My 2.8 Yr Old Daughter Cannot Form A Sentence

[fimbles]

She saw a sppech therapist in November 2003 who said she was average and said she should be reviewed at 2.11 months. However last Monday she saw a Paediatric Consultant for a general review on her health and she said her speech was very behind.

She DOES find it difficult to talk in proper sentences ans says mainly 2/3 word sentences. If the sentences are longer, the real words are filled with babble/stammer. I brought this up with the speech therpaist and she said it was normal and they will grow out of it.

I am now left feeling VERY worried and wonder what will happen next. They said she will have to have some non-verbal tests first. Does anyone know from their experiences what this could entail and how does the speech therapy actually work?

I have spent alot of time talking to my dd,giving running commentary on what I do and her activities, infact giving her the words and sentence as advised to do so by HV's etc but she still caanot talk properly. When she is upset, she seems to forget everything - Is this normal?

Looking forward to any responses which I expect will be tomorrow am. Thanks in advance.

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Hi socci, from what I can remember, she just cried up until 9 months (which is when she crawled) old and then she got the object herself, but still cried for her milk etc. Her first proper words were at 18 months and from 22 months (approx) she just dragged us everywhere if she wanted something.

Hope I've answered this correctly!

What's her overall communication like? Also does she understand things like my your (eg would she respond correctly to "where's my nose" "where's your nose")

What they will want to find out is whether she has a speech and/or language delay or a speech and/or language disorder. A delay at 2.8 wouldn't be of huge concern as she could well have caught up by 3, a disorder would suggest that more inpput could be needed. Although having said that ds2 ws diagnosed as having a speech disorder at about 2.6 (just speech though understnading was fine) and then started talking properlyabout 2 weeks later (literally the SALT couldn't believe it), so even a disorder can sometimes sort itself out.

What's her understanding like? How about attention and play etc (as attention and play develop with language)

fimbles when she dragged you everywhere what did she do when she reached the thing she wanted? Did she point or diid she vaguely flick your hand in the approximate direction or something similar?

Hello jimjams - nice to speak to you.

My dd's understanding in my opinion is good. She would answer the question where's my nose/yr nose by pointing and saying the word "nose". She follows the majority of clear instructions and her attention has improved. We can play playdoh, painting, reading for approx 1 hr now and she will be engrossed in that activity. When we are playing, I'm giving her new words and she will remember that word ie the playdoh is now flat and smooth. She will use the word herself the next time we play.

With regards to the pointing I don't think she pointed until after 18 months. When she dragged us everywhere, I am quite certain she would indicate what she wanted by pointing or ie open the drawer herself. She just wanted a member of her family to be there whilst she got the item she wanted. I do remember that she always brought the book, toy to me from about 18 months or earlier so we could play it together She does point now all the time.

Look forward to hearing from you.

fimbles, some of this is familiar to me. We have a boy who is now just over 4 and a half years and some of the things you have said about your dd remind me of him at that age. I noticed when he was about two and a half that all his friends could talk and he couldn't. He really just had single words, occasionally 2/3 words, but he spoke fluent "finger" - he could point his way to whatever he wanted. In fact, when he was nearly three, we had an argument over who was meant to be hiding in "hide and seek" - and I look back now and think this was amazing considering he couldn't speak!! He would mime things too to help us understand what he wanted.

Anyway, he was assessed by a speech therapist when he was 3 yrs and 2 months and she said his understanding of language was within the normal range but that his expressive language was behind, well behind, where it should be. One of the things that she pointed out was that he didn't have any verbs (although he did have a lot of nouns). We worked on this in much the same way that you work/play with your daughter, "giving" him words when we interacted with him, and actively doing things she suggested - like showing him pictures. The speech therapist provided A4 sheets with about 6 different pictures on, eg 1. teddy running, 2. boy running and we'd look at them together and I'd start by saying "Look, teddy is running. What's this boy doing?" etc. You can make your own or use books or I'd be happy to send you some of our spares, if you like. Gradually he got more words.

He continues to get more words although we don't have to work so hard to "give" them to him now, he just picks them up.

