Speech problems in 2.5 year old.

[AndiMac]

Our son has been learning to talk but he is often very unclear, using a lot of "g" and "k" sounds for other consonant sounds. When I listen to other children his age and look at video of his sister at the same age, he is definitely not at the same level. He can make the noises and speech patterns, but understanding the words when he says more than a couple at a time is very difficult, if not impossible. Not just for others, but us as well.

For example, he will say "gikkle" for "little" and "geekp" for "sleep". Mister Tumble is "Gigga Gungle". He is very sociable, smart and easy-going (other than when he's tired, but hey, that's 2 year olds for you) so I don't think this is anything other than related to his speech. His hearing was tested when he was a baby and there weren't any issues, nor does anything now make me think he can't hear.

There is a drop-in speech therapy session where we live, so I took him in for an assessment and was told this is called backing. They asked if he could make all the other sounds individually, which for the most part he can. He can make "s" "m" "b" and will use them in some words such as "yes" "morning" and "baby" but not in general use.

The speech therapist suggested to just leave it until he's 3 and see if it clears up, with simply the suggestion to repeat the words back to him correctly. Well, we are already doing that and it doesn't seem to make a difference. I'm not sure if I should just sit on my heels about this for another 6 months, I feel like we're just being postponed. I would think that the best chance to correct his speech is while it's still developing, or am I totally off in this?

firstly he is very cute, beautiful singing

realised a trip to GP to look in his ears should let you know if he has glue ear, they'll be able to see the ear drum and if it looks dull and blocked, might be easier and quicker than hearing test referal.....

Also, when you say he has final consonant deletion - two questions. Is he saying many cvcv words e.g. mama, baba, nana, tata and is he closing any syllables e.g. are there any words with a sound on the end? Children sometimes do with some sounds but not others e.g. they may say dop for stop but baw for ball. Also, I noticed he said "ai" in the middle there for "sky", do you ever notice him missing sounds off the beginning of words when he's talking? I wouldnt class it as initial consonant deletion in a song but it is an important thing to watch out for in other contexts.

Thanks, I of course think he's extremely cute, but I'm obviously biased. Pardon the big smear on the picture, I only noticed after filming him.

When we are talking, I can usually understand things in context if he keeps it short. It's hard to say how much he uses g and k vs the other sounds, because of course I become accustomed to it somewhat. I also taught English as a foreign language for many years so I'm pretty good at figuring out what people are trying to say. But it's tough when it's not something in context that either of us can point to or if he tries a longer sentence. When I say I don't understand, I'll try a few suggestions to see if that's what he means, or I'll ask him to show me. He'll sometimes repeat it, sometimes take me to what he's talking about or wait for me to figure it out. Sometimes we just have to live with his point not being made. I'm pretty sure he's well-aware that we don't always get what he's talking about.

For your last question, he does do cvcv, baba, gaga (water) and nana spring to mind. As for sounds on the end, he says daddy, but not sure that counts, plus the "s" in yes, (h)ouse and some other words. Now I'm getting tired and can't really think of specific examples for the consonants, nor for the initial consonant, if he ever leaves it off rather than substituting a backing sound.

Oh, and bdaonion we are the same borough, the drop-in at St. Marks. :)

Daddy would be a cvcv too - da dee. It's good he is using some sounds word-finally.

I think at his age it's really hard to tell without a full assessment but on the basis of what you are saying, your level of concern and what I have seen of him, I would advise you to seek that full assessment really. It sounds as though you have been through triage, and from what you have said the decision was based more on what information you could give the therapists vs direct assessment of your son. This is not uncommon in these types of drop-ins, it's not as though they did anything wrong and 2.5 year olds are often very reticent in this type of environment so it is often necessary. However, I think it is worth revisiting.

If you go through the NHS first, highlight that you have followed all the recommendations re: modelling and all the communication strategies you are already using e.g. getting him to show you what he means, giving him time, encouraging him to repeat etc but that you are very concerned.

It sounds as though his range of consonants might not be very broad e.g. g/k/s/m/b and this might be worth bringing up in the context of him using some 3-4 word sentences that are clearer.

If they don't want to give you an assessment with this information because it doesn't fit their pathway etc, I would consider seeking a private assessment, looking for someone who says that they have significant experience of speech impairment. This is NOT because I think he IS speech impaired by any means, but because someone with this background will have the best "ear" for what he should and shouldn't be doing.

Expect a session to last 2-3 sessions and to look at all areas of speech, language and communication.

The evidence says that "watchful waiting" for speech delay in the under-5's (e.g. doing nothing but monitoring/reviewing) doesn't result in major differenes to NHS type therapy for the same age range BUT until you have a full assessment and are confident of the diagnosis, you don't know that there isn't something going on that might just benefit from further intervention. It might be something, it might be nothing but as a mother of a 2 year old myself and working with children with speech and language impairment myself, I wouldn't leave it to chance. You have nothing to lose except time worrying and second-guessing your own intuition in the interim.

Thanks for your thoughts working9while5. Maybe that's it, my intuition is saying this isn't something to ignore. It can't hurt to go back and ask again. I just found out it's a 6 month wait to see a speech therapist, so I can at least push to get things organised now. If he gets it on his own before then, all the better. But I don't want to wait 6 months to be assessed and then another 6 months to do something about it.

