Best childcare for speech delayed DS

[firsttimer08]

It seems that DS (14 months) may have speech delay. I work full time and our nanny is leaving I am wondering now whether it may be better for ds to go to nursery instead, as interaction with other children may help his speech. On the other hand, the nursery i'd send him to full time has many children and they don't appear to receive full attention.

Any views would be appreciated.
Thanks !

my ds has speech delay and when he started nursey (at school) his speech improved a great deal

How do you know he has a speech delay at just 14 months?

Isn't 14 months a bit early to be diagnosing speech delay? Does he have any other symptoms? I child mind two kids who have just turned 2 and 3 respectively, and both only really started started speaking in more than the odd word at 18-20 months. My own DD spoke earlier, but then girls do. I think an adult one-to-one can encourage speech sometimes even better than nursery, where it's all noise and babble of 10 or more kids. My son has speech delay but that is because he's autistic, but on the speech front I've found 1-to-1 adult attention has been better than nursery.

its suspected at the moment only based on discussions with ds's carers. I met with the health visitors today too and they seem to think that he may require more encouragement and a lot of hard work. DS has not said even his first word so far and there are several other indications that HV pointed out.

firstimer, can I suggest a couple of things which speech therapists used with my boy? The reason I want to tell you them is that the sooner you start, the sooner you can stimulate the speech centres of his little brain, which apparently are at their most receptive up to the age of 5. Try and teach him first to imitate an action. Eg say "Do this" and get him to stamp his feet. Or clap hands. Or raise an arm. You may have to prompt him using a hand-over-hand approach at first. It could take quite a few weeks. Once he does it, prompted or not, give him a big reward (praise and /or sweets). Get him to learn to imitate lots of other actions, so that he realises that the command "do this" means "copy what I'm doing ". Then find something he's really motivated by - eg a push on the swing. Say "Do this" and make a "p" sound for him to imitate. If he even tries to move his mouth, give him massive rewards and a big push on swing. Keep at it, till he makes the link that mouth movements (ie speech) get him good results. We used this method to motivate my DS to say his first word. It's different because he's autistic, but I see no reason why this apporach shouldn't work for all speech delay, as most speech is based on imitation. Traditional speech therapists don't like this method, as they prefer a more "organic" approach to speech/language development, but my view is that you use whatever works. The tutors who work with my DS believe that speech is a behaviour that can be taught like any other, using the right motivation.
I myself found traditional speech therapists pretty uninspiring so wanted to share this method with you , in case it helps.

hi there,

thank you so much for the advice. I will try and implement this into our routines. It sounds like a really good idea to use reward as a way to encourage ds to speak. He has not been imitating any of the sounds we make so far which has been a bit of a red flag.

We do not have the all clear on autism either - though he does point a lot (in fact almost all the time these days at something or the other). Also he is generally quite aware of his surroundings, loves to engage with other ppl and exchange smiles.

Pointing is a very good sign - apparently lack of pointing (particulary to share something with you, eg something he wants you to look at ) is a first sign of autism (my boy never did it, for instance, and we have had painstakingly to teach him to point). Teaching your DS to imitate could be key to getting him to speak, but be aware that the SALTs (speech and lang therapists ) will tell you NOT to do it this way, and will try instead to ignore words, but go for pre-linguistic things like turn-taking and eye contact. I found that all useless and quite baffling. After all, most small humans learn to behave in a certain way in order to get what they want (eg a baby cries to get food) so why on earth shouldn't speech be taught in the same way. Good luck!

firsttimer,

When he's three, you can seek out an excellent pre-school where his interactions with other children can be fostered.

But at 14 months - especially 14 months with some delays -adult 1-to-1 is what he needs. I'd hire another nanny if I were you. Nanny will take him to toddler groups, etc.

My DS will be 14 months old in 2 days time. He babbles and points lots and says Da every time he points, but he has not said his 1st word yet. Is he speech delayed? He has been at nursery ft since 5 months. I hope this is not affecting him.

DS1 didn't say anything until 14 months, but by 20 months he was such an advanced talker that he was a subject for research by a paediatric psychologist. All sounds a bit premature to me.

I gave in to pressure to send my severely speech delayed DD1 to nursery ( OK just a couple of mornings a week ) and she didnt' utter a single word for the entire time she was there.
As others have said, it depends on the reason for the speech delay.We now know that DD1 has a severe speech & language disorder, but one of the great myths surrounding language disorders is that the DC will learn speech from being around other kids - IMO simply not true.
I tend to believe that most kids with speech difficulties will benefit a lot more from 1 to 1 attention

Dizzee - babbling & pointing at 14 months is exactly what you want. Please don't think anyone is saying your DC's normal speech or development will be damaged by a nursery

i'm so glad for mumsnet and the advice that's what i would think that he may need more of one-to-one, though the health visitor seemed to think nursery environment can be quite good. I'd be interested in a qualified childminder, but the area we live in has a dearth of childminders - so while that would have been my first choice, its unlikely we will find one near enough.

dizzee i can only say that ds is the same just pointing and going "aah" "ooh" and "da da da" but nothing more beyond that. I don't think nursery can curtail a child's development though. There are other babies i know of the same age as ds who go to nursery ft and are fairly advanced in their speech. I am hoping as other posters suggest that each baby is different and some just like to take their time.

I hope you are right that pointing is a fairly positive sign that ds may not be autistic, though i guess its also too early to mark it down yet. As I understand autism can only be diagnosed closer to 2 years age.

firsttimer, like some others on here, I've gone through this worry and it's awful. I do think 14 months is way way too early to make any predictions about autism or long term speech development. I've known so many 2 year olds go from a handful of unclear single words to speaking in sentences practically overnight.

