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.

The first time DS2 said mum, I cried, and then posted in the SN bit on here. He was 3y6/7mo.

You wouldn't believe it now - I got called in after school this week to be asked to get him to try to stop talking in class when he should be working! 6.5 years ago, I had given up hope of him ever even calling me Mum...

Comparing DC's is never a good idea. Celebrate each little step they make. They aren't other people's DC's, but they are YOUR DC, and every step forward they make is something to treasure.

I remember having a smile a mild wide when DD learnt to tie her shoelaces at 12yo...

So what that she was 12? SHE had worked hard to learn how to do it, and she actually HAD to work hard at it. To see the pride in HER face was a wonderful moment that I won't forget.

Thanks ladies, it's good to vent to people who understand. The mum at Talking Tots was asking me if I thought her DS needed speech therapy because a few of his words were unclear - that really crushed me! But I guess it shows that everybody has their own worries about their DC.

Actually, yesterday, DS2 gained a new word 'orange'. Quite unclear, but it definitely was! It was when I asked him to choose between blackcurrant & orange squash, by holding them both up for him. He said 'onange', then when I asked him to point, he tapped the orange bottle, so I'm sure that's what he was saying. Made my day .

Also, while we were watching DS1 at swimming, he kept going up to a little (about 4) boy also watching, smiling at him & babbling away, trying to play with him I think. The boy didn't want to & kept putting his hands over his ears because DS can shout when he babbles, but I'm hugely encouraged that DS2 wanted to play with the boy, it shows he was being social I think.

I definitely like the idea of celebrating the small steps, I write everything down for our next SALT appointment & these are both going on my list

ilovenice 'my book' is a brilliant thing for your DS to say! Used in context, more than one word -wow! Well done to your DS

Hi confused. I feel really, really sorry for you at the moment, you're going through a lot being preggers n all. You're doing SO MUCH already - I don't think you can or should do more.

Your lovely DS sounds so much like mine (you remember from the other thread?). Well, he's only just started repeating words and phrases and is just shy of his 3rd birthday. He also seems 'babyish' compared to others. I'm sure if he was asked to build towers he'll be knocking them down willy nilly without waiting (even though I know he can build 12+). Wrt the doors, I'm reminded of my (totally normal) neighbour's child who obsessively checks tyres to see if they're inflated enough. Every tyre he goes by. Gives them a squeeze then decides they need pumping up. Makes me laugh actually .

Sorry not helpful, but, please, have hope and (as I keep reminding myself) try and enjoy this time. I already look back with a bit of regret at all the worrying I did earlier on (I was convinced DS had MS because he was displaying handedness at 10mo!!!).

I do think you DS does need a proper assessment by a developmental paediatrician. Have you ever been referred? If not I would push hard for a referral.

Thanks, BFG. I do vaguely remember you from a previous thread, but I'm afraid I can't remember your backstory etc. It's great that it sounds like your DS is making progress, stories like that always give me hope It is quite possible that I am guilty of worrying too much about everything

sunny no, DS has never been referred to a developmental paediatrician. The SALT mentioned it as something we might like to think about if DS' speech did not improve by the time we saw her again, which it has greatly (which should have been in December, from September - we are still waiting for another appointment ). Also, the audiologist who performed his first 3 hearing tests mentioned it to my HV, as she had 'concerns about his development' as he was not cooperating fully with the hearing tests (more interested in playing with the toys they were using to distract him ), but my HV was reluctant to refer based on the views of somebody who had only seen DS 3 times, for 20 minutes a time. The audiologist at the hospital, by contrast, said that many 2-year olds do not cooperate with the tests that DS didn't and they consequently found 2 a very difficult age to assess hearing at.

Have physical causes been investigated?

Kids with tongue and lip ties sometimes have speech delay and it is also linked with ENT problems. The thing about tongue tie is that many of them go unnoticed because the tongue appears normal to the untrained eye. And I include most HCPs in the untrained eye bracket, unless they have taken a specialist interest in ties.

The things you mention - later development of gross motor skills and obsessive play are exactly the way DS1 was, he also had congestion and hearing loss for several years. The ear trouble was linked to reflux I'm sure. His palate was very high and narrow so took up the room for the eustacian tubes preventing them from draining properly. I am pretty sure that his gastric fluid was being forced into the tubes and then not draining well causing the congestion. We had his ties revised age 6yo and the reflux stopped, and lo and behold at his next audiology test, his ears were clear.

He's 8yo now and all is well. His ties are all revised and he has braces to expand the high palate.

you seem to have a lot of concerns. just follow your gut and get them checked out.

my DC1 was only referred to developmental paed after the 3rd birthday and only after I refused to the leave GP office without referral. Between 2 and three I dragged him countless times to the GP, saw HV and SALT. I had concerns since the 2nd birthday. Even when he turned 3 nobody was really concerned but me.

DC1 is 6 now, in special school and has a dx of severe ASD and still only very little speech. I am not suggesting that is the case with your DS at all - I guess my point is to follow your instincts. I would insist on a referral.

mawbroon we have been to the audiologist (3 times at a local clinic, once at ENT at the hospital) 4 times now, but they have only ever looked in his ears. We have a follow-up appointment in May, so perhaps it's worth mentioning then, thanks.

sunny I have moments of being concerned & not. I know that DS is behind his peers, but I am not sure by how much. Some DC he seems a year younger than, but others he seems almost (but not quite) on a par with, especially if you discount the speech delay. My main concern with him is the speech delay, but I am also mindful of his love of doors & the fact that he has to be encouraged to pretend play.

Tbh, this is why I asked for hearing tests & speech therapy at his 2-year review. I am glad I did that as early as I did, because I don't think he'd have made the progress he has without SALT input, plus the free nursery hours are very useful, we would have struggled to afford 15 hours otherwise & it seems to be helping him.

Hey, confused, my DS would not cooperate for a hearing test at 2.5 either. Audiologist said 2.5 to 3yo is the age toddlers typically start cooperating. I think visiting a developmental pediatrician is an excellent idea. They see a lot of problems and will give you straightforward feedback about your worries. We see one (related to DS's premature birth) - and she has always been very happy with DS's development (even verbal development - she sees many children that only start speaking properly when they start pre-school) even though he is generally uncooperative (her expression).

I wouldn't expect an audiologist to know about ties/high palates affecting ears tbh.

Ours looked at me like I had two heads when I mentioned it.

I wondered if they might call somebody else in/refer on the spot as it is the wing of ENT mawbroon? If not, who do you recommend bringing it up with?

When I picked DS2 up from nursery yesterday, his keyworker said he'd been 'absolutely brilliant' He'd been interacting, laughing & 'chatting' loads, following instructions really well & said 'thank you' when given his food, without prompting (his version of, but she obviously understood him with ease, so must have been quite clear). Then this morning he was positively cheerful when I dropped him off, this as opposed to sobbing a fortnight ago. He is definitely making progress in all areas, and I'm hoping speech will be one of those. It is really nice that nursery notice & remark on it, too

Sadly, most HCPs are clueless. I went through all this with the NHS and had to go private in the end. Even the "expert" who revised it first time didn't do it properly, so we went to a dentist who had trained with Dr Kotlow who is a world leading expert on the matter.

There is a facebook group called tongue tie babies support group, ask to join and then you will find a wealth of knowledge and experience on there. Most are babies, but there are also some with older kids and some SALTs and other professionals on there.