SALT say no - WWYD?

[Sleepstarved]

DD 16.5 months was referred last month for SALT but letter has come back saying, due to her age and the problems outlined in the referral (probably non-specific, lack of pointing, had some words but lost them), they won't be seeing her. Come back if problems persist.
I guess they are snowed under.
DH thinks this is good sign as he believes she is too young anyway.
DD has a hearing test booked for next month.
Would you go for SALT privately? Are private SALTs any good?

to be honest, I would be concerned about lack of pointing and loss of words in a 16 months old child.

If you can afford, I would probably make an appointment with a private Salt. We saw a private Salt before having Salt on the NHS and she was very thorough.

www.helpwithtalking.com/ is the best place to find a private Salt.

She was referred by developmental paed at request of portage, though paed said at the time their input would be minimal because of her age and their workload.
At a year she had Daddy, Ca for cat, sometimes Badbo (approx of cat's name) and had copied woof, spoon, shoes but not used independently.
They all went by about 14 months.
Dada and daddy may be making a comeback, she has said approx of elephant recently but not consistently and has just started making elephant noise but apparently a lion says the same thing.
She looks at things when asked where they are but does not point at them.
She has some gross motor delay.

Hello, I remember you said she made some progress physically recently, do you think that caused a kind of pause in her language (focusing more on the physical stuff?)

It is good that she has some new words, does she gesture towards things at all, or is there no pointing at all? Also how is her understanding?

Hello Hazy - waves.
Yes, she has recently started pulling up to standing a lot but the pause in her speech came way before that.
The GP said they do that sometimes and was not at all concerned.
I think it may be glue ear - I've always had eustachian tube problems. Hearing seems really good though, she loves music, hears tiny noises so I really don't know.
I think her understanding is good but sometimes it is a bit like she is ignoring me.
She doesn't really pick stuff up and hold it up to 'show' me nor point at something as if to say 'look mummy'.
But she will shake her head and do a kind of wave for 'finished', make a shrieky excited noise for 'again' when being chased ect.
Can point out some body parts sometimes.
She has always been incredibly passive though, I've heard her tummy rumble and she's not been demanding food. It has been quite hard to get her to laugh but that is coming on now.
She tries to put her socks on, washes her toes in the bath when asked, brushes her own teeth, can sort some simple shapes.

Well it could be nothing or it could be something. You would probably feel best if a professional monitors her? Or you could go back in 6 months and ask for reevaluation (sort of monitor yourself and make sure nothing is missed).
You will get here mostly the parents where lack of pointing etc indicated extra needs and not hear back from those where it didn't mean anything. That's good to keep in mind. DD never pointed and it was a sign for something severe. I would follow my instincts - if you think it's glue ear, that's the first thing to rule out. All the best.

I would recommend the book "Baby Talk" by Sally Ward - it's gives a lot of advice about activities to do with your child to help with their communication. It is aimed to be used with children from birth until about 4 years. It also give guidelines about development and how your childs communication skills should be progressing. You may be able to get it from your local library.

In our area they usually do not see children under 2 years old unless their is a very obvious difficulty, however, we did manage to get a referral as DD turned two and were told everything was fine. Fast forward 18 months and DD was diagnosed on the autism spectrum. So we wasted time thinking things were fine although my gut was telling me "things don't seem as they should be".

I'm not suggesting your DD will have the same outcome as my DD by any means but like I said take a look at the "Baby Talk" book I think it is fab!

The pointing at body parts is good, maybe get some photos and sit with her pointing out eyes, nose etc. Ds only recently started pointing and we did a lot of the things that zzzzz suggests (although ds has a few sensory issues with sticking his fingers in things!) The best thing was doing hand over hand and holding his finger in a point on our portage ladies ipad, he really seemed to 'get' pointing after that. Looking at ds's developmental assessment, it seems to suggest that pointing should come around 15 - 18 months, which would seem ok wrt your dd - especially if she will point to some body parts. The helping with clothes is good too.

It sounds as though getting her checked for glue ear is going to be really important, but if you have to wait for SALT, maybe start on some of the things they may suggest to you at this early stage anyway - eg signing, simple word and picture books, give her simple choices between 2 things, lots of singing etc.

Thank you all.
zzz they are really good ideas, thank you. I do try to do over the top praise but I know my DH who is a SAHD finds that harder.

I have made contact with a couple of private SALTs on that website, thanks choc. I will talk to them about whether we do anything before the hearing test, which is next month anyway.