His speech and language is still behind where it should be. The SALT now works on his speech, because he has enough words now for her to begin to correct the mispronunciations and make him more intelligble.

All I would say is don't despair because most likely it is something that can be fixed (if it does turn our to be a problem) even if it will take quite a long time. Our boy, so far, as remained happy and sociable and his problems don't hold him back in school. He is lovely!

hope that is of some help.

Hi ChocolateGirl

Thankyou for yr reply. Yes, from you've said my dd sounds like what yr little boy used to do. It seems a very long slog to get to where they should be and I wonder why some children pick it up so quickly and others find it VERY difficult.

You said it does not hold him back at school - was that always the case?

My dd cannot expess herelf and gets frustrated and upset and says on occasion says "I sadee" (I'm Sad!) infact come to think about it, she puts alot of "e's" on the end of every word in what I would interpret as trying to complete the sentence. Eg put it on"eee",take it off"eee".

Very kind of you to offer the spare books. I will wait to see what the SALT says, hoping to arrange an appointment asap. I don't want to wait and I am prepared to go private if necessary. I hope it won't cost the earth!

Thank you once again for the input.

It sounds as if receptive language is pretty good (which is good as much harder if not).

I would really recommend going privatel unless you have been given a firm NHS date. You could get an assessment done - and the SALT would provide stuff for you to do while you wait for the NHS to get in gear. SALT provision varies on the NHS from poor to dire tbh (by whch I mean access to provision- ds1 had a great NHS SALT we just never got to see her- saw her twice last year-0 for a 5 year old with no speech who had been assessed as being the child in the city most at need on her list). For a full on assessment, report and communication programme expect to pay around £100- but that would be thorough. Have a look at ASLTIP to find someone.

Where are you I may be able to recommend someone.

Hi I was a bit concerned about one of my twin boys speech when he was a bit younger. he is now 3.5 yrs. I recall being told by a speech therapist and read it many times that 3 words in a sentance is within the normal range for a 3yr old , albeit it not the average. My DS had 3 words by about 2 yrs and 5 months and then about 5 or 6 regularly by 3, sometimes more.He had a big spurt between 2 1/2 and 3. I think if understanding is good and non verbal communication is good , thats a good sign, although it cant hurt to get it checked out Maggie.

I live in Manchester. Had a look at the ASLTIP site and there are quite a few in M/cr. When I saw the list of conditions the SALT's treat, I felt a little afraid. Do u need a doctors referral letter to attend a consultation?

On the whole, how often are the sessions once the initial consultation has taken place, ie is it every month or does it depend on the condition?

Jimjams, can I ask whether u know anything about ADD? One of my friends (who has no children) thinks my DD has this condition because she is very loud and excitable when happy and then she can be extremely afraid and stressed if she is upset. Thanks fr yr time.

You decide how often to see someone. We've used private SALTS both for one off consultations and reports and for long term weekly sessions. Initially in your shoes I'd go for a one off visit and report (or one off with follow up a week later to get tips). the reports can be useful for bashing nhs professionals into doing something. I don't know anyone in manchester- do a google search on some names or give a couple a ring. You don't need to involve a dr at all.

I don't know much about ADD, but poor attention (at least adult directed) pretty much universally goes with delayed language.

fimbles, ds1 went to a private nursery two mornings a week from 10 months, then school nursery 5 mornings a week from just over 3 (he is a summer birthday), and now in Reception Class five full days a week now he is 4.

He has always been happy, sociable and confident, keen to contribute and join in in class, even though they cannot always understand what he is saying. Having said that he is also happy to play on his own/with children he doesn't know if we go somewhere and he doesn't want to play with his friends.

He has grown out of this a bit now, but when he was younger he was happy when he was happy, and hysterical when he was upset. He could also get upset easily. I don't know anything abut ADD though, maybe your daughter is like this because it's the only way she has of expressing herself? Just a thought... I don't know.

We currently see a private SALT once a week/fortnight but they will advise you on how often.

hth

Thank you once again everyone, I'll ring one of the Salts and arrange an appointment. I was wondering whether they visit you or do you go their clinic? Anyway, that can be established when I ring..

