What to do about speech delay in 2.9 DS? Long sorry!

[confusedofengland]

Hope somebody has some advice for me that we haven't already tried, because I am getting desperate!

DS2 is 2.9 & has very little speech - around 30 words at the last count. Most of these are pretty unclear. He also knows a couple of baby signs - 'milk' & 'all gone'. He also babbles a lot & will sit & look at eg a catalogue with somebody & chatter on & on whilst pointing at pictures, but just with few or no recognisable words. I would say he comes across more like a child just turned 2 than approaching 3.

He has been under investigation for hearing problems since around his 2nd birthday. We have just come back from his 4th hearing test, this time at ENT at the hospital, and for the first time there is no fluid present. The previous 3 tests all found fluid. We are to go back again in 4 months, by which time he'll be 3.

We have been receiving SALT. We took part in group SALT sessions around his 2nd birthday, then in the summer (August I think, so when he was around 2.4) we had our first block of individual SALT sessions. There were 5 sessions, 1 he couldn't make due to D&V. The SALT said he made great progress in those sessions, more than she often sees in many children.

He goes to nursery 2 days per week (8.30-5.30 & 8.30-3.30). We receive the 2-year funding for this because of his speech delay. They have him on an IEP. The report we have just had for nursery (on Friday) states he is making steady progress, but still needs lots of support in social skills & vocabulary. When I picked him up last week, they emphasised how much better he is doing & that he is now trying to play with other DC rather than just watching them or playing next to them. He was unable to attend nursery for around a month from mid-December to mid-January due to firstly a bad cough then nursery closure over the holidays.

Outside of nursery, we go to 1 toddler group, 1 Talking Tots group, 1 library story & rhyme time & usually 1-2 playdates per week. At home, he likes to watch In the Night Garden, Numtums & Something Special, but I try to limit TV to max 1-2 hours per day. He also enjoys building blocks, puzzles, cotton reels, books, 'helping' with housework, wrestling/chasing with his brother, singing etc In all of these activities, I have noticed that he is starting to focus a little longer. He loves numbers & will point them out wherever we go & has 'words' (noises) for lots of them. He has also started to enjoy soft play, which before the summer he was not keen on, preferring to wander round & 'chatter' to people while his brother (now 5.1) played. He doesn't have as much pretend play as perhaps he could/ought to, although he went through a dolly phase a while back, he is just now more into cars & bricks, but will do things with dolly when prompted.

He is an excellent eater & sleeper & has recently started eating even more foods, mainly fruit & veg that he wouldn't eat before. He feeds & settles himself quite happily (although feeding himself was a late skill to develop, about 18mos).

Historically, he has been a late starter with all his skills - walking, pointing & waving, self-feeding, crawling - which SALT said may be significant. He is a very happy little boy, who loves playing tricks on people & making people laugh. He is also very well-behaved & doesn't really have many tantrums etc.

Yesterday, I bought some Omega-3 syrup from Boots, of which he has had 1 dose. I will try this for a few weeks & see if it makes any difference, as I have heard it can improve concentration & speech, and I figure it certainly can't do any harm.

One thing that puzzles me is that he will copy a lot of phrases, but as sounds not words. Eg, if I say 'off we go' he will copy the sound of what I have said, with the same intonation, but not the words. He will then use the same 'phrase' without words at appropriate times, so he understands what it means.

His understanding on the whole is fairly good in that he will follow 1 & 2-step instructions, but I don't think that he understands some concepts you might expect of a nearly 3-year old.

He does have a great love of doors & must always make sure they are shut. Sometimes when he is tired he will open & close a door repeatedly, whether a real door or on a toy car etc. But he is easily distracted from this & will play other things. Eg at toddler group yesterday of 75 mins, he probably spent 10-15 mins total on doors, 10 mins group singing, 10 mins snack time, then the rest flitting between craft (10 mins), dolls' pushchair, puzzles, building bricks (5-10 mins) & other toys.

One or two family members & friends, none of whom see him more than once a month or so, have said they think he may have autism. The SALT also mentioned it as one of the common reasons for a speech delay but said that, IHO, if he had it, it was very mild & she wouldn't like to say either way.

