speech and language delay in a 3 year old

[row78]

My son is 3 years and 3 months old. He started saying words, and was combining ("Hello mummy") at around 16 months old. Then he just stopped. Finally at around 3 year old he's finally started up again and has around 50 words. We finally got him on a 5 week NHS speech group at the beginning March which he has just finished, and now they say they'll wait 2 months, reassess him and then put him on another group (which based on past experience will take at least 3 months from referral, so I'm not that happy). I work with him as much as I can, I can get him to say new words but you really have to hammer him with it constantly. For example he finally understands the word "eat" but it took 2 weeks, there are thousand of words in english, I can't do this with them all!

To be honest I'm just feeling a bit down at the moment about it all and I'm finding it hard to see the light at the end of the tunnel. He does seem to have difficulty understanding things and the gulf between him and his friends widens every day. I really don't think he's autistic as he is very sociable and has good eye contact etc, but honestly to me it just seems like his language skills are delayed. I'm just wondering if anyone on here had similar experiences, how they dealt with SALT, anything that really worked for their children and how they progressed.

Many thanks in advance

Did your SALT recommend Hanen? Some places offer a Hanen course, which is fantastic, otherwise the book, 'It Takes Two to Talk' is good. Check out Amazon etc, but Winslow Press is often cheaper.

We already have "It Takes Two to Talk", that's really helped us to get him to the 50 words and words like "more" and "gone" but it's very slow progress. The book is Hanen isn't it but beyond that I don't know anything about Hanen. The SALT hasn't really said anything or recommended anything.

has he ever been seen by a developmental paed? If not I would get him referred asap to rule out any other underlying issues.

my DD (4) has been diagnosed with classic autism recently and her eye contact is great. but I am not suggesting that your DS has ASD, just saying that things are not always that clear cut.

also maybe an obvious question but have you had his hearing checked?

chocjunkie - The health visitor is going to catch up with me this month and she mentioned referring him to a behavioural person to check that, after that would they refer him to a developmental paed? If not how do I go about it? I don't think it is ASD but obviously just in case it was I would rather he started to get looked at earlier rather than later. What symptoms did your daughter have? He's had hearing tests, apparently fine except for very waxy ears which he had suction on one ear last month and the other ear is being done this week, you've reminded me to use the ear drops!

most obvious symptom was her speech delay/disorder (also massive trouble understanding). she is also not interacting with her peer group and rather prefers the company of adults. a number of small weird rituals but nothing major. no obsessions with routines. her play is also behind - rather repetitive and no pretend play.

our HV told me for an entire year (between 2nd and 3rd birthday) that DD is fine. the usual "they are all different" bullshit. In the end, I got DD referred via GP as HV would not refer and rather telling my I am an overworried mum (thinking that DD's autism is pretty severe it still makes my blood boil ).

I would go down the GP route for a referral.

bypass the HV. Honestly, don't go down the behavioural road (can of worms where they spend ages assuming that all problems are due to parenting) or delay your referral to a developmental paed.

So many developmental problems can be vastly improved, even cured completely if you get accurate and timely early intervention.

A paed referral won't subsequently get you much mind, but with an accurate description of problems you'll have a starting place for researching what you can do and how you can do it.

Investigate the CHAT questionnaire, researc dyspraxia and ADHD and make a list of 'symptoms' from all of them that you think might apply to your ds. Don't try to diagnose and use anything that applies regardless of whether you get a scattered picture. Then list one or two examples of how this applies to your child in real life.

Then get yourself to the GP for a developmental paed referral and mention 'regression' as many times as you can during the appointment.

thanks chocjunkie and starlight. I have family around next week so I'll book a GPs appointment for then as they can take my daughter whilst I take my son there (less stress in the waiting room means I'm less likely to forget things!). I'll research those things you mentioned starlight.

We did some private speech therapy last year and the therapist did woder aloud if he had dyspraxia but when I mentioned this at the end of his speech group the therpist said she didn't think he did. I've mentioned the regression until I'm blue in the fact to SALT but they just nod and say this can happen.

I second what the others say about getting him seen to rule out other problems.

Try not to feel down and keep working with him, you won't need to "hammer" every word in like this for the rest of his life, and you will make progress if you keep at it. I found these: teachmetotalk.com/ DVDs very helpful, if you don't want to buy the DVDs there is a ton of free info and some short demos on that site about how to get that first language going through play.

