Major Speech Delay

[justoffshift]

Posting here for traffic.
Have a ds who is 3 in November this year, so 34 months today.
He has a huge speech delay, he can say a number of words (maybe 25) but all with parts missing, such as water - war or ter, Max - Maaa, Biscuit- bis, Strawberry- straaw, cracker- crack.

Mummy is the only word he can say fully. He is nowhere near potty trained, has issues with socialising (i.e. walks around with no awareness of other children near him), struggles to respond to commands and voices a lot of the time unless it's something he really wants such as a food. Nursery have raised concerns before now and again today, we have weekly input (for a year now) with a parent infant psychotherapist as well who is helpful but again, I know everything that she and SALT are telling me to do with him, it's nothing new but he just doesn't respond whatsoever to any input.

That said, he sleeps fine (always has), eats a few things but can be restrictive to dry foods often,can respond to some simple instructions such as put this in the bin, fetch your shoes etc (and remembers routines such as shoes off at the door), and his gross and fine motor skills are excellent.

AIBU to ask what on earth else I can do? My almost 5yo smashed all his targets and more very early on and has always been very advanced.

Has his hearing been tested - specifically for glue ear? If he has glue ear then definitely push for gromits.
Also contact Afasic. They are a charity for children With speech issue. They may have some suggestion. www.afasic.org.uk/

For full context as well he goes to a state preschool Monday-Weds mornings and a private nursery all day Thurs-Fri. I work FT so am not around that much, and between DH and I we are always rushing about so he doesn't get that much quality 1:1 time.

[quote Serenschintte]Has his hearing been tested - specifically for glue ear? If he has glue ear then definitely push for gromits.
Also contact Afasic. They are a charity for children With speech issue. They may have some suggestion. www.afasic.org.uk/[/quote]
Everything that @Serenschintte said.

Get his hearing tested ASAP if you haven't xx

[quote Serenschintte]Has his hearing been tested - specifically for glue ear? If he has glue ear then definitely push for gromits.
Also contact Afasic. They are a charity for children With speech issue. They may have some suggestion. www.afasic.org.uk/[/quote]
Interesting, so the GP wouldn't refer as DS understanding was good therefore he could hear? We are well acquainted with Audiology as my DH is profoundly deaf in both ears so we could push for another referral I suppose, we both also work in a hospital, my DH in paediatrics so maybe he could ask a colleague for advice.

I'm surprised by the GP as I would expect him at that age to follow more instructions than the few you described. So it could be a slight hearing issue so definitely get him tested for that.

Definitely push for a hearing test.
It can make the world of difference.

Have the Nursery got him on any support plans ?
Have they got support from their Area Inclusion Officer or Area SENCO or whatever the team is called in their area ?

@BackforGood

Definitely push for a hearing test. It can make the world of difference.

Have the Nursery got him on any support plans ?
Have they got support from their Area Inclusion Officer or Area SENCO or whatever the team is called in their area ?

Nursery were just following the SALT advice from a drop in we went to before lockdown, very basic stuff that anyone clued up would know anyway. Nursery this morning were saying about a multi agency approach (can only imagine the length of time that will take to sort out).

I'm going to get DH to ring the GP tomorrow for another referral, also wondering about a tongue tie?

Tongue tie might affect pronunciation but would not reduce his vocabulary, so that's unlikely. Definitely worth getting hearing assessed though, particularly with a family history of hearing problems.

My sister had significant hearing loss due to glue ear as a child, and speech delay as a result. She would understand IF spoken to directly, facing her, otherwise might not even realise she was being talked to. Gromits completely changed things for her!

I don’t understand why a hearing test hasn’t been done as a matter of course. My DS was not saying ANY words at all at 34 months, not even Mummy. Actually that’s a lie he was saying yes and no. Not mummy though or even a sound near it. However he was extremely communicative by using signs and basically grunting and pointing, and he could get on fine. It was flagged at his 2.5 year review, where he scored 16/16 for understanding, 0/16 for talking! First step was he was immediately referred to audiology, then SALT etc. Hearing was first on the list to check even though his understanding was perfect. Good luck

DH hearing problem is as a result of chickenpox at 2yo not picked up until 5yo therefore we are well aware about missing these crucial years of learning. No HV has darkened my door since he was about 1yo and I requested a visit!

Mush- DS can get by with signalling etc but still. People can't believe he is almost 3 as he is like a baby with his speech and general gormlessness.

I have two boys with language disorders. They both had hearing tests very early on.

Yeah it's highly frustrating that the GP didn't just bang out a quick referral

Mine couldnt say anything at 3 he has Apraxia and didnt speak until he was about 8. He speaks beautifully now as a teen.

Good luck OP. My sons had about 5 hearing tests they kept doing them but his hearing was fine. He ended up getting sent to a specialist speech therapist in London (2 hour drive there and 2 hour back from where we live was ridiculous but they were good)

DD was sent for a hearing test 'just to make sure' after we attended a SALT drop in at two (so the referral didn't come from GP) - her understanding was good and hearing fine, but good to rule it out (she spoke eventually!).

Op can you push for referral to local community paediatric team? He would benefit possibly from full development check given what you’re saying. Definitely push for full audiologist assessment

I have children with hearing loss.

I can't believe they haven't given him a hearing test. Even without the family history it seems ridiculous not to rule that out at least.

Also there is a difference between 'hearing' for the purposes of understanding what is meant (which also has the benefit of lip reading, body language, context etc) and 'hearing' well enough to learn how to form words yourself.

Demand a hearing test. I am shocked at how bad the advice you've been given is.

DC1 had some of these issues and at 2.5 was diagnosed with glue ear and enlarged adenoids and tonsils. He had grommets put in, his adenoids removed and his tonsils reduced (weird laser thing our hospital offered) Honestly, he was like a different kid within a week. Definitely something to investigate. Best of luck

Thanks, I would hope that we could get grommets etc and other bits sorted fairly fast (hospital is a major teaching hospital). It really is impacting him so much.

OP in my area you can self refer to Audiology. You just contact the department at the hospital, say that you are concerned about your child, and they will book you in without a referral from a GP. It might be worth seeing if it’s the same in your area. Good luck.

I'm a SALT. He appears to have delays in several areas, not just talking. I would be considering possibly a referral to Community Paediatricians to rule out any wider issues e.g. learning delay. What you have described sounds like it is likely to be due to attention rather than hearing, but it is always worth screening hearing, as obviously it's a chicken and egg situation; if it is harder to hear, you pay less attention. As I'm sure you know, hearing is very variable depending on situation so he might hear fine 1:1 but struggle in a noisy nursery room.

Learning words comes before pronunciation, so I wouldn't overly worry about HOW he produces the words right now, but focus on increasing his vocabulary using the strategies you have hopefully been given. It does often take a while, as they have to build understanding of the word first and then work out saying it.

Yes he is delayed in several areas I agree, such a shame as I don't want this to impact him long term but I can already see it happening in day to day life.

He cries and whines quite a bit too, creates when he doesn't get his own way a lot of the time. Nothing at all like my older child

My little boy was picked up for a delay in understanding and speech at his 2.5 year check. We went private and found he had glue ear. At this point he had two words. He had the grommets and now 9 months later he has around 50 - 70 words. Understanding still not there but some children are quick others like mine have been slow and lockdown hasn't helped. I'd use the strategies speech have given you and check his hearing. My little one also has meltdowns on a daily basis if he doesn't get his way, his attention isn't there so it's difficult to get him to focus so we are working on exercises that teach him verbs so he can start asking and attention exercises. Increasing time spent each time. As I work full time this sometimes is only 20 mins a day but little and often and repetition I find helps.