speech delay in 3 year old...where next?

[jellybean321]

My little boy has just turned three and is very difficult to understand. He had glue ear which has now cleared but it has been one of the main causes of his speech problems He has plenty to say but his speech is very poorly pronounced making him very hard to understand. Of course this is causing him to get extremely frustrated and cross. He tries to interact with other children but they soon give up on him as they can't understand him. He reverts to playing dinosaurs or lions and roaring at them at the hope he can communicate in this way. We have had his hearing checked. We have contacted the site i can and taken onboard their advise and ideas . we have been though the NHS and SALT and have appointments to check progress but there isn't a lot! They have offered us in 6 months time a small set of group sessions but nothing now. We have in desperation paid for a speech and language therapist privately and after 6 sessions and little progress have been told to wait a while. My son does have quite selective concentration!!! It is quite poor so both the NHS and private therapist have told me there is nothing they can really do until his concentration improves...I worry though that that could be a long time and therefore am looking for advise where to go next?! I have an appointment with a paediatrian in a week to check there is nothing underlying that is causing the delay. Any advise please? Thanks x

If he no longer has glue ear, I'd say there's a lot you can do at home while you wait for professionals. My DD(4) had severe glue ear for her first 2 years and had no language at all at age 2. She's now 4.7 and it's only been this last fortnight where I'd say she's caught up with her peers, so it IS a long haul thing.

I didn't get SALT or any other support, so I tried my best just me and her. I started with single words. When she started using them, I'd repeat them back with an extra word added - ie she'd say 'water', so I'd say 'want water?'. Once she said 'want water', I'd extend again to 'you want water'? And then 'you want some water?' and so on. Over and over. But I really stripped it right back to basics and started from scratch. I continually model correct pronunciation and grammar even now, so if she says something wrong, I repeat it back as a question, using the correct form.

I also made sure I was always facing her when talking to her, so she could see my mouth (DD was a lip-reading pro). And I tried to keep background noise at a minimum. I also backed up my questions etc with clear gestures - so ingrained now that I still catch myself miming along to what I'm saying .

But it's slow going. Ask simple questions that force a response. Read stories and ask questions about the pictures. Just keep it going.

Another thing that DD struggled with was auditory processing. She got some limited vocabulary fairly quickly, but she really had difficulty interpreting what people were saying to her. She couldn't decipher it fast enough and would shut down. Imagine learning some simple foreign sentences, then someone responds fluently at length. You just stare at them, totally befuddled. Even though you might know some of the words, you just can't make sense of it all fast enough. That's how DD seemed to be. So make sure she has time to understand responses. This has been the slowest thing for us to get through, and as I wrote earlier, it's only been this past fortnight that she's operating at something approaching normal speed. Almost 3 years later!

Sorry if this is long! Just wanted to respond with a yes it's hard and frustrating but you WILL get there. And I actually found it an interesting journey. Something DD and I fought through together. It's made us a great little team.

Good luck! xx

Thanks for for your detailed response mynd. My son does understand what is asked of him and speaks with strings of 3/4 words but the pronounciation is just so poor. We repeat what he says and model correctly and have started with simple single words but he doesn't repeat them back correctly. We try lots of repition, sharing books etc which he loves but the single words are still very unclear. He has now started putting an ' a ' sound on the end of words he did know which is making it even harder to understand. E.g he could say juice and now says jua and no is now noa... Its so frustrating for all of us I just want to help the poor thing and don't seem to be getting anywhere x

Has your little boy got grommets, or did it clear on its own? If grommets, long has he had them? If a while, are they still in or have they fallen out? My DD lost her grommets after about a year, I think, but in her left ear, the hole didn't heal and she was left with a perforated eardrum, which gave her hearing loss.

If he hasn't had any grommets fitted, are you sure the glue ear isn't coming and going? My DD has worse hearing if she has a cold, so even now it fluctuates. It doesn't take much for sound to become muffled, especially at certain frequencies, and sound quality is pretty crucial when you're trying to learn how to talk :-(

Really sorry to hear about how much you're struggling. Can promise you I've been there too and it's so tough, especially when progress feels slow or even backward. I'm not a speech therapist at all and I'm sure there'll be people along soon who know proper stuff. I can only give you my own experience dealing with a child with no language and hope that maybe some of it overlaps with your own situation!

I do think that acquiring language isn't straightforward, and there seems to be a lot of experimenting from the child as they work things out. Some experiments work, others definitely don't, but I think there's some logical process going on in the child's head that makes them try out bizarre ways of saying things.

