speech at 4

[fluffymouse]

Nursery has recommended a speech therapy referral for dd aged 4.5

Her speech is still not clear, and in particular has difficulty with r,l and th sounds. She can understand well, and express herself, though I think her grammar may not be up to standard expected. For example she confuses pronouns, has difficulty with verbs. Eg always uses he, never she, and says 'I are'
How much of this normal/what would warrant referral?

In addition GP practice says they won't refer and we should ask preschool, and preschool are really dragging their heels about this (despite recommending referral). Any advice how to get a referral? Is it worth paying for a private assessment?

My dd is the same age.

She is about average in speech I think though I do kind of hope her pronunciation improves soon....

She talks just like you or I would normally, she doesn't pronounce things that clearly though.

Eg says singers not fingers, lellow not yellow, free not three.

She doesn't really get pronouns or anything mixed up.

Try and read this

DD just turned 4. No sign of 'th' happening correctly at all. But otherwise her speech is very clear, words in the right order, pronouns and verbs etc all correct (occasionally makes up words!)

In terms of getting a referral, my experience from friends has been that it's always the education provider (eg preschool) that makes ref unless it's picked up earlier by health visitor.

Hi.
Well, if gp won't refer and preschool recommend it, you need to push them!

Usually we end up going private because the local authority/ nhs salt depts don't think your case severe enough, esp if funding is tight. Which it usually is.

You can either plead poverty and push preschool or bite the bullet and find a good private therapist who will asses and give you a report. Then take it from there.

Our Ds had to have intensive private salt. He was virtually non verbal at 4, but he was given no NH's help. Goodness knows what might have happened if we had not taken it upon ourselves to help our son. He's 8 now and a wonderful talker. It was worth every penny.

If you don't do it now, you'll have to go thru the same thing at primary school, by which time her peers may be further ahead of her. However, from what you say, I don't think her need is that severe. A good private therapist will smooth out those issues in no time.

Good luck.

Hiya.
The grammar thing is normal and will improve. Just model back in the correct way without actually correcting her. Or another tip my DS therapist used was if she says 'I are' then say you can also say 'I am' . DS did this kind of thing and grew out of it (he sometimes still says things like runned instead if ran but that's improving too).
We also went private as DS speech was very unclear and NHS waiting lists etc meant it just wasn't enough.
For the unclear speech, do push for something to be done- preschool can make the referral for you. This is how we did it. If you want to have a go at doing some stuff yourself check out the website wwww.mommyspeechtherapy.com - I found it an absolutely brilliant resource.
The th sound is a later one to develop but it will have some tips on the website on how to encourage this if you want to have a go yourself.