"Moderate Speech Delay" in DD2 (2.6)

[lulurose]

DD2 is 2 and a half. We saw an NHS speech and language therapist today who diagnosed moderate speech delay. She will re assess in the Autumn and offer a block of therapy then.

DD2 has less than ten clear words but does babble and "sing" constantly. She had good understanding and can follow quite complex instructions, ie go to your room and fetch your red shoes from the drawer.

Should I be worried? She has given me a few games and ideas to focus on at home but if I'm honest didn't seem too worried about her. She checked her mouth and ruled out verbal dyspraxia.

DD2 has T1 Diabetes too and is starting nursery 3 mornings a week from September. She will catch up won't she? She has had a rough year, I just keep thinking maybe the illness prior to being diagnosed with Type One may have affected her development in some way

Any thoughts/experiences would be appreciated.

bump...

As you said the speech therapist didn't seem worried so that is a good sign. Often young children who haven't said much will start chattering when they start nursery and spend more time with others. Play the games suggested and sing songs and rhymes and encourage her to join in. At school we do something called bridging which means we talk through everything we do ... so I'm going to make a ball with the dough...look it's big and smooth...let's roll it into a wiggly worm... I'm going to make it longer/thinner...

Mrz

Thankyou, no she wasn't overly concerned but does think she would benefit from a block of speech therapy, she has put our names on a Makaton course waiting list.

Have others had this diagnosis? Was the eventual outcome ok?

might be worth you posting this on the SN board. DS was diagnosed with severe speech delay at 36 months, and a year later the diagnosis has improved to moderate speech delay (he's about a year behind now) so kids can certainly catch up. DS was in a worse position than your DD in that his understanding and ability to follow instructions was also severely delayed; the fact that your DD's understanding is so good is a very very positive sign.

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myDS2 has aspeech and language delay but he couldnt follow even simple instructions. Hopefully things will improve for your DD when she starts nursery. Also my DS has improved a lot over the last 4-6 mths, he starts school in sept so as Totalchaos said kids DO improve. good luck

actually in DS's case, he's not really caught up yet, more "made good progress", so maybe catch up wasn't a good choice of words by me.

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"An awareness of positive adult-child interaction should be part of any effort to promote children?s communication development. A key role of language specialists is enhancing the interaction skills of parents and childcare workers.

Listening to babies and children
In order to talk with a child, it is necessary first to listen, and watch.
A child needs time and an opportunity to talk. When an adult listens, they give the child space to speak. When an adult watches, they can see what a child might want to talk about, even if their words are not easy to understand. This means that the child?s attempts to communicate can make sense to an interested adult. Then, at last, the adult can talk with the child.
A child engaged in this way will learn new words and want to talk, because they know that their attempts to talk will be heard and understood. A listening approach gives a child much more scope for learning to talk than does an adult reliance on naming objects, or asking a child to name objects.

Listening to children
Why?
? See what your child wants to say
? Give your child a need to talk
? Give your child time to talk
How?
? Watch what your child is doing
? Match what they do with what they try to say
? Repeat what your child says or tries to say
Referenced
Adult-child interactions Literature
Talking to babies and children
Babies and young children learn to focus on adult speech very early on in their lives. It helps if adults make their communication easy for the child to listen to and to understand. Parents often do this.
They adapt their own language levels to those of the child to help them to listen effectively. The focus is on giving the child a listening and speaking part in the conversation. This contrasts with an adult using a high proportion of directive commands, which do not allow the child a turn to speak.

