Talk to me about speech therapy

[laraeo]

DS is 2.5. He went to nursery/creche a few times a week until we moved back to the States from the UK in May. The nursery staff were never worried about his lack of speech (he'd make lots of noise but no proper words and hit his other milestones within the average timeframes) and I tried not to worry about it too much. Upon getting settled back in Stateside, I took him for a well child checkup and the doctor was appalled at his lack of speech, wanted his hearing tested (it had been several times in the UK - had a bit of glue ear that resolved itself) and immediately put into speech therapy.

He went for his initial speech assessment a few weeks ago and it's pretty much as we suspected. He's very far behind in speech (tested at 1.7 years) but ahead in comprehension (tested at 2.9 years). We've been going 3 times/week for 1/2 hour sessions since then.

What I'm trying to figure out is generally when does it start to make a difference? He's got about 6 words now (one he just got last week) the others he had before he started therapy. There hasn't been tons of feedback - what I get is in the waiting room which is filled with people and there's only a minute or two between appointments. They suggested today that we work at home on getting him to make faces so that his mouth is in the right position to make different sounds. He is clearly getting more and more frustrated that he can't talk - a few nights ago he desperately wanted to tell me something about the windows (I think) and there was furious pointing, grunting and other sounds but nothing comprehensible. It went on for about 5 minutes (until he gave up and put pasta on his head ).

Other than for the initial assessment, I haven't been in the room while he does his thing - which is play-based - I guess what I need is to be regaled with tales of how much speech therapy has helped other DCs.

Regale away!

They are a lot more pro-active in the USA about speech (hyper interventionist in most medical matters, I'm sure you're aware). That said, your DS would qualify for a referral in the UK, too, ime). But at his age, it would only be a place on the waiting list.

What do they do at your DS's speech therapy? Why aren't you in with him? Would help a lot if you understood better what they are doing and how they do it. DS3 is also 2.5yo and can't get any SALT until he is at least 3yo (they said the SALT won't really work then, anyway). I can't believe that they aren't including you closely in the process, we had just one session/week but daily homework otherwise.

DS2 had speech therapy at age 4-5yo (so after he started school, even); just 12 sessions and they helped A LOT, although he still (now 6yo) struggles with some sounds/words.

If hes getting frustarted I would say they need to be doing some signung with you both so he can at least try and express what he needs bless him.
It does seem ludicrous that you are not in the sessions-my DS (verbal dyspraxia) has been having SALT for nearly 2 years and I always go in-the sessions with the salt are only the start-most of what he achieves is through the continual repetition and modelling done at home based on that weeks therapy.
What I have found is that DS speech and language comes on in fits and starts so he will show massive development then plateau off for a bit then have another spurt in language production and articulation improvement. It depends what they think is wrong-is it language delay or disorder? is it articualtion of sound production or actual expressive language...I would be asking some questions if I were you and asking to be present so you can help him at home.
HTH

You have to present, my SLT believes in teaching the parents as much as the child, as you're with them all the time, not a couple of hours a week at best.

A weekly session with a SALT is only the tip of the iceberg - you should be heavily involved as you are doing most of the "therapy" at home. On the NHS a 2 year old with a language delay would probably only get reviewed and the therapy would be done through teaching the parents how best to encourage language development. I like the HANEN approach a lot.

I was in the therapy room for DS's assessment and it was just asking him to do different things, asking him questions about different stories, etc. to get him to speak. During the assessment I asked whether I should be in the room while he had the therapy sessions and they said they prefer parents not to be in the room because they'll distract the kids. The first time we went after the assessment, I had to go back with him because he didn't want to go with the therapist by himself. I settled into a chair in the therapy room (which is pretty small) to read the paper and after about 30 seconds, DS was trying to climb all over me. I suppose if I went back every time, he'd eventually learn that it wasn't mommy time (but then when would I read the paper? ). Next week I'll ask for some additional time to sit down with the therapist for a more in depth analysis of what they think is going on with him and what they actually do. He's very happy to go now - he runs back as soon as the therapist comes to the waiting room and is pleased as punch to return and show me his reward sticker.

The other thing is that we're in a rural setting and there's only 1 provider of pediatric speech therapy within a reasonable distance. So it's not like I can change providers if I don't like the methods used here.

What is the difference between a language delay v. disorder? Is there a website that explains it in layman's terms?

I had a look at the HANEN book website when we were in the UK - I was lurking on all the threads about speech. At that point, I wasn't overly concerned but I did bookmark the site. I think I'll go back to it and order the materials. Luckily, today's payday !

As for the whole medical thing, I honestly thought I might have to battle for a referral (we're covered by the military insurance plan which is a different beast than the disaster which is the rest of the US health care system) so in some ways I was glad that one was offered up immediately.

Thanks for everyone's input.

I still don't really understand why you're not in the room with him - DS3 has speech therapy for years (verbal Dyspraxia - and yes, it worked wonders. Unintelligible at 4; he's 8 now and you only really notice difficulties when he's tired or ill or upset, although he sounds a bit robotic) and I was always in the room - because otherwise, I had no way of knowing how to practice at home with him.

Can you make a bit of fuss about it? Can you insist? We used to have weekly half hour sessions and then practice for 10 minute bursts here and there throughout the week.

If your ds concentrates better with you out of the room, the SALT should be having you in for 5-10 minutes at the end to go through what has been done and give you lots of things to do at home. Really, the home input is so important at this age as you are with your son all of the time.

You could have a look at the ICAN website, there are also others if you google something like "speech therapy resources."

Language delay means your son is following a normal pattern of language development but slower than average. Language disorder means the pattern of development is not usual, e.g. he could have advanced development in one area of language but delayed in another. From what you say it sounds like expressive language delay only, but you should ask your SALT about that.

At this point I'm not in the room because that was what they recommended and since I'm a newbie at all this and they're the experts, I bowed to their expertise.

I agree with dreamworld that DS will concentrate better without me in the room. Having said that, I think the suggestion of going in for the last 5 minutes or so is a good one.

I will ask the SALT on Monday for a time when we can sit down and discuss if they've got any ideas as to what's going on with DS and see what they think of the idea of going in just for the last 5 minutes or so.

Now I'm off to look at the ICAN website.