I really hope my dd will improve and they can help me to help her.

hi there

I'm just wondering if you've thought about signing with your Dd?

this would help her to express herself simply and encourage speech.

I signed with my Dd as a baby and even though she is speaking now, we still use signs for new/difficult words, or if she wants to emphasise a point etc. So I'm still finding it v useful

maybe something to try? happy to talk to you about it more if you are interested

that's a good point signing can work well with lots of children- although ds1 never got it. SALTS usually use makaton so if you did decide to do it would be best to stick wwith makaton (UK version).

I've had SALTS come to me, and I've gone to them- depends on the SALT. A lot operate from their own homes (mums with kids usually :-) ) so don't be surprised if they're not clinic based.

Ds's speech was never that good, but he could understand what was said to him. His nursery set us up with some very basic SALT which helped him a great deal. We were encouraged to use very short (three word) sentences with him that were very directed. This was set up for him when he was about 3. This helped him and he now chatters away,(age almost 5) even if his use of language is still a little 'young'.

Hi redheadmum

What do u mean by signing exactly? Do u mean for eg a square, outline the shape with yr fingers?

When I read to my dd, and I come across a new word I literally act out what I am saying with sound effects if necessary (sometimes I feel quite silly - but it's all for a good cause)
A recent eg woud be the rocket ship "zoomed" high or Mrs Straw is very "kind", I would elaborate on what "kind" is.

Is this what u mean or have I got it completely wrong?

Hi Happymerryberries

I was asked to do the 3 word very direct sentences which meant missing out alot of the joining words ie, and, the, to. When dd did say something to us, it sounded wrong. I've recently, myself decided to speak to her as I would an adult and stopped saying eg "Give Mummy the ball please" and instead now started to say "Give me the ball please" She never says I, Me, You etc.

I don't know whether my dd is sometimes stubborn or she just simply can't understand. When she wants something ie Juice, she will grab my hand lead me to the kitchen and just say juice. For months I have given her the words "I want juice please" she will just say "Pleeease" or "I want" She just can't join the sentence together.

Hopefully the SALT will be able to help us get this sorted.

Thanks everyone again for yr advice .

we were seen by a developmental paed last week and dd is 28 mths, dd does not even form sentences, but says a lot of two words, usually more followed by water/nana etc
DD has been seen by a Speech Therapist and diagnosed with a slight language acquisition delay.
But the developmental paed said that if your baby is communicating well, and understands most of what you say, then you can relax a little as it will come.
But even if your dd does not have a serious langauge issue it is still worth following up the therapy as it is really helpfulMy 1st talked in full sentences horribly early and I am finding this delay with dd quite frustrating as I KNOW she knows, she just does not want to do it yet, she was exactly the same with walking so it is partly her character
Apparently plonking them into unfamiliar social situations is good for getting them to ask for things and also giving them a choice, do you want the apple or the banana, that sort of thing
Also we find songs have helped enormously as has wait for it

a leap frog phonics radio that great granny got for xmas, dd loves it and is copying all the sounds and songs and even gets the game right - which stunned me.
Go buy one, I hate them in reality but it has brought dd stonkingly quickly...
Sorry this is long, you are not alone and these late talkers DO catch up in almost all cases
Hugs
CAT me if you want to know anything else petal...

Also upon thinking a bit -my dd has no verbs or emotions although she conveys them really well...
And really bizarre words like bra and beer!
hmmm

fimbles- makaton is a simplified version of british sign language. There are other sign languages out there, but SALTS etc always use makaton so prob worth using that if you can. Maybe try the Makaton dave video here Both my older boys love this and its an easy way to pick up signs.

I'd really recommend that you DO continue to use very simple sentences. it's been the biggest help to ds1, and has made more of a difference than anything else we've done. His understanding is improving now but a short direct sentence is still more likely to get a response, even in a very familiar situation. Talking wiith long sentences to a child who has a delay really doesn't help as they just switch off (all goes above them). Be aware as well that children can be very good at hiding how much language they don't understand- I always thought ds1's understnading was much better thanhis expressive language- until a private SALT eventually assessed him at 3 and a half and we found out he understood nouns and absolutely nothing else (his noun vocab was good). The SALT explained that he'd hidden it well as his situational understanding was good- but strip away all the other cues (my gestures etc) and get him to rely on language only and he was stumped. The way she tested this btw was to get some pictures and say "show me the ......" he was fine with nouns, but as soon as she said "whose running?" "point to jumping" etc he couldn't do it. that was a surprise as if I said to him "jump" he would jump.

