To ask if anyone can help me work out what might be causing my son's speech problem

[grizzabellia]

Hi, I posted a couple of months ago about my worry about my little boy who is now nearly 3 and not speaking properly. He is under nhs speech therapy but appointments so far have been sporadic and the first therapist left so there was a gap and we have only seen the new one once so far. I am finding it frustrating that so far no-one has been able to give any clear answers or a prognosis, although I guess they are still undertaking an assessment and it may be difficult at this stage as he is so young. The one we saw most recently thought he seemed to have a speech disorder rather than a delay, as there are a number of sounds he does not seem to use much, mainly consonants. I got the impression this was more severe and was really upset as I had actually gone to the appointment thinking his speech was improving!

Currently he has very little clear speech but he does vocalise a lot and a lot more than he used to, and in context I know what he is trying to say so the number of words he uses is increasing. He also now puts some words together such as 'look mummy' (more like 'ook' though) and 'blue car' ('oo' 'ar') and police car ('eece' 'arr'). His longest phrase is 'more milk please' ('ore ilk ease') and he will now put the end 'k' on milk which he wasn't doing before. He understands absolutely everything people say, including when I have mentioned to people I am worried about him, when recently he has gone very huffy and clingy so think I should stop doing so in his presence. Otherwise he seems bright enough. i was a bit worried about ASD as there is a tendency to geekiness and eccentricity in my partner's family but I don't think he would meet criteria for this - he loves pretend play and is very focused on what he is doing for long periods, so his attention is good. He is very expressive facially and can also modulate his tone to convey different emotions. He is reasonably sociable and will play with other children though also plays well on his own.

I have googled various things and read about verbal dyspraxia as a possibility though in one source I read this is actually very rare. His motor skills are good so he does not have dyspraxia in this area. He also had a lot of ear infections as a baby - we have had his hearing tested twice, once at about 10 months and at just over 2 and they said it was ok but the test did not seem very rigorous to me - they play sounds and when the child turns a scary tigger thing does a dance. My mother in law recently commented that when he does speak he doesn't seem to modulate the volume very well and wondered if he might have a problem hearing consonants. He does still seem to get quite a lot of wax in his ears. I also read one post somewhere about a child who had eventually had a problem with palate muscles diagnosed which required surgery so am wondering whether to ask for a referral back to ENT.

I would be really grateful if anyone could offer some advice/expertise as I just don't know what the future will bring, whether he will be able to talk by reception and the impact on his social abilities - it is really worrying me a lot! Thanks for anyone who has taken time to read this.

Grizzabellia I'm an slt that works with a lot of children with severe speech disorder including dyspraxia. Happy to give you some advice if you want to pm me.

I would definitely say get the hearing checked again as hearing can fluctuate and with the previous history of ear infections I would say this is a must.

Even though your ds is small there are lots of strategies you can put into place to try and help. It sounds like you are doing some good things already. Working on verbs sounds appropriate as you need to build up a solid language base before you can work on getting the clarity of speech. Giving lots of choices instead of asking closed questions is a great tip as your ds will be hearing vocab and sound structures over and over. It might not change the way he says things for a while but it is all going in.

I would suggest some signing to support development of language. Can your ds imitate words, sounds, noises?

In terms of speech development there are 2 areas we work with delay and disorder. Delay is sounds developing in the correct order but not when expected. Disorder is when the development goes wrong and needs some rewiring of the brain to sort it out which is whete slt comes in. Children need to be ready for direct therapy to be effective so often at a younger age it is often strategies and providing another means of communication to support the development of verbal communication e.g. signing or pictures

My son had a speech delay due various issues y & he also had glue ear due to Pierre Robin sequence & palate problems. It is worth getting an ENT specialist & a cleft palate specialist to have a look.

He may need grommits in his ears to clear the blockage like my ds did. The act of chewing helps to naturally break down the wax in the ear canal. Pierre Robin can result in narrow ear canals hence the wax build up. My ds could barely speak before the operation & within 3 weeks it was as if somebody turned the on button

www.cleftline.org/parents-individuals/publications/pierre-robin-sequence/

There is also a condition called a hidden cleft palate & as its not physically obvious therefore harder to diagnose.

www.google.com/cse?cx=004217774030076444073:s59ah4orvge&cof=FORID:0&q=hidden+cleft+palate#gsc.tab=0&gsc.q=hidden%20cleft%20palate&gsc.page=1

www.autism.org.uk/about-autism/related-conditions/asds-and-hearing-impairments.aspx

My DS had delayed speech although different problems...Two things ..Our Local chidlrens centre did monthly drop in sessions where you could talk to speech therapist, every tip she gave me helped.