Hazy, the body parts thing is more of a pat than a point. I am not sure how significant the index finger point is rather than signalling what was asked?
Does anyone why there is particular concern about losing words? A few people have said that but I don't know why.
I have an ipad but she gets a bit frustrated with it.

Eveie, I will take a look at that book, thanks.

I am really worried that with the gross motor delay and now this, are talking about GDD.
BUt surely at this age it could go either way?

zzz DD is so overtly sociable, not behind on that at all according to portage. Paeds have said she has amazing eye contact, has had from very very tiny and in fact has always preferred people to toys, is very affectionate ect so they are not considering autism.
Honestly, my gut tells me different things. Sometimes I think she is a bit behind, for whatever reason, and will catch up, I can explain away each thing.
Other times I completely despair and think we are on the route to SN, senco, statement, this whole world I know nothing about and want nothing to do with.
Mostly I just want it to go away.

If she's seeing a paed that's more important (IMO) than an NHS SALT who will be useless anyway (they will give you a piece of paper you could have printed off the internet which will tell you to blow bubbles). If you can afford a private SALT and you choose carefully you might get somewhere.

Ds1 has great eye contact and is very sociable - I was fobbed off - but I was actually right. If YOU have concerns keep pushing for help where needed and don't be afraid that you might be overstating problems. The 'great eye contact, very affectionate, definitely not autistic' stuff they came out with froze me for about 8 months - I thought I would have been accused of MSBP if I pushed - although I knew something wasn't right. We wasted a lot of time - and emotionally it was hard on us as a family. Never be afraid to follow your instincts.

Have you seen the videos on the first signs website? Let's you compare typical/atypical behaviours. It would have been useful for us.

I agree about the SALT - ds has severe speech delay, and has only just started getting some more useful input from the SALT, most of the stuff we have been doing up until now has been the stuff suggested on here, which you would be able to instigate yourself.

What does the paed say about any delays/concerns? Do you have a regular appointment. I guess there must be a delay in more than one area in order to be accessing portage.

I can't remember whether she has had any medical tests?

hazy I am going to talk to private SALT after hearing test next month.
Developmental paed said keep doing what doing and see her in six months, said she is delayed but is very non-commital (we had an inaccurate diagnosis already from her dept so maybe be reluctant to go down that route).
GOSH have now ordered MRI and bloods.
She qualifies for portage because of delay in speech and gross motor.
She also has physio.
saintly I've had a quick look at the firstsigns videos and really the only thing is the lack of pointing and showing. Portage has said she has good joint attention, copies gestures ect.

Copying and joint attention sounds positive :)

Oh and if I remember rightly, ds's SALT said that gesturing and patting counted as pointing in the early days.

You sound so frustrated and down about it, but really your dd sounds as though she is progressing really well.

saintly the developmental paed said the pointing may be because she is delayed. She was late using her hands for anything because she held them up in a high guard for balance, due to weak core.
She was also late clapping and waving but does this now.
I have wondered about ASD because of her general lack of communicating her needs/wants but she is incredibly passive.
If something was out of reach and because of her gross motor delay was hard to get to, she wouldn't bother

DD was late pointing due to her motor skills (mild CP). We started with an arm at about 15 months and then hand/fingers by about 18 months. She couldn't isolate a pointing finger until 2 ish. She was communicating her needs in other ways though.

Portage sound very positive about her which is great although might be why SALT aren't being more helpful? The clapping and waving are good progress too [smie]

Thought has just struck me on the pointing thing.
She will isolate her index finger and use it for poking things, like squishing blueberries on her table and poking the particularly hard shapes into the sorter (can do ordinary circles and squares herself but not the animal shaped ones, so I hold it in the right position and she pokes it through).
So that means physically she can point but she is not using it for communication.
I dunno, am clutching (or pointing) at straws now

I was drawn into the thread because of speech theme (2 DC have had delayed speech, but qualify as NT otherwise). I gather your DD has complex SN distinguished by delayed gross motor skills (I wasn't sure how delayed?). I just wanted to contribute that all my DC (including those who never had SLT) have gained & lost words at around this age, it's like they get it a little but forget again before relearning. Mine were delayed wrt specific sound production, not otherwise language disordered. So gain & loss is normal to me & not something I'd worry about.

Pointing: if she's pointing at body parts she IS pointing, no?

Early SLT is all about listening skills, which you can easily do at home with slow narration of her own activities.