Talking to children (0 ? 2 years)
? Speak about the ?here and now?
? Use simple words
? Use key words only
? Use fewer word endings
? Use sentences which are only 1 or 2 words longer than your child can use
? Speak slowly and carefully
? Repeat ideas

Talking to children (2 ? 4 years)
? Use pictures or actions to show what a new word means
? Use a new word several times in one conversation
? Repeat back correctly a sentence which your child has said in a childish way
? Add in ideas to your child?s sentence when you reply
? Use sentences a little longer than your child can use
? Give instructions clearly, in short parts
? Speak clearly and not too fast
? Repeat back correctly a word your child has said wrong
? Enjoy rhymes and rhyming words

If the understanding/receptive language is there, the speech (which is the icing on the cake) should follow in time and nursery should help. 10 words is a little on the low side for two and a half but if she has been ill that could be quite normal. The significance of the fact that the speech therapist was not overly concerned is harder to assess. The 'wait and see' approach is very common and SALTs may not know enough to spot other problems or may feel it is not their place to raise concerns. Anyway, I'm not trying to worry you esp. as it seems that she has the required understanding.

cyberseraphim I'm a paediatric SLT- part of our training is to look out for other diffs and refer on appropriately. For example, if a childs profile at assessment appears to be delayed or disordered in areas other than speech/ language I would always pass on to a professional with relevant skills in that field (e.g. paediatrician/ clinical pyschology, dietician, etc). SLT's rarely work in isolation and more often than not work as part as a multi disciplinary team.

It is always our job to raise concenrs as our duty is towards the child's care.

Lulurose, I am assuming your little one has a diagnosis of 'moderate language & speech delay.' i.e. her expressive skills (words, grammar e.t.c) are delayed and so are the sounds that she makes?

She is still young, and may well make good gains in the next 6 months. It is very encouraging that you describe her understanding to be good. However, this should be assessed over time. I am also encouraged that she will be offered a block of therapy as a prcautionary and 'diagnostic' measure...i.e. see whrether she makes increased gains when supported.

Children with a pure 'expressive' delay tend to resolve with some support- or sometimes without over time. Gains are slower if they have difficulties with understanding.

The best advice I can give you is to press for therapy, further assessment over time if you feel she is not making the progress you would expect. We know that early intervention is ideal. Do the games she has given you and ask for clarity/ more ideas if you get stuck. Let nursery know and ask how they can help- put them in touch with your SLT so that she can give them ideas.

very best of luck.

Hi Mamabea - I think I probably phrased things badly, all I meant to say was that although obviously SALTs are aware of what the underlying issues might be in some cases and do make the necessary onward referrals, from the parents point of view, it feels as if you are not getting anywhere. We saw a SALT three times after the age of 2 1/2 but although in retrospect, I apprecicate they probably did spot the real problem, all they were able to say at the time was to 'put him in small friendly nursery', 'talk to him more' etc. We had to pursue a diagnosis via another route which led to him being dxd a year ahead of the official schedule - which was a godsend for us strange as it may seem !!

Thankyou everyone for all your posts.

Mamabea thankyou, the SALT, like you said that in six months time there would be significant improvement. Hopefully the block of therapy we are hoping to have in the Autumn will help.

She seemed to suggest that we should keep instructions and conversations short and clear, read, and leave pauses and not put pressure on DD2 in any way. Giving choices when she wants something too, so as to give an opportunity for a response of some sort I guess. I'm glad you think nursery will help, I was worried she may get frustrated and feel side lined but its a nice small setting with a good ratio so I'll press on.

Is there any link between strong left handedness in young children and speech delay? Just something I've come accross on the web and DD is definately left handed and has shown a left dominance for some time now. I'm probably reading too much!!

I get you Cyberseraphim - totally understand!Also fully appreciate how important a diagnosis can be especially when it means you can get the 'right' kind of support and insight .

Lulurose- Fingers crossed that the therapy will be useful.

I am sure nursery can be helpful-but do be a pushy mum and ask them to show you what they intend to do/ do do to help. Same goes for your SLT- be pushy if needs be.

Haven't read that research re left handedness.. not used clinically as an indicator/ risk factor for sp/lang diffs.

Unfortunetly we don't always know why a child may have lang probs. Sometimes genetic, often not.

It's it possible to have an update on your children please? This sounds like my little girl x

It's it possible to have an update on your children please? This sounds like my little girl x

Hi sally there is another thread on here called speech delay support thread or something like that which is a but more recent that might be if more help. I will try to find it and bump it for you.