DH & I have noticed lots of progress from him in all sorts of areas within the last 3-4 months, from eating, to concentration, to more awareness of toilet function, to little things like being happier to have his face wiped or tshirt pulled over his head.

He has a big brother of 5.1 who is the total opposite in a lot of ways. DS1 was advanced with talking & continues to be academically advanced at school. DS1 is not very good at physical stuff eg sports, park etc whereas DS2 picks these things up naturally & is almost at the same level as his brother in some things. Both are very affectionate . We also have DS3 on the way in just over 4 weeks. We moved house earlier last year.

Anyway, so sorry for the essay, I just wanted to give as clear a picture of DS2 as I could, in the hope that somebody understands & can give me any advice to help him, particularly his speech.

Forgot to say, around his second birthday he had about 5 words, increasing to 10 at 2.4 when we saw SALT, so this gives some idea of the improvement he has made.

Does the speech therapist give you7activities to carry out at home?

There are lots of activities that you can do at home, I can make a l;ist if you want, but first you could read two books: It Takes Two to Talk and Baby Talk by Sally Ward.

Some children need a lot of help and support to speak, others will do it naturally without much effort from the families and environment. Some people might say to you 'just chat to him all the time' but that's. Not very helpful. I am sure you speak to him a lot. And that kind of comments can make you feel guilty. It's not the amount of words tht you say it's how you say them and how your child is listening.

Others might suggest a disorder or autism, but fact is, if your child has had glue ear he will have missed some important months of development associated with speech.

There ae lots of websites you could check, ICAN is very good.

Let me know if you want some other tips, examples of activities you can carry out at home.

At 2.9yo, DS3 had just 15 words, and 4 signs.

He had had SALT, 3 individual sessions, and I was given lots of activities to do at home with him.

He will be 3yo this week.

He now has 100+ words , and is putting words together to make 3-4 word sentences.

To give you some hope, my older DS2 was 3y6mo before he even said his first word, Mum. He didn't put together 2 word sentences until he was 4y5mo, started Reception at 4y9mo with just 2-3 word sentences.

He is now 10yo, (turned 10 at the end of November) and could talk the hind legs of a fecking donkey!! The only remaining issues with his speech are some interesting sentence structures, he sounds a bit Yoda-ish, but even that's improved massively over the last 6 months.

I hope that gives you a bit of hope - I had given up hope by 3yo that my DS2 would ever be able to speak. Now he's the most chatty of all my DC's. We joke that he's still making up for lost time!

It Takes Two To Talk is what we used with both DS2 and DS3.

blueberry yes, the SALT did give me some activities to do at home, but a) the sheet seems to have got lost in our house move and b) a lot of it was things I was doing anyway with DS eg the tickle game to encourage eye contact (which he gives me & DH plenty of, although the SALT observations seemed to be different) & encouraging DS to make choices, which we do. So, yes please, any more you have would be very helpful.

I do have one of the books you've recommended on loan from the library, I just need to get round to reading it, so busy atm! Actually, your thoughts on glue ear echo DH's, that even if DS does not have glue ear now, he may be 8 months behind from the 8 months he had glue ear, iyswim. He has definitely made a lot of progress more quickly in the last few months. My sister, who mentioned autism, is insistent that DS has autism because her DS had glue ear & still learned to talk OK, just with mispronounced words, but surely every child is different

Couthy that is encouraging to hear of your DSes, thank you It is just so difficult & worrying to know whether he is simply a late developer or if there's something more going on.

I wont lie to you, DS2 DOES have Autistic traits, and DS3 has been assessed for Autism, though their results were that he has GDD with autistic traits.

But no full dx of autism IYSWIM.

Speech therapy? And continue with the sign language it promotes communication
Narratate everything going on. Encourage language before giving him what he wants. Like for ex. A toy, simply hold it for a second touch his lips and say something like say please, say toy and an effort is all you should look for. If your using two languages in the house that could make things harder.

izzy yes, as per my OP, he has already had his first block of speech therapy sessions & we are waiting for a second block (should have been in December, good old NHS ) I have been thinking about sign language but don't know how I'd go about him learning it, I feel he's probably too old for baby sign classes. He does love Mr Tumble, though, and I think that's where he picked up the sign for 'milk'. We already try & make him 'ask' for things that he wants, although when in a hurry I am guilty of just giving him what I know he needs. From doing this, he uses the word 'more' very clearly & spontaneously, which is great, as well as a few food words (nana, milk, yoghurt (sometimes)).