The other thing was matching signs with words...

My DS has normal speech now...When I look back..I talked an awful lot in the hope he would aquire language and didn't leave enough space for him to actually answer...

I really do sympathise with you OP. DS2 had a moderate to severe language delay - 12 to 18 months delay at 3y 6m and I was worried sick. In his case it made him a nightmare at nursery because he couldn't communicate and used to act up: he was unhappy, I was both anxious and mortified. In his case, not only did he not speak, he also didn't understand what was being said to him. I didn't handle it well because language is very important to me (languages degree, albeit ancient languages) and also because I felt that DH left the burden of sorting it out largely to me and didn't make much effort to encourage DS2's communication. We were lucky that NHS speech therapy was well provided for in our north London borough and he had loads, including intensive courses. It was very hard work for DS2 and for me. He continued to have (private) speech therapy in Reception and Y1 and went to the Learning Support teacher. I thought he would never catch up, but by the end of Y1 it was clear that the problem was largely resolved. I think I relaxed when he started reading. He's now Y6 and has just taken his Kindle to bed to read The Thirty Nine Steps.
Sorry if this makes me sound like the stereotypical pushy north London mother, but I'm trying to convey the anxiety that a child's language problems induce.

My son was exactly the same at that age and I could have written your OP. We had him formally assessed at 3, he was diagnosed with a severe speech delay at that time and then PDD-NOS at 3.75 years. We did have him assessed for autism several times but his social behaviour did not, and still does not, indicate that. We also had his hearing checked multiple times. He is still receiving weekly speech therapy during school term ( but attends regular classes). At four he was practically non-verbal (but very expressive with his jargon - making all the right infkections IYKWIM). Now,at seven, we can understand about 80% of what he says but I'd say he's still at least 2 years behind his average peer with speech. The 'silly sounds' can still get a bit overwhelming at times.Funnily enough, teaching him to read (he is above peer level in maths and reading and has not had any other academic problems) has helped him learn to talk. Has your son shown other signs of delay eg with walking, toilet training etc? I would only recommend that you start getting help now. We started noticing at two but left it for a year to see if he was just a late starter. With hindsight I regret that decision.

Forgot to mention that though initially he was diagnosed with a severe delay, this was later changed to a speech disorder diagnosis as he still clearly has problems with grammar even when he has the vocabulary.

Your Ds sounds just like mine who had barely any words by 3 and like your Ds couldn't not pronounce a large number of consonants.

The things that worked for us:

1. ENT appointment diagnosed glue ear. We had hearing tests which showed his hearing was "within the normal range" but the ENT did a different test which pushed air through his ear to test if the ear drum was resonating properly and it wasn't. So he had grommets put in at 3. These were not actually the big success that we had hoped for until we had his enlarged adenoids removed when he was 5 and new grommets inserted. It was like having a different child and his speech improved overnight.

1. We removed all dairy from his diet. This helped reduce mucous in his nose and ears and generally made him feel better. We saw improvements in speech within a week.

1. Weekly speech therapy which initially focused on increasing his vocabulary, then when he had more language, his slt worked on his articulation.

1. Fish oils every day. We use Nordic naturals pro line - 2 efa and 1 EPA. Start with one and then build up. The brand we use is made with deep sea fish from the seas around Norway so is very good quality.

1. Exercises to help improve his tongue strength and mobility of his lips. Can your Ds use a straw? Can he move his tongue all around and up and down? If not, there are fun exercises to do that will help. Do them in the mirror with him so he can see what he needs to do.

I hope the above helps. Happy to chat via pm if that's easier. My Ds is 6 next month and although his speech is a bit behind his peers, the improvements have been dramatic. The first thing to do is to really push for a proper assessment of his ears and if you can afford it, pay and go and see and ENT ASAP as grommets in and adenoids out could make a vast difference. Does he mouth breathe? Is he a snorer? Both are indications of enlarged adenoids which can result in prolonged glue ear.

Good luck

Thanks for all the advice.

