Referred to SALT and SENCO - would welcome advice

[astronaut]

DS age 3 has been referred by HV for assessment by SALT, due to delay in speech development. In addition, his nursery have recommended an assessment by the Early Years SENCO because they have observed problems with his speech, comprehension and attention span. Has anyone gone through this? Would appreciate advice on what to expect from the assessments and the relevant questions to ask?

My ds2 was referred for SALT a little before he was 3. He had a language delay.
I'm not sure I can advise on questions to ask but the whole thing was very friendly.
he attended a course of group therapy, the parents met in another room and were given information and advice - almost like a short course, very good.
He was discharged by SALT when he was 6 or nearly 6.He received therapy at playgroup fromSALT and at schoolfrom TA under advice of SALt.
I hope this is some help.

Thanks for your reply TooTicky - I like the sound of the group therapy sessions. Think that one issue is that DS lacks confidence with speech especially in a group setting. I was shocked to hear that he didn't say anything at nursery until recently, then started to come out of his shell only to regress when his sister was born 4 months ago.

Ds2 lacked confidence too, but is now a talkative 7yo who maybe doesn't get every word just right but is confident enough to phone the headmaster and leave a message on the answermavchine

He didn't put two words togethr until he was 3 and couldn't put the first sound on his name until he was just about five. Amazing progress is possible.

I agree that SALTs can work wonders - and they do make it fun, so as far as your DS is concerned he will just be playing some weird games. I've always found the assessments a nightmare - they go on too damn long - and then there might be a gap before the therapy starts, depending on whether there's a group for him to slot into or an individual SALT available.

My DS3 is a testament to the benefits of early intervention - was still largely unintelligible at 4, now at 6.5 is easily understood. He has something called verbal Dyspraxia, so will always have slightly odd speech and still needs a lot of SALT input, but he's where he is today because a clued up HV referred him early. So I'm pleased your HV and nursery are on the ball - always good to have someone to help fight your battles.

Hello astro.

I'm an SLT.

What will typically happen int he assessemnt is:

detailed case history (talking through early development/ your concenrs etc)
a look at his attention and listening skills i.e. how he attends to self chosen/ adult led tasks and how he responds to support to attend.

a look at his:
play & interaction skills

understanding of language and non verbal skills

expressive skills- how he makes his needs/ thoughts etc known e.g. with words and or gestures etc.

speech sounds (pronounciation)

the SLT should ask for yuor input throughtout the assessemn i.e. ' is this what he would do at home?/ what else would he do/etc.

The SLT should be able to tell you why they are doing what they are doing as the assessement unfolds.

Most of the assessemtn may be informal i.e. through play/ use of toys etc to illicit responses from your DC.

The therapist may try a number of approaches in order to engage and help your DC.

Do ask if you are unclear as to what is happening- also do let them know if he is not showing skills you have seen in other contexts.

at the end of the session ensure that you feel confident as to the outcomes of the session i.e. where DC's areas of strength lie/ needs might be and how the SLT might recommend supporting these (if appropriate).

Ask about waiting times.

Ask what you can be doing to support DC's skills at home, and ask the SLT how they might link with nursery to support staff in helping DC too.

rushed response but hth

Thanks so much for your input everyone.

TooTicky, Hassled - great to hear of the progress made by your sons in a relatively short timeframe. DS turns 3 next week, so hope he will also benefit from early intervention, and that we won't have to wait too long for any therapy to start.

Sparky - found your advice really useful, much more informative than the leaflet sent with our appointment letter. I have a number of concerns about DS's speech and language, and it sounds like most of these will be addressed in the assessment with SLT. If not, do you think it would be appropriate to mention these other points during the initial assessment as think we only have a limited time for our appointment?

My concerns:

1. DS is a prolific thumbsucker, and sometimes speaks with thumb in mouth. I wonder if this has had an adverse effect.

1. Pronunciation of some words isn't clear. DH & I can generally understand DS, although there have been many occasions when we haven't been able to understand him, despite DS repeating himself. I've observed that his nursery workers sometimes don't understand him or misinterpret what he's trying to say. I know DS finds this very frustrating, and wonder if not being able to communicate contributes to his many tantrums.

1. DS lacks confidence especially in a group setting and with people he doesn't know. He quickly becomes discouraged if he attempts conversation that isn't understood. He's a sociable little chap and loves being with other children. It breaks my heart to see his peers lose interest in him when he can't continue a conversation.