Couthy I am under no illusion that some of DS2's characteristics could be autistic, such as the obsession with doors & the delayed speech & perhaps the lack of imaginative play, but I honestly don't think he would meet the criteria to be diagnosed with it iyswim. He has no issues with food, sleep, routine, meltdowns, sensory issues, all of which I read about in connection with autistic DC. Also, sometimes I feel like others are describing a different child to the one I see: eg nursery says he needs help with his social interaction with peers, but I see a little boy who loves to chase his brother & friends around the playground & who at soft play just wants to be in the ball pit with the other DC. I do think it will be easier for him to join in once he has the language skills, though. And it has been mentioned that eye contact needs to be encouraged, but he will sit on people's laps for 5 minutes at a time, babbling away while looking in their eyes & if he wants something will always go & point to the thing and make a noise while looking at me. Sometimes if he can't catch my eye because I'm leaning over, he'll bend over too to catch my eye

Why are DC so complicated?

Mr Tumble is bloody wonderful! I credit him more with DS2 starting to sign, and then talk, than I do the NHS with their woeful SALT provision, or lack thereof.

Learn the signs from Mr Tumble, and "sign and say", so that they learn the sign, associate the word with the sign, learn to say the word, and then drop the sign.

Ask your HV and SALT (you can ask on the phone, don't wait for next appointment) if there are any signing groups you could go on a waiting list for, and go on them.

Also, often your local SEN school will run signing courses, and your DC doesn't usually have to be a pupil there for you to attend, so that might be another route.

My DS3 is described as having a 'spiky profile', which is a phrase used often to describe DC's with Autism.

No dx though...

Accept that these Autistic traits may mean a slower rate of progress, but take heart from the fact that he us TRYING to communicate, and has some words - that means that it is likely that he WILL catch up, like my DS2. I worry less about DS3's speech because I gave seen that like DS2, he's going to do it in his own sweet time!

Another Hanen book called More Than Words is very good and it's full of strategies to encourage eye contact, appropiate social interaction, etc but your Ds might be a bit young for it so I'd recommend you borrow it from a library if possible before buying it (it's not cheap).

With DS games like spotting the odd one out were great to increase his vocabulary, he needed to point to the odd object, name it and try to explain why it didn't belong to the group, like for example pointing at the picture of a hammer with pictures of fruit, saying hammer and try to say that it wasn't a fruit but a tool.

copy and model it's essesntial, when he points at a car and says or tries to say car, you say," yes that's right it's a red car". So you repeat what he's saying and expand on it, never correct though, just model the right way of saying it. DS(7) still gets many words wrong like this morning he said " x throwed the teddy on the floor" soI said " oh dear x threw the teddy on the floor!" " yes he threw it".

good luck

• find fifteen minutes a day for one-to-one play with no music, radio, telly and sit on the floor with your DS. Narrate what he does, encourage him to lead the play, and comment on what he does with simple, short sentences.
• use short sentences, and repeat key words. 'Look, a red car. CAR, red CAR'. I know it sounds silly, but it works.
• get his attention before speaking to him. Clap your hands, say his name, whatever works so that he looks at you.
• encourage mouth movements by showing him to blow a whistle, suck with a straw, play 'blow football', blow bubbles.
• Sit him on your lap facing you. Pull funny faces at him and encourage him to do the same faces back at you. Do it with a mirror so that he can see your silly faces.
• make lots and lots of animal sounds, 'the cow says MOOO' etc. Same with car, trains, anything to get him to many any noises at all.
• play musical instruments, wooden spoons with pans, shakers, etc just to encourage him to make any sounds at all.
• say silly things like 'let's put your shoes on your hands' and see if he can spot the mistakes. Then you can laugh at it together when you say 'silly me, shoes go on your FEET, not on your HANDS'!
• sing the same nursery rhyme many times in a row, for a few days, then skip a word of the rhyme and see if you can fill in the blank.
• food is a fantastic subject to encourage toddlers to talk. Repeat simple words such as 'more', 'again', and any fruit name and food name. Repeat them lots and lots, using simple short sentences.
• children who speak late are not 'lazy', so it's important to praise any sounds they make even if the word is not pronounced correctly. Keep on repeating the word correctly, don't say 'no it's not TAR, it's STAR'. If your DS says TAR, say 'yes, a STAR, a bright STAR'.
• most important, encourage him to listen. make sure he pays attention to you and go down to his level and use simple, short sentences repeating key words.