Absolutely. Good luck with it, any further questions don't hesitate to ask.

incywincyspideragain

Glue ear is a cause of auditory processing disorder (APD), a listening disability.
And it is the APD which is the cause of the speech delay
have a look at my UK APD links list, especially the links to the Medical Research Council and their 2004 pamphlet

Er, are you diagnosing APD as my son's problem or refering to incywincy? I hope it's the latter, as I would hate to think you would be so presumptive.

AndiMac

I would try to diagnose anyone, but replying to incywincyspideragain comments regarding her DCs

huge theard highjack (sorry AndiMac) thanks dolfrog but I thought APD was when the hearing was good but the child couldn't understand the sounds they hear?

glue ear meant that none of mine could hear well. The hearing team supported me in explaining to School that ds1 simply couldn't do the phonic sounds ie 'ch' 'sh' 'th' sounded all the same - 6 months after his grommits he moved from a 'non reader' to stage 6 ORT. There was a physical barrier to his hearing not a processing one.

I think ds1 could have mild APD now (although school don't seem to recognise this) as he has to catch up with some of his processing (mostly following complex instructions) but the speech improvement especially for ds3 improves daily just because he can now hear the full range of sounds and can mimic them.

Not a huge hijack at all. This all may become relevant, depending on how things go!

Hi op, just wanted to say, defo get his ears checked. My liitle boy was exactly the same as yours. He's 4.10 now. He backs and I was told by my salt, as woking has said, that it's not typical development. He's been seeing salt since he was your sons age. Some via nhs and some privatly, I'm currently just about to fight to get him a place at the local speech and language unit.

Anyway I just wanted to say, I took my son for a hearing test before seeing the salt, purely because I knew he would probably be reffered anyway if is speech was bad, I never actually thought for a second his hearning was down.

I was therefore really shocked to find he had significant glue ear in both ears and his hearing was well done. I felt awful as I had no idea, so please do get it chacked.

Got to dash now but will post later

incywincyspideragain and AndiMac

When children have Otitis Media with Effusion (Glue Ear) they children have hearing problems. After the Glue Ear has gone the after affect is APD.
When the glue ear is present the brain has to process a distorted version of the sounds the ear hears, and develops systems to understanding of this distorted version of sound input. When the Glue Ear goes the brain still expects to process the distorted version of sound information, and does not completely recover to always be able to correctly process what could be called pure sound (not distorted sound). This has been the case in some communities that have no natural immunity from ear infections such as Glue Ear such as the Aborigonies in Australia.
The Medical Research Council included this underlying issue in their 2004 APD pamphlet.

Thats really helpful, thanks dolfrog - I'm not sure what your back ground is but the leaflet states 'long term middle ear diease' what would be classed as long term?

This would be an area I would have to push with School to get any assistance because academically ds is fine, reading is amongst top (one of the key things highlighted on the leaflet) but concentration is poor and processing has been described as 'slow'

incywincyspideragain

my background - I was the parent who got lumbered running the the UK APD support organisation APDUK back in 2002 lol

then I may be back for advice been reading your links but finding it difficult to find anywhere that suggests practical things to help, most have been done for ds already due to hearing (position in class, eye contact etc) but his processing is slow - any ideas where to find strategies to help him grasp instructions and stay on task? With our School I need to try something and home and suggest it to them....

incywincyspideragain

Following verbal instructions is very difficult for those of us who have APD, as we have problems processing what people say, try to use alternative instruction methods visual charts, diagrams practical demonstrations that we can watch and learn.
Have a look at the visual learning style section of the APDUK web site (try to use the graphic menu at the top of the pages)
Or you could try some of the links from my own web site (especially the ones with a cat)

I'll be going back to the drop-in tomorrow hopefully to talk to them further. I'll let you know what happens.

So we were back this morning. They noted it had only been a couple of weeks since I had been been there before with him. I explained that I felt that the advice they had given was things I was mainly already doing and that I'm normally pretty laid-back as a mother but that I really was concerned about this; I didn't feel it was something that could be just left to see if it got better. I also explained that everything I had read said that backing would need intervention to improve. Even if their therapy program would only take children from the age of three, I know there's a 6 month waiting list for that, so I would rather get on the list now than wait 6 months until he's three and then another 6 months for an appointment.

It was a different therapist today and she agreed to arrange a hearing test for him, send us some phonic sounds to practice and also to put us on the list to join some parent-child speech play group that will likely be around Easter.

I'm glad I went back again and feel things at least are moving along. Thanks to everyone on the thread for their advice and support.

Thats great news AndiMac glad you went back as it sounds like some positive steps and at least to are now 'in the system'

Thanks incy. It certainly seems like a case of being a squeaky wheel!

hi AndiMac - wanted to see how your ds was getting on? We've just taken ds3 to SALT drop in clinic and he's now been referred but like you it could take 6 months but they said they'd rather do that and have to cancel it than wait till its really bad, they are keen to interveen in his preschool year - I don't think it'll come to that but its reassuring - and very proactive of them! They also gave some guidance on what 'normal' is (I don't know what that is - all 3 of mine had bad hearing ) did you get referal for hearing test? Anyway looking for a chat really