1. Vocabulary and sentence construction. Seems to have quite a wide vocabulary of individual words, as judged by what he can identify in books, but he doesn't make use of these in conversation. Sometimes uses pre-constructed sentences or phrases, not always in the right context, e.g. "it's a big one" or "good boy mummy".

1. Wonder if his hearing should be checked as he often ignores us or doesn't respond unless we repeat ourselves several times. Could of course be down to typical toddler "selective hearing"!

1. Comprehension. Often unable to give appropriate answer to simple questions or to recall recent events, e.g. when asked what he ate for lunch, will always reply "pasta".

1. DH had speech delay and according to MIL wasn't understood by anyone outside the family until age 5.

Can't help with anything except 2) - yes, DS3 found it immensely frustrating when he couldn't be understood and that affected his behaviour - it still does when he's having a bad day. I had the advantage of having DS2 about, who has always been able to understand DS3 completely and could translate.

The benefit to that frustration is that DS3 is a feisty, resilient, determined child which won't do him any harm in life .

Re 3) - yes, DS3 found the fact that his peers couldn't understand him very discouraging, and was quite withdrawn pre-school. However, that was built into the Statement of SEN he has, and the school put a lot of time and effort into developing social skills etc. They involved classmates in the speech therapy exercises DS3 had to do - all linked in with the Jolly Phonics Early Reading scheme, so of benefit to them too. He now has a close circle of friends.

Hello again,
have cut and pasted your concerns and added comments (poor memory otherwise!)

1. DS is a prolific thumbsucker, and sometimes speaks with thumb in mouth. I wonder if this has had an adverse effect.

don't know is the answer...sorry. Mention it though

1. Pronunciation of some words isn't clear. DH & I can generally understand DS, although there have been many occasions when we haven't been able to understand him, despite DS repeating himself. I've observed that his nursery workers sometimes don't understand him or misinterpret what he's trying to say. I know DS finds this very frustrating, and wonder if not being able to communicate contributes to his many tantrums.

-yep important to mention. strong link between behaviour/ confidence and language skills

1. DS lacks confidence especially in a group setting and with people he doesn't know. He quickly becomes discouraged if he attempts conversation that isn't understood. He's a sociable little chap and loves being with other children. It breaks my heart to see his peers lose interest in him when he can't continue a conversation.

as above really, the SLT will understand this and know that early intervention is key.

1. Vocabulary and sentence construction. Seems to have quite a wide vocabulary of individual words, as judged by what he can identify in books, but he doesn't make use of these in conversation. Sometimes uses pre-constructed sentences or phrases, not always in the right context, e.g. "it's a big one" or "good boy mummy".

you have fantastic observations- another great insight to give to SLT.

1. Wonder if his hearing should be checked as he often ignores us or doesn't respond unless we repeat ourselves several times. Could of course be down to typical toddler "selective hearing"!

-Useful as diagnostic/ precaution. Definetly mention this (your SLT will probably be thinking of refering to inform their differential diagnosis) but you are right. Often it isn't the actual 'hearing' more 'listening' to language and attending to another persons agenda that is the difficulty

1. Comprehension. Often unable to give appropriate answer to simple questions or to recall recent events, e.g. when asked what he ate for lunch, will always reply "pasta".

• mention this. Good example.

1. DH had speech delay and according to MIL wasn't understood by anyone outside the family until age 5.

again, important. We often see family history with S/L diffs.

I wish you very good luck- I'm sorry this response is rushed (bedtime for DC's)

Hassled, sounds like your DS3 and my DS share similarities in their personalities. Feisty and determined could describe my DS also. He's become very independent and wants to do everything for himself. We get a lot of "I do it, I do it", accompanied by DS batting my hand away from whatever he wants to do without help!

Your DS3's school and their inclusion-centred approach to his therapy sound great. I had hoped that DS would start pre-school nursery sessions at our local primary school in April, as this would be a good transition into the reception class. But now wonder whether he would find it too intimidating. He's been at his current nursery since 8 months old, and it's a homely environment with lovely, caring staff.

Sparky, thank you for taking the time to give your feedback. Really appreciate your comments on each of my concerns, and it's encouraging to know that the information will be relevant to the SLT assessment.