You will find lots of tips on ICAN website, and also in a book called 'The cow says MOO, ten tips to teach toddlers to talk.

Also, playing with doors could simply be a 'schematic play' phase, www.choochoos.co.uk/information/schematic-play. a repeated pattern of play does not necessarily mean that a child has autistic traits. Most children will display some kind of schematic play at some point. Some children will spend ages and ages filling pots and emptying them. Or lining up cars and trains. Or pulling pull along toys up and down and up and down. If you search schematic play early years in search engine you will find lots of information about it.

When we initially started signing with ds, i wrote a list of 20 signs i wanted to introduce into the day eg more, biscuit, daddy, mummy, sister's names, teddy etc Then I googled or asked on the sn boards here, and made or printed off the drawings that showed how the sign was made and stuck them up on the wall. We just focused on these signs first, then increased as we got more confident. There are also some great signing dvds on amazon, Singing Hands and Dave Benson Philips are both good ones.

I know not all repetitive play is evidence of Autistic traits, dS2 and DS3 have both had Autism assessments - my DBro has Aspergers and their Dad has Autism...

My DC's have been assessed as GDD with Autistic traits. I'm not saying that the OP's child has Autism, just that it won't hurt to use some of the techniques for encouraging eye contact, pretend play, speech etc used with children with Autism may help the OP to get her DS to talk.

Yes, of course. I can also recommend a book called Motivate to Communicate, 300 games and activities for your child with Autism, and I use it a lot for children with speech problems, not for children who are autistic. But it's more for older children, I'd say age 4+.

Hi, I was thinking about the part when you said he copies the phases with intonation but not words. My son has articulation disorder at 3 he had very few recognisable words, he would sort of make sounds but nothing clear e.g he had a blankie which he would refer to as ne-ee we were trying to guess what he meant asking oh is he called nelly etc and would say no until we said blankie- in his head he was saying blankie! He is great at coping rhythms and tunes though.
Anyway it took us a while to figure what the problem was so I was wondering if you have noticed what his mouth. Shapes were like Shen he is trying to talk. My son could speak while 'sentences' barely moving his mouth so of course nothin was coming out clearly! He did lots of exercises starting with things like blowing bubbles, whistles, straws etc and also making sure he could see my mouth when I was talking to him (he has no hearing problems it's just a matter of him learning what his mouth should be doing). He's done lots of work on this, using a mirror to see what his mouth shape looks like and using the iPad app bigmouth phonics.
He was 5 in November and when starting school in sept he was almost completely unintelligible - now he still has some unclear speech but is able to understood the majority of the time by unfamiliar people now. He has a long way to go still e.g. He doesn't use blends yet so now we have a bankie rather than blankie! But I can now see everything falling into place. He has been having private salt since sept and it has been invaluable.

I have a 4 year old son who is in reception 9 (august birthday). He was born with cleft lip and palate, had glue ear and has a speech disorder - articulation and phonological which is not all related to his cleft palate. He has problems with first letters on his words and cannot blend sounds, he too can say words with vowel sounds and the right intonation. he receives weekly speech therapy at school and school have applied for him to be assessed for a statement. it is a slow progress and each word he can say clearly is celebrated. I feel that speech delay does impact on a child's communication, social and play skills. In some ways his behaviour is for a child at a younger age. He will play imaginative games with his older sister, but does not play imaginatively by himself. wish you all the best, but having a child with a speech disorder can be difficult as it is not visible to other people.

