What do you think this old be? Glue Ear?

[SoulTrain]

I know the subject has been done to death but I'd really like some thoughts on DS and his significant lack of speech.

DS is 2.1 and has extremely limited speech, maybe 5 words. Those words are mispronounced or said incorrectly "mumum" for "Mummy" (and pretty much anything else) "der" for "there". He says "bower" for flower. He makes noises for things like animals and cars etc but they aren't said correctly, for instance a cat is just a high pitched noise as opposed to anything that resembles a "miaow." He says everything with a soft noise ie, ending in an "aaaa" but the majority of the time is just making noise. He does "jargon" where he goes up and down like the tone of a conversation and I feel for the most part is loud but DH disagrees (pfb ) with that bit.

BUT his understanding is excellent, he follows instruction very well and communicates his needs well through pointing, making signs etc. He has been seen by SALT, she diagnosed a severe speech delay and gave us some ideas to use with him but the problem he makes no attempt at all to imitate or repeat. If he asks what something is (by pointing) and I say "digger" or whatever he repeats everything by saying "Da"...there is never an attempt at another sound or whatever. He has had no ear infections and appears to be hearing us well and in general is a happy boy but I can't understand the lack of attempt on his part or limited noises. I know people say "boys are lazy etc" but I don't think that can be the whole reason for no speech at all really.

I'm feeling increasingly disheartened by the ack of speech, especially since recently it was his birthday and I saw a video from his first speech and he is making the same noises as then, and if anything there has been a decline in his speech because when he was 1 he would say "bubub" for Daddy but just calls DH (and everything) "mumum" now. I don't feel there are any issues, he's affectionate, good eye contact, mixes reasonably well etc.

I've read a lot of the threads on here but the majority seem to have some proper speech but are mispronouncing or appearing to not hear. I am also loathe to take him to the GO, ours are useless - should I go private? In some ways I'm almost hoping its glue ear because at least then I would have a "reason" for this distinct lack of speech. However, what could it be if its not glue ear? Why is he not attempting to talk? We are chatty with him and read a lot....I'm feeling a bit upset about it all, do some kids never talk? The image of him actually chatting seems so far away at this point, I just can't imagine it happening.

Any thoughts would be most appreciated.

Sympathies.

The SALT said his speech was severely delayed - this means that it will take longer to develop, not that he won't have any. It sounds like you are doing all the right things as well as the programme they have given you. Are you getting regular reviews?

My DS had glue ear (although I don't think it was a particularly bad case) and it was dealt with well by the NHS.

When he was referred to SALT, was he not referred for a hearing check too?

You may get better advice if you post on the Special Needs boards

Thanks bigtilly, I asked his hearing and she said that she hadn't seen anything that is of concern with his hearing but I want to get it checked just do rule it out. We see her again in 3 months...

Yes, definitely get it checked - surprised that that hasn't been done as a matter of course.

In this area the first thing the speech therepists ask is have they had their hearing tested, and refer them if there is any possibility that hearing may have contributed.
Having got a ds with glue ear, ENT have said that most parents don't notice unless it's extremely severe. However time I notice his hearing is just after the grommet op-when I suddenly realise how much more he's hearing. Children adapt very well.

Tongue and/or lip tie can cause speech delay.

Could that be a possibility? How did feeding go as a baby? (either breast or bottle)

Sorry, only just seen response. Feeding was a nightmare, he wouldn't latch and would resist the boob. Bottle feeding was always ok apart from random vomiting (reflux?) all the time.

My mum is tongue tied...I don't know what else to look for?

Well, going on what you have said, I would say that it is fairly likely that he has some sort of restriction, be it tongue, lip or both. Tongue tie is highly hereditary and your feeding history would also point to perhaps a problem with tongue or lip tie, as does the speech problems and reflux.

Other problems that seem to be common amongst tied kids are poor sleep or sleep apnoea, ENT trouble, difficulty with solids, dribbling, allergies and intolerances, gastric problems, high palate and associated dental problems. Some kids have all these things and some may not have any.

What to do? Well, the first thing is to get somebody who knows what they are doing to assess him. That is more difficult than it sounds. Your SALT is unlikely to be clued up on tongue tie given that he or she hasn't mentioned it up to now as a possibility. Some SALTS even claim that tongue tie doesn't affect speech! which is complete bullshit. GPs and HVs are also unlikely to have good knowledge and are quite likely to miss the more difficult to spot posterior ties because the tongue can look absolutely normal to the untrained eye. There is so much more to it than speech and feeding which is normally the line that most docs focus on.

Anyone you find on the NHS who is willing or able to diagnose and revise a tie is likely to want to put a child of his age under GA. This is not necessary, and it is actually preferable to have the patient awake when revising a tie so that tongue function can be assessed as they go.

I would point you towards the Tongue Tie Babies Support Group on Facebook (it's a closed group, but just ask to join) and also Dr Kotlow - he is a world leader in this field.

This is interesting but is more about babies than toddlers as is this which talks more about the consequences of untreated ties in children and adults alike (you may well find that you have a tongue tie too)

There are two dentists in the UK who have trained with Dr Kotlow and do laser revisions of tongue and lip ties. They are Malcolm Levinkind in North London and John Roberts at the Cote Royd Dental Practice in Huddersfield. Saying that, the last I heard was that John was only revising under 1s and over 6s. Either of these two would be able to assess and advise you further.

I won't bore you with the very long story of ds1 and his unrevised ties, but the summary is that he suffered loads of problems which I subsequently learned were related to his ties. I banged my head off a brick wall with the NHS doctors for a while and then realised that I had to educate myself and find the appropriate treatment for him. He had his done last year aged 6yo. If I had known what I know now when he was a baby, I would have hot footed it straight to one of these dentists to have the ties revised.

He first had a costly revision under GA which wasn't even done properly, so we later made the 400 mile round trip to Huddersfield to have it done again correctly. A good frenectomy is worth travelling for.

Sorry for the essay!!