Mimishimi - what was the rationale for the PDD diagnosis in your son? Were there some other issues than just speech. My understanding is that this is sometimes diagnosed when there are some ASD traits but maybe not enough to meet all the criteria. My son has not been delayed in any other milestones particularly, although I would say he does not still show a definite hand preference (though inclines towards the right) and does not hold a pencil or draw particularly well compared to my daughter at this age (and shows little interest in this). He can however manipulate very small lego pieces so think his fine motor skills are not too bad. I have made only a half hearted attempt at toilet training and he has been very resistant and refused to wear pants/ give up a nappy, I suppose I am a bit worried the speech thing will make it difficult, though as he can communicated his needs it shouldn't really.

3asabird, I'm sorry to hear you have had people being, it sounds, quite rude about your son. So far this has not been an issue (people commenting), if anything my little boy looks young/ small for his age and in public is usually running around which gives little opportunity for people to comment on his speech. I do feel very defensive and protective of him however, and worry about people might think. Like sicutlilium I also have a language based degree and I suppose somewhat arrogantly assumed that speech and language would not be a problem for my children. If anything comments made by people so far have been along the lines of 'oh, so and so didn't talk till they were 4 and now they're doing a PhD' etc! or 'you can tell he's bright' though not sure if this is because they expect he should be bright!

eastendfareast, that is interesting about the other hearing test, it sounds a bit more conclusive. When he had the bleepy test at 10 months or so they said he had done ok for a child with a current ear infection(!) which struck me as a little bit odd then, though at the one when he was two they just said it was fine - though it seemed to me he had not turned especially quickly to some of the sounds. He doesn't really snore or mouth breathe so I am not sure if adenoids could be a problem...?

Regarding the dairy, I had not read this before but did so somewhere else earlier today. He drinks a ridiculous amount of milk, probably too much as he is very fussy about food in general, and I know we probably need to cut this down but it is very difficult. I think it would be difficult to cut dairy out of his diet but I suppose I could try him on soya products - he does not seem to be especially mucousy, does anyone know if too much dairy can be linked to the speech problems in general or only if there does seem to be a lot of congestion? He can drink through a straw and has been doing a game called Mr Tongue at nursery and I have now got the sheets to show me how to do this with him at home.

Can anyone suggest any games to play with him that don't have an obvious agenda? And that my 5 year old could join in? The speech therapist who left gave us some cards with consonant sounds on but I'm not entirely sure what I should be doing with them. Anything that is obviously trying to get him to make the sounds seems to go against the general advice not to ask children to say words and when I have tried using them with him it has not been very productive! Games I've googled for seem often to involve reading and be more suitable for older children. They suggested things like making animal noises which he has always actually been ok at and I have tried blowing bubbles and saying 'pop!' - he loves the bubbles but will not say pop!

Also, eastendfareast, read about fish oils earlier today, just googled nordic naturals but their junior brand says age 5+ -can you give them earlier (or does anyone else know?) Also does anyone know any fish oil preparations likely to be acceptable to a fussy 3 year old (the more like sweets the better!)

I don't use the junior brand of Nordic naturals but the pro line and have been doing so since ds was 2 and my ds2 has had them since 2. They really help and we also make sure he has plenty of fish and a generally very good diet (with the odd great of course). We had him tested for food intolerances about 18m ago but I already knew that dairy didn't agree with him as milk gave him a terrible stomach so it came as no surprise. Prior to the diagnosis though we had allowed yogurt and cheese in small quantities but removing those too helped his general levels of concentration, speech and snot levels. Have a read around dairy and look at the health benefits of it - much has been made of how it's essential to our diets, but that really is not true. We use nut milks like almond as an alternative which taste great. He's also gluten free, again this has helped with focus and concentration and speech.

I'm on my phone so can't review your message so apologies if I miss anything. Please push for an ENT referral and please don't listen to the stories about Einstein not speaking till he was 4 etc. what's important is early intervention and a wait and see approach will just make life harder for you all.

At home, model good speech to him so if he says oo ar for blue car, model back to him slowly the correct pronunciation. Lack of consonants is consistent with glue ear and if he does have that you need to have grommets. Push push push everyone you can - gp, HV etc as it's such a crucial time to learn language and something obviously isn't working quite as if should.

Sorry for the essay - I've been dealing with this for over 4 years now and it's been a tough journey. My ds is doing brilliantly but it's been hard. Happy to chat via pm.