Please try to stop even thinking about this until your ds gets to 18 months and you can do the CHAT (Checklist for Autism in Toddlers) test on him. The fact he's pointing now is a great sign. I agree that adult interaction would be great for him, alongside a playgroup now and again. I'd get another nanny.

ds1 did have several words at 14 months but is still being assessed for ASD at 4. If your ds is sharing attention with you and pointing, that sounds fine for now. It would also be very unlikely that anyone would diagnose him at 2 - many paediatricians prefer to wait until nearer 5. I found my HV really helpful, more so than our GP as she had a special interest in ASD and speech development.

DOn't mean to sound dismissive but am sure many/most (?) children don't say anything much or even anything at all at this age and IMO it's far, far too early to describe him as having speech delay.

Sorry forgot to say I do agree with the advice that if you are worried about him (as you obviously are) then one to one care is probably best, if not then a very good CM.
I wouldn't recommend nursery as there would be too many babies to carer ratio for him to get as much attention as you would probably like.

When I was pregnant I put ds's name down for the smartest and most expensive nursery in town (the only one that could do the hours I needed). I thought I was making the right choice for ds.

When he arrived early and poorly I had a major rethink, added 4 months to my 6 month maternity leave and got a CM. Main reason was continuity of care. I didn't want ds to have a 'key worker' who may or may not be at the nursery every day and which I wouldn't necessarily know at drop off time (ie they might start later).

I needed someone who wouldn't just look at ds's chronological age and expect him to be doing x,y and z. He was developmentally delayed and pretty poorly for the first 4 years of his life - very poor immune system so seemed to be constantly ill.

Some days ds went to the CMs when he wasn't well (probably more than ideal but as a single parent I had no choice). I was comforted that he was going to a loving home environment and that the person I dropped him off with in the mornings was the person who spent the day with him and whom I collected from in the evenings every day. None of my nursery-using friends could say the same.

My CM administered complicated medication, did ds's physio with him etc etc.

If you don't want another nanny I would chose a CM over a nursery every time.

PrincessToadstool - my dd probably only had a handful of words at 2.2 years...she didn't see a SALT and had no intervention at all. I WAS getting worried about her so I do understand yours and firsttimer08's concerns but once ds was born (dd was 2.3 years), her speech came on leaps and bounds...not sure whether this was because she needed to be heard (!) or a coincidence. I have been at home full-time with her since she was born (she's 3.6 years now). I can see pros and cons of nursery with regards to speech. Yes, they are hearing the other children and perhaps having to be heard may encourage the speech, but they are also listening to other children whose speech may not be very clear. I have to say though, I always anticipated my dd's needs so perhaps sometimes she didn't need to bother to speak.

My ds is now 14 months and doesn't say any recognisable words at all. He also doesn't point (apart from with his whole fist)...I'm not worrying about it at all at the moment because my dd was also very late with these things. In my opinion, there is no way you can say a child has speech delay at 14 months.

DS1's ASD could have been dxd at around 12 months as his ability to share attention was impaired/limited compared to that of a typical child so although he could not have been described as 'speech delayed', he was delayed in the development of shared attention and communication as he did not readily follow my attention or want me to share his attention. I found that full 1-1 attention was best for his development . 14 months is young though so keep an open mind.

having had a lang delayed pre-schooler agree with the other ladies about 1-1 being more important for picking up language than being around other children for a child who has language difficulties.

PrincessToadstool - forgot also to say that although dd didn't start to talk until over the age of 2, she is now nearly 3.6 years and we rarely get a word in edgeways! Some words are still muddled but the sentences and range of vocabulary she has compared with a year ago is amazing...I was at the point of demanding to be referred to a SALT but then she just started chatting away. Hang in there - hopefully it will all fall into place...I know what it's like though when you hear other children the same age or younger gabbling away in full sentences before your child has even put two words together.

On the hearing front, I had to take my ds (14 months) for a hearing test last week and his test was 'inconclusive' as apparently he wasn't concentrating properly! The people who did the test said they have to be at exactly the right age to be cooperative in the test...seems a bit hit and miss to me!

Anyway good luck...I bet in a year's time, you'll be needing earplugs from all the chatting!

DD has a slight speech issue (she's 3) and we have hired a slovakian nanny. Our nanny speaks quite slowly to her and it's really helped her speech - she's only been here a month and already her speech is twice as good as it was.

One thing I did realise is that we speak really fast as a family and it's hard for both DD and DS to pick it up. So we're trying to slow down too.

I know your DS is much younger but perhaps something to think about?

thanks for the tip whomovedmychocolate" - i have been in the past month trying to really enunciate properly nad using only 2-3 word sentences. I didn't say before, but maybe speech delay is less of a concern, its becoming more and more aparent that ds does not really understand us very well. Sometimes he'll bring his shoes if I ask him, other times he will just ignore us and go about doing his own thing - I am not sure if that could be an issue of shared attention as cyberseraphim* suggests. We got in touch with a private centre here in london and based on the detailed responses I have given them, they would prefer to do a full assessment for ds rather than just a speech/language one.

We have already had his hearing tested and all is ok there.

As it is a lot of money, i'd rather wait for the full private assessment, especially as so many posters here suggest that its really too early to know. But then at that same time, i just want to know asap if anything is wrong and then just work out the right treatment.

DS also does not like doing puzzles at all. When I met the HV last week, she was surprised that he cannot do the shape sorter and wanted me to spend more time with ds on it. However, i have tried so many times and he just gets bored and runs off to play with something instead. Building blocks can keep him quite busy though. Not sure again if that is also another ASD sign.

Anyway what is quite clear from all the comments is that he does need 1-1 attention and another nanny would be the way to go.