I wouldnt even take your Ds with you. I would make some notes and make an appointment in your Ds's name.

You can talk better without LO's with you.

Good luck.

"I've mentioned the regression until I'm blue in the fact to SALT but they just nod and say this can happen."

While it is true that this can happen, doesn't mean they should ignore it. I second the advice about mentioning it as much as possible alongside all your concerns. If the GP is any good, it should get their attention.

Agree - definitely go via GP and don't let them fob you off either - from my experience they are great at spotting a broken leg but useless at spotting subtle developmental issues. I originally asked for a private paed referal, thinking company health insurance would offer amazing dx and therapy for
autistic traits >>>bitter laugh

good idea Ineedalife, I never thought of going without him.

Thank you all for your thoughts, you are all giving me a lot of confidence in bringing this up with the GP and when I next talk to SALT, and it is all incredibly helpful. He's my eldest so it's hard to know what parts I should be highlighting if that makes sense. It's hard to talk to people who's children don't have the same difficulties, and I feel like people now look at me like I'm a bad parent because I'm trying to stop meltdowns and talking to him like he is a 1 year old. Oh well, on we go, he's a wonderful boy I just wish I could help him with his frustration with his communication.

If he is really struggling I would suggest using some other forms of comm. with him to support his speech. I've seen children in clinics who have started watching Mr Tumble on Something Special and have picked up the Makaton signs and are now signing along with speech - really supports comm, reduces frustration in the child and allows the speech/lang aspect to blossom without frustration/high processing to get in the way! I'd definitely suggest alternative systems to support him through his struggle whilst awaiting nhs support from paed/slt.

You need to start a paper trail.
So whatever you get told follow up in writing or keep a diary e.g. we discussed whether DS had ASD / dyspraxia but you felt that DS did not have z, y, z etc. That way they won't keep dismissing poss diagnoses without really thinking about what they are saying and what is being recorded.

You could ask for a second SALT opinion on the basis not got to the bottom of the problem yet.

Regression should always prompt a paed referral imo. My DS lost speech at 2.3 and was dx with autism - his regression was very severe - from phrases to just 2 functional words. Regression can be associated with other conditions e.g. epilepsy etc so certain things should be ruled out. I have not really heard of speech loss where there was no related condition / illness etc.

Doctors can be very dismissive. Even though we were telling the paed DS had lost a lot of language the Dr was saying 'well perhaps you are just comparing him to other children who are moving ahead faster and you think your DS has gone backwards when really he has just plateaued' (even though he was our third). It was only when the nursery backed us up then lo and behold we were believed.

You can look at ICAN or AFASIC for ideas / courses etc. By the sound of it you are probably going to be your child's best speech therapist. Most NHS SALT just looks to the parent or nursery to do the therapy and them to provide 'advice and support'.

You can also look at having your child statemented (see IPSEA) as a Statement of SEN could specify a set amount of SALT or even lead to a place at a speech unit etc. Basically you don't think your child's needs are being met. SALT for speech delay is really an education issue and the responsibility for meeting your child's education needs lies with the Council's SEN dept. You need to put your child on their radar. Personally I would apply for a Statement. Your child has waited long enough for a proper SALT programme / assessment to be put in place. Your application will almost certainly be refused - but you appeal and to defend the appeal the council has to collect evidence about the problems and support that is being provided and satisfy a tribunal that all of your child's SEN are being met.

Look at SEN Code of Practice and SEN toolkit.

hi there, I had a son with severe problem understanding language at 3.

for me, the key thing was to concentrate on the problems understanding language.

using visuals made a huge difference

I took a long time - too long really - to accept that he had sensory issues such as genuinely oversensitive hearing and undersensitive vision. (see " Sensory Integration and the Child" or Hanen's other book "More than Words" to investigate this. )

try Linda Hodson's "Visual Strategies for improving Communication" to really understand what visuals can do for a child.

And I strongly recommend the DVD "Teach me to Listen" from the teach me to talk site at www.teachmetotalk.com. It is appalling how few materials there are on teaching language comprehension even though teaching speech without comprehension is pointless.

