?' etc etc.
• There is no such thing as too many nursery rhymes.

Ask for a hearing test first, my DD1 had speech therapy at age 3 for about 6 months, until I finally convinced docs for an ent appointment and it turned out she was practically deaf in both ears due to glue ear and needed grommets plus her HUGE tonsils and adinoids removed - so essentially speech therapy was a waste of time! By all means get speech therapy, but push for a hearing test too.

Good luck! X

When they say more, make it into a game "more kisses or more food?"

This is a useful chart

Do they use all the sounds on the first block of letters

www.bisd.us/sharp/English_Developmental_Sound_Chart%5B1%5D.pdf

2 or 2 1/2

We got a referral from gp and hv when ds was 2 1/2 but it was not v intensive and we eventually got referred to a specialist.

But remember they are still young. Could there be anything else? A friends
Little boy could hear and follow instructions but kept getting ear infections and had delayed speech - it turned out he needed grommets and his speech is great now.

My ds is now 5 and we still attend as although the specialist speech therapist said he was age appropriate his teacher still has difficulty understanding him.

I'm a SLT. Buy the hanen "it takes 2to talk " book as a starting point. Can get it from Winslow press. Try not to get into " you want x? -child only needs to answer y/n. Offer choices - "you want milk or juice?" model lots of single words, createopportunities for them to communicate- so rather than pour the bubble bath in -give them the bottle of bubble bath so they have to give it to you to request. Model the word bubbles over and over .
Waiting lists areoften long so sooner the better.

Just as xxmush says - hearing test an absolute must!

Get a referral they normally slow waited approx 5 months for dd, If at the assessment the SALT do the report and see where it goes from there.

Speach problems are better caught early

Talking of bubbles - blowing bubbles is good exercise for their mouth muscles at least that's what SALT told me!

I waited 9 months for the appointment for salt after the initial gp appointment.

If they recommend you buy a book called it takes two to talk then let me know! It costs about £25 but my copy is available as my son had speech problems, not language. My ds was 1.10 when i got him referred. Defeinitely an issue and he still having salt 7y later so dont be put off about not asking for an assessment. Message me if you want, Good luck!!

Sucking McDonald's milkshakes* through a straw is also very good exercise for their mouth muscles.

*Sorry - v. Un-mnet

Yes, get a referral. My DS was referred at 2yrs (had around the same level of speech as your boys), and it took a whopping 9 months of waiting to be seen by a SALT...

No YANBU

A 'wait and see' approach would be fine I think, but being referred to a speech therapist when they don't need to be isn't going to do them any harm.

DC3 didn't talk at all until he was nearly 3. We took him to the GP at 2 and she checked his hearing and understanding and said 'wait and see', bring him back in 6 months. We did and although his speech had come on masses in that time she referred us anyway. Now at 4.5 his speech is completely normal and in line with his peers.

It a good time of year to get on lists - well that what I was told last year. As in September and later months DC are starting nursery and school and language and hearing difficulties are picked up and referrals made so lists get longer.

My DS did suddenly make a huge leap before we were seen but it still helped us know there was nothing wrong. Though hearing testing at school has again put us on waiting lists despite having it testing with speech last year we were told it was all fine.

you can get it at that age... i had a severe speech impediment and started about that time.

My DS started SALT at 1.11 after he lost all his speech. He is now 5.2 and he still has SALT.

YANBU to seek help if you think they need it

YABveryveryveryU to blame yourself!