I really would stick to 3 word sentences (for example today getting into the taxi he jumped across and sat in the escorts seat- rather than saying "that's not your seat sit on your seat" I said " DS1 sit on seat" and he responded immediately. Talking in that way will only speed up langauge acquisition it woon't damage it at all. I spoke in the same way to ds2 (partly out of habit) and at 3 his language is now advanced for his age - I'm not saying that's happened becuase I spoke to him like that- just that it hasn't damaged his langauge aquisition.

Hi, just wanted to say not to worry too much, my nephew has only just started speaking properly at four, after sessions with the SALT people, but he is now nearing coherant with most of what he says.

Thanks jimjams for the advice, I am assuming the makaton helps them understand and say the word correctly - hoping my dd does not just use the sign and not say the word. she doesn't actually have a problem in saying or repeating the majority of words - her vocabulary is quite good, she can't/won't join the words together. Is it like the cbeebies programme - something special? My dd loves that but I have never seen her copy the signs - just repeat the words.

We have been speaking the 3 word sentences for a long time now and she does follow all EASY instructions given but not improved her overall speech. I thought that if she heard a complete sentence it would help her fill in the missing words. She just babbles the missing words ie ticker, ticker, ticker "sun outside". I will then say to her yes that's right look at the sun outside. She just simply is NOT improving

I was also interested to hear that HappyMerryBerries ds's language was still a little young at 5 follwing the 3 word sentence approach. I suppose that is not really a big issue as long as he is now chatting away.

Thanks everyone you have given me alot to think about.

Hi piffle

Where can I get one of these leap frog radios? I have a few of the vtech toys which says the words ie red circle, blue square, and it gives numbers all with music I may add.

Yes, singing songs REALLY does help dosen't it - one of the best teaching tools I think.

My dd will not answer questions except when I point at a picture and say what's that and she answers with the approopriate sound effect too. If I give her a choice:- do u want milk or juice - she has yet to answer me. It's as if she is almost embarrased or shy even to reply. The speech therapist said that she was still too young to make choices. I have seen other toddlers younger than mine making harder choices than this. I suppose it is largely down to the personality of the child.

Thank you for yr advice.

Hi frizbe - Thanks for yr support - feel a little more confident about the whole thing and will let u know how I get on with the SALT whether it be private or NHS.

Something special does use makaton.

Sign will never replace speech - it just gives something visual to aid with understanding, and if a child has speech production problems it can help withthat. it aids language development (rather than just speech- havin a child expressive and receptive language problems and one who just had expressive problems- imo it's far more important to work on receptive langauge). I think studies have shown that sign helps speech aquistion - certainly doesn't delay it. We don't use sign as ds1 was never able to copy the signs and use them himself- so instead we've moved onto PECS (a picture symbol system) but the basic idea of reinforcing speech with something visual still applies. I have a feeling that although they use PECS as the main system at school they still use makaton for reinforcement.

Does your dd say yes or no? DS1 still doesn't understand the whole concept of choice and yes and no and it makes life difficult- ds2's first word was no and it really aided communication and helped prevent frustration before he could speak properly, so if your dd is using it make lots of use of that!

Another good teaching tool can be videos. There are some produced in the states - and I can't remember what they are called which specifically teach nouns or verbs etc. The picture quality wasn't very good though so worth getting dvd's. I'll dig them out and post the website details later.

Do you think the main problem is in speech production (ie coordinating her mouth to make the sounds etc) or in that she doesn't have the intrinsic language to make sentences? Both would be treated in a different way (ie if its just the speech rather than the language that was a problem then you woudln't need to bother with 3 word sentences and would do lots of licking type exercises- if its language then you wouldn't need to worry about speech but would want to increase her understanding - and then speech should follow).