I have to confess that the main benefit to DS2 of all the work I did teaching him to say words was that we were communicating and so it subtly improved his overall communication skills. But we could have progressed quicker if I'd had structured guidance about what the milestones for understanding language are and what roadblocks the child may be facing.

some receptive language milestones for you.

[[Question-asking skills - receptive language.

In order of development (but I don't "do" milestones so I'm not putting any ages in here)

1. "where's mummy/teddy/something exciting?" by looking at the object or otherwise reacting in a way to show understanding.

1. Choice questions

start with holding one of each in your hands or using a visual.

1. "where's the X?" on a picture - respond by pointing.

1. Go get/show me the X.

(v) ideally, from another room (iv)if that's too hard, try from across the room (iii)if that's too hard, from a selection on the floor (ii) if that's too hard, from two objects in the adult's hands (i) if that's too hard, adult takes child's hand and selects hand over hand.

1. "What's that?" - respond with appropriate noun

1. "Yes/No".

NOW TO THE TRICKIER ONES - I WILL NOT SAY WHAT AGE LEVEL THEY EXPECT BECAUSE THAT'S NOT HELPFUL BUT THESE NEXT ONES SHOULD ONLY BE ATTEMPTED WHEN YOU CAN DO THE ONES ABOVE.

1. Respond to "where's mummy?" with an answer like "at work" or "in the sitting room"

1. Object function questions

"Who says moo? does a sheep say moo? NO! A Sheep!" "Can you point to something that we wear?" "what do we need to make dinner? yes - the pot". (more details on this in my other thread of today)

1. Critical thinking questions - making inferences.

"What do we wear when it's cold?"

10. Categories
    "Which one is an animal? Which one is a building?"

11. Negation - "which one is not wearing a hat?"

12. Quantity
    "Can you give me the rest of them?" "Can you put some in the box?"

Hope that helps.

www.mumsnet.com/Talk/special_needs/750157-Radio-programmes-on-receptive-language-delay-www-teachmetotalk-com

www.mumsnet.com/Talk/special_needs/973999-DS-39-2-year-check-with-HV-big-elephant-in

www.mumsnet.com/Talk/special_needs/752062-another-receptive-language-programme-on-the-radio-with-the-annoying-bits-taken-out

www.mumsnet.com/Talk/special_needs/895654-the-famous-Moondog-quot-calendar-quot-post-re-teaching-time

I hope these old threads on receptive language are useful, and that you go stick your calendar on the wall this very week, good luck.

Thank you all for your replies. I made a doctor's appointment but then we all caught chest infections so couldn't go. So I booked another and then we all got
gastroenteritis and we're still recovering! Somone doesn't want me to go to that appointment! My mum is visiting in a few weeks so I'll make another one then and even if I'm coughing up a lung I'll get to it. Bizarrely though the chest infection helped because my baby daughter slept loads and I had time to hammer my son with his speech "lessons" alone (taken from It Takes Two) and he has come on quite a bit since then.

sltstudent - we started using signs when we saw the private speech therapist and it really helped him, like it helped bridge a gap and he would also say the word with the sign. He's just started really getting in Something Special (wasn't really fussed before) so I think that's definately a great idea and I'll put it on series link.

Agnes - I started a paper trail already because I was forgetting what had happened when I needed the information. I'll mention what you say about regression to the doctor and I'll start to research what I need to do to apply for a statement. I didn't know you could apply whilst they were this young and you've given me some great starting points to be looking at.

lingle - thanks for all the info and links! I'm trying to track down a calendar as we speak! (the one recommended was sold out). On your list of milestones 4 months ago he couldn't do 3 but now he can do 6 (well mainly no, but he can yes at things like "chocolate"), so that shows progress, I'll start work on 7 next. I'm going to listen to those radio shows you linked to and look at the DVD, websites etc. Do you mind me asking how things went with your son and how he is doing now?

Thanks again everyone for your help and advice, it all helps so much in deciding what to do to move forward.

Hi all... Even I have experienced the same with my sis daughter who is 4 years old suffering with speech disorder. We tried alot to overcome that but failed many.. With one of our friends suggestion we tried the speech-language development program and worked out well for her.. They used the best speech therapy for her such as naturalistic play contexts, spelling skills etc..

Thank God that she is now out of it.. I hope this might be helpful to you too..