Dear OP, I have DS who at the age of 3 had three sounds, (not words). He also had lots of ear infections and ear wax. He had grommets in both ears and his ears syringed and this really made a difference.

He did have speech therapy (this was 20 years ago and I really had to push for it, sadly it seems things have not changed) and by the time he started school just before his 5th birthday he was fine and could speak clearly and fluently. Some of the speech therapy was private and some national health (at that time my husband had private health insurance through work and I had a really supportive GP who wrote a supporting statement).

He also had hearing tests which were ok, I personally think now that he missed out vital stages of learning to speak through having repeated ear infections and blocked ears. DS also always understood everything that was said to him.

3asabird - I used to get hurtful comments too, I used to tell adults that my children had been told not to speak to strangers. Some people are the pitts.

I firmly told off some spiteful older children in the park once who were making fun of DSs speech.

Eastandfareast, do you mean the Nordic Naturals ProEFA and ProDHA gels? Is EPA a different thing - I can't find that one. Did you check with your GP it was ok? (am imagining they won't have a clue).

This was my DD at that age, she could communicate well, but her speech was unintelligible. I was fobbed off a lot. In the end on the day she had her first day of induction at school at 4, the teacher came out with a form for speech therapy referral, her speech was still unintelligible to anyone but family. She's 8 now and her speech is pretty much fine after 2yrs of speech therapy. Their assesment was that she hadn't learnt to use the muscles on her mouth properly, for instance she couldn't stick out her tongue and we 'd never noticed. Oral dyspraxia was mentioned, but they thought it was unlikely and she isn't tongue tied. We had to do lots of mouth exercises with her and it took a while, but she is fine now and flying at school ??

Grizzabellia I use: these and these

I didn't check with my GP at the time but I now live in Asia and my GP here was very supportive of my choice of brand and dosage.

Thanks grizzibella and chottie its upsetting as in every other way hes fine and for nhs nurse to assume hes on autistic spectrum.

bit of update here

I have been concerened since 18months visited hv then.

I was then concerened at 2 she said she refer him then said sorry he dont meet criteria.

By 2,5 she said ok I refer him.

hes now 2.8months

hearing test last week fine repeating again in 6

i feel bit stuck now .months time.

yesterday speech /language assessment.

he made eye contact
smiled
played with her
could clearly hear
made sounds but not words.

Right now shes not sure autism.
I asked about global delay, verbal dyspraxia.
she was really vaugue maybe trying not worry me

she says she wants to see him again and speech therapy.
but theres a waitlist in the mean time

do makaton sign language with him.
try group with singing.
keep doing what we doing.

hes suppost t start school sept 2015 that sort of worries me.
right now he has no preschool place and would rather know what his exact issues are to pick the right setting.

dd2 is at a preschool but big one and feel uneasy about him starting there if eh cant actually communicate can see him being bit lost there and over whelemed not to mention cost of 2 preschoolers he wont get funding until september as hes april birthday someone did mention funding if problems with speech but neither the hv or the speech language therapist know anything about this.

I did wonder if smaller preschool or one attached to school would be better as maybe have more experience of language delay than afflunet village hall his names down for.

I feel bit stuck in limbo until april as we moving house, hes 3april, find out what school dd2 will get april so nothings going to chaneg no additional support offered hv seems most unconcerned.

Even my own mum shes nt exactly sane just say you need to talk to him more like i dont already so then i think people must think im crap parent too.

Hope you have better luck

Hi

I found this post when googling desperately for my son and I could have written it myself.

My soon to be 3 year old says lots of words but misses the initial consonant off lots. So for example “bear” will be perfect but “bed” is “ed” etc.

He also is delayed I would say in the construction of sentences but I’m almost not sure if this is because the more words he strings together often the harder it is to understand.

If anyone reads this and has an update on their little one I would be so grateful.

Thank you

I hope some of the original posters reply @picklepants18 but in the meantime I thought I’d mention my brother.

My late mum always said he missed the beginning off of words (I want my truck became I ont eye uck) he got frustrated and the more he tried to speak the worse it became. But apparently it gradually got better without any intervention and by the time he started school he was nearly the same level as his peers. Over the first year or so of school he caught up and was fine. It didn’t affect his schooling or having friends. He’s an adult now with a successful career, wife and family.

I wish you luck and hope others can be more helpful.