4 yr old with unclear speech - advice on getting help

[ChazsBrilliantAttitude]

DS2 has unclear speech and doesn't form some of his words properly. He understands language, has an appropriate vocab for his age and can hear when you whisper (if he wants to ). I would say that I don't understand 25%+ of what he says first time around and his teachers have commented on his speech too (started YR in Sept).

Note - his school is private so I don't think I can get a SLT referral through them.

DS2 had chronic tonsillitis from a few months old until 2.10 when he had his tonsils and adenoids out. Prior to having his tonsils removed he was missing off the beginning of words but this has improved. However, I think he may have missed some speech development through his ears being blocked, having a sore throat etc. DS2 is also bilingual and is unclear in both languages.

I have an appointment with the GP to get his ears checked for glue ear and to request a hearing test. I assume my GP can refer to the SLT as well. Does this sound like the right approach? Is there anything else I should be doing?

I am in London and I hear SLT waiting times are long does anyone have any experience of that (I would be prepared to pay for a private SLT if necessary).

Your GP can refer you, this is how I got ds's referal, dd2's was through her nursery.

SALT waiting times are pretty long everywhere, I live in the NW and it was a few months before I even got the letter confirming the referal then longer for the actual appointment! Dd2 was refered while in nursery, she was assessed in the summer holidays and then I got her work sent to me through the post, her reception teacher photocopied it so we could do it at home as well as school.

Hi Chaz, I'm an Early Years SLT and yes, your GP will be able to refer to your local SLT service. Organising a hearing test is a very good idea. I also highly recommend going to your local Children's Centre. They should have an SLT there who you could have a chat with (you may have to book an appointment) and he/she could give you advice on how to support DS at home.

Thanks to you both. I spoke to the Childrens Centre who said they only refer non-school age children but gave me the number of the right people to speak to about SLT for children of school age which is a step forward.

The GP's appointment isn't for nearly 2 weeks so if I can move things forward with the SLT in the meantime I will as I suspect we will have a fairly long wait for a referral.

In the meantime, I am getting DS2 to slow down and try to say each word clearly (not for every sentences but a couple of times a day). If necessary I am modelling the word for him and the movements needed for the sounds.

SOunds like my ds who's also just started school. He was referred through our GP, although he was already on the "observe list" due to severe glue ear and grommets.

I was told to focus on one sound at a time ("c"/"k" is our present one) and get him to practice saying "c" a few times. You make it fun by both going "c...c...c" as you do something. Then move on to saying things like "c...ar" befoe you try and get him to say "car" in one go.

Not to keep saying "say that properly" or imitating him.

We don't see the SALT in school though, and have to take him out of school for it.

We were referred to SALT via our Health visitor when DS was 4.

Yes, modelling clear sounds and words is a good way forward but try not to ask him to copy or repeat words after you because that can become a big drag for him. If you have understood what he says, even though it's not clear, just copy the word back to him the way you would say it - for example:
Child - 'Look! A goggie (doggie)!'
Adult - 'Yes, it's a doggie'.... and then just carry on as you were

I wouldn't advise doing any work on sounds, getting him to copy sounds after you or making him look at your mouth when you say certain sounds. Again, it's making a 'big deal' out of talking which can feel very odd for children - it's not how we usually communicate with each other and your DS is likely to pick up on this. Don't worry too much, you're getting a referral sorted out and even if the Children's Centre can't refer you, they could definitely give you advice and support while you're waiting for an assessment.

Thanks for the good advice everyone.

I am conscious of drawing too much attention to his speech so I will be careful not to focus too much on his pronunciation. Luckily my Arabic (DH's language) is not great so I have the boys teaching me sounds which I get spectacularly wrong at times (e.g. mixing up "grape" and "rabbit") so practicing language sounds is not so unusual in our house.

I will reflect back what he has said using the correct version where possible, I tend to ignore the mistakes when sorting them out would destroy the flow of conversation.

I'll try to pop into the Children's Centre for some advice.

I will also take a deep breath and try not to worry too much as I am sure that with a bit of help everything will get sorted out.

Chaz, since he has now started school it would be better to see the school nurse who can refer directly to SALT. No need to wait 2 weeks or see the GP with this. (I'm a HV and the school nurse does the same role with over 5's or school age 4, as opposed to the eldest who have just turned 4 in Oct)

AnxiousElephant he is in a private school so there doesn't seem to be a school nurse. Ideally, I would have preferred to go down the route of a referral throught the school but I don't think that is possible.

Usually the HV will know who the school nurse is in the locality as even private schools get immunisations like HPV for example, phone the surgery for the school nurse team in the area. I'm sure they will have the notes.

If you have a nice HV team they will know the quickest route in your area

Chazs - if you're not bothered about paying, you could ask the LS teacher at your current school for a recommendation (if it's a private pre-prep only they may have a contact at the local prep for a good one) Your ds at state school would probably only get a small number of appointments in a year (3 for instance is usual in this area - Surrey) so it really is up to you.

This is all really useful info. I can see I will be making a few more phone calls over the next couple of days to work out the best options.

I am happy to pay for appointments if necessary. The main problem I face is that I don't know what I am looking for so I will check for recommendations.

Chaz, google ASLTIP - Association of Speech and Language Therapists in Independent Practice. You can search for private SLTs in your area

Good news - the SLT at the Children's Centre gave me the name of the SLT for the schools programme. She had discussed my son with the appropriate people and they have decided to see him in the EarlyYears team as he is a summer born 4 yr old who has just started school. The coordinator for the Early Years team is going to get in touch to organise a referral (she was copied on the email from the schools SLT coordinator so I know who she is).

I am pleased he is being seen by the EarlyYears team as he is only 4.2 and has just started school.

Thank you all for your support and advice. I felt a bit lost and didn't know where to start to get my son assessed (this is why I love MN - there are so many helpful and knowledgeable of people)

Good luck with it all Chaz

Thats great Chaz! Good luck