My own DD refused to differentiate between he/she/her/him/his/hers for the longest time. Not just mixing genders, but also the grammar - ie 'him's coat'. She knew the difference between a boy and a girl but refused point blank to grasp the language aspect. It's only been this past month that she's getting it right MOST of the time, but it's still a weird quirk that pops up in her conversation after nearly 3 years of me modelling the proper words .

Hoping a therapist pops along shortly for you! xxx

Thanks again for replying. He doesn't and hasn't had grommets. I have asked about them but because his glue ear wasn't present at the last hearing test and his hearing was OK they were not interested in them and have signed him off for no more hearing tests.

Do you think he has hearing loss? I knew DD was severely deaf from the get-go, but not one solitary person agreed with me until she got tested aged 22 months. Something just bugged me. She was prone to drifting into daydreams. Was repeatedly knocked flat at nursery because she couldn't hear other kids running past her from behind. Was very into lights and images and not so much into singing or music. She struggled to locate sound so she'd hear my phone ringing on the table next to her but she couldn't pinpoint where it was. I'd listen in bemusement at other parent's tales of having to tiptoe around their sleeping baby, when I could've dropped a dozen pans right behind DD's head and not woken her up.

I think it's a gut feeling. If you think he's fine, maybe the delay is due to other reasons. I just hope you can get some proper support asap, because it's a very tough thing to go through.

I think he can hear OKnow yes i worry and wonder what else could be causing the hearing loss x

Hi, my son was like yours at that age but without the glue ear or any hearing issues. He had plenty to say but his pronouncation was so poor even I had trouble understanding him. He understood everything that was said to him though and always came out high on comphrehension testing. We had private as well as NHS therapy. I know you are struggling with this because of his concentration (interestingly by the time my son actually got an appointment for any therapy he was 4 so I don't know if he too would have struggled at 3. As it was he made really good progress so maybe it will come down to maturity to some extent). If you want to do some stuff at home it might be width checking out www.mommyspeechtherapy.com
I found this website brilliant for understanding the processes in speech development as well as ideas for things to do.
In the worksheet section there is a document on the process of articulation therapy which was really interesting and helped me to understand that rather than concentrating on a word to start with there is so much that comes before that. So for example one sound we work on with 'f' he needed to master the sound in isolation first so lots of practise with this (making bunny teeth etc), then add a vowel sound so f- ah, f-oh (also with f at the end e.g ah-f) eventually pushing the two together and only once this is confidently mastered, move on to word level and so on. It all explained much better in the website. There is also an articulation screener so you can see where the issues are. If you are doing it at home you can take it slowly and just do a few sounds at a time. Tbh with my DS it was most sounds!
We also did lots of things to try and improve the oral muscles eg blowing bubbles, playing with whistles, blowing a ball with a straw etc.
And to make the activities more fun as it can be dull, I did lots of things like putting the sounds under skittles for him to bowl down, whichever on he bowled down he would practise saying, burying them in sand, picking up with a fishing rod, treasure hunts round the room etc.
my DS is seven now and people often comment on his good vocabulary and how well spoken he is. It a tough ride but there is a light at the end of the tunnel.

Thanks jellyandjam05 I'lltake a look at that website to see if there is anything i haven't tried. Thanks for the advise Iwill try these ideas as welland hope it helps to move him on. Its hard when I don'teven understand him myself a lot of the time

I know how hard it is, I'd say that was the worst part for me. When I did understand him I was his voice with other people but when I didn't understand him either it was frustrating for him and heartbreaking for me. When he first started therapy I'd get frustrated too as it seemed to be so slow and things he'd do at home, he might not do when in therapy. Our therapist was really reassuring though and told me that it would be slow because there is a massive amount that needs to happen/change for a sound to become embedded and used in conversation and he needs to go through each part of the process completely (and bearing in mind there were multiple sounds my DS couldn't not say, plus he used to miss off the ends of words as well as doing something called harmonisation - where for a word like time he would say pime- because a p and an m are made in the same part of the mouth whereas a t and an m are made in different parts so is harder to say) but she assured me that it would happen and she was right. I did the articulation screener with him and at the age of four (almost 5) his speech came out at less than a 2 year old. I knew how bad he was but seeing that made me cry. We had a very long way to go. What I'm trying to say I guess is hang on in there and keep at it. You will get there. Good luck.

Thanks I'll look at that screener. We went to see a paediatrian today to see if there is anything else that is causing problems and I was told he is behind in three out of five key areas of development and is now being refererred for a multi agency assessment. I'm so gutted and sad for him. rthey have suggested global developmental delay or possible slight traits of autism but the appointment won't be ubtill august...that's a long time to wait with my stomach in knots I just so want to help him x

The waiting lists are terrible.
The website is American so for the odd picture that needed it I substituted for something more English!