Keep up the eye contact and enunciating all of the sounds in your own words very clearly. Early SLT is mostly about improving child's listening skills and you can do a lot to facilitate that right now. Good luck. x

ps: he needs to see your mouth as you speak; see how your mouth makes those sounds.

blueberry some great tips, thank you. A lot we are already doing as we were taught them at group SLT, but also some new ones to try. Interesting to ponder whether the doors is schematic play or something else, he has been doing it for months now & doesn't seem to be able to resist closing an open door, but it's just part of him! I tell people 'he does love a door ' I think the advice on using techniques that can also work with autistic DC certainly won't hurt, so that's great.

hazey will check out those DVDs, thanks. I will also look into signing classes as lots of people on here seem to be recommending them.

jelly that's interesting about your DS. I must say I haven't really looked at DS2's mouth when he's 'talking' but I have before had the feeling that may have something to do with it. He definitely wants to talk & spends ages babbling at people & repeats 'phrases' at the right time & in the right tone but without the words, so I feel in a way it's just the words that are missing. He was late to learn to use a straw & to blow (both after age 2, iirc - I remember he was unable to blow out candles on his 2nd birthday cake), so I don't know if that's relevant? He can now do both OK, but blowing is still not as clear as it could be. He also took ages to learn to kiss & it's not a kiss like other people give. It is something I will ask SALT about when I eventually see her again.

loverunning thank you for sharing about your DS, too. I certainly feel that a child whose language is not developing in the right order or at the right pace could be affected in other areas. It sounds like your DS is making progress, which is great.

Today has started off very positively, with DS having toast for breakfast & pointing to & saying jam (dam) as soon as he saw the jar, because he wanted some on his toast. He then went off to nursery quite happily & did not cry when I dropped him off for the first time since October! A small thing to celebrate but a good one, nonetheless

Well, having a bit of a down day today. Went to Talking Tots for their 4th session (but only our 3rd as DS missed the last one as he was having a hearing test). We are in the Sprinters class for 2-3 year olds. They do the same activities for 2 weeks running & DS was totally lost this week & out of his depth this week, ie the second week of this lot of activities To me, some of them seemed rather complicated for a 2-year old, but I just don't know any more. Eg in one activity, we were given 12 pictures of household items, plus a larger picture of parts of a house - garden, kitchen, bathroom. The DC had to put each smaller picture in the room it belonged eg toothbrush in bathroom. DS didn't have a clue, although when I said to him, put the toothbrush in the bathroom, he did once I had pointed out initially where the bathroom was. In another activity, the DC had to build a tower of 5 small wooden blocks, then knock them down when the teacher said 'ready, steady, go'. DS built the tower when told, but then kept knocking it down by accident, or trying to touch it. He did knock it down on 'go' though. He did join in musical statues really well, though & the hello/goodbye songs. He just seemed behind all the other DC for all the other activities

Then after the class I got chatting to the mother of another of the DC in the class. This DC is 3 tomorrow, so about 3.5 months older than my DS. The difference between the 2 DC was really quite something! Her DS is very chatty, has lots of words, but they are not very clear. He answered questions which my DS does not. They were 'playing' a fishing game, where each had to pick up a wooden fish with magnetic fishing rods. Her DC did this well & was able to name some fish. My DS didn't understand the game & just kept putting the fish back in the tin (where we were putting 'caught' fish) without trying to use the rod - although he did try it once or twice towards the end. Then in the soft play afterwards, her DS went off happily on his own. Mine tried to, but couldn't get up the large platforms without help. At one point, her DS came looking for mine &, with me following them, they went round happily together.

I think the whole morning just showed me how behind DS is. But he is progressing & that I know is the main thing. I just wish he could wake up one day & be magically 'cured' or 'normal'

Sorry for the moan, I am feeling particularly fragile today. I also went to hospital yesterday (with DS, some great imaginative play from him there as the toy garage had no toy cars, so he pushed a building brick around the track) to receive the date for my ELCS, in about 3 weeks' time & that has scared me a bit (excited too, obviously).

My DS (3.0) is also delayed and I know only too well that thing of watching/comparing other children at activities, birthday parties etc. And don't get me started on show and tell at nursery school (today he apparently managed to hold up a book and say "my book"!) I don't have any particular advice beyond what you've already had about encouraging speech (all good stuff!) but I do offer a hand hold...

We all have bad days. It's hard not to compare with other children but try not to. You say your DS is making progress so try to focus on this and celebrating the small steps. I couldn't believe how good it felt when DS learnt to say words he'd never been able to say before like jam, time!
And font apologise for moaning, it's hard

*don't not font!!