DS (5) has a phonological disorder so he pronounces some sounds incorrectly though his vocab and grammar are good.
He had severe bilateral glue ear which distorted the sounds he could hear and meant he couldn't hear some at all - s, f, ch, c etc. He didn't seem deaf as he could hear other tones and so responded to his name and could understand you.
His speech didn't develop when it started, ie bus stayed bu even though it was a favourite thing to see out and about.
I got his ears checked, glue ear diagnosed, waited for the confirmation then had to wait for the grommet operation. So it took a year between raising his speech to having grommets in so he could hear again. He was nearly 3 when he had the op. It took 20 minutes and the grommets are still in over 2 years later with no side effects.
With his distorted hearing it was painful to be in loud acoustic halls and the grommets stopped that. He has never had an ear infection or any sign of trouble with hearing at all.
The speech therapy was able to start once he could hear and he was referred to a speech and language unit for starting reception which he went to last September. He has done 3 terms and has one more to go and has made a lot of progress.
He attends his MS school one day a week to keep contact.
It took a lot of pushing to get him looked at, they nearly didn't do grommets though his speech was already badly affected by the hearing loss, but I felt he wouldn't improve speech without clear sound.
The SLU was a fantastic placement for him and I was very stressed about the lack of alternative if he didn't get a place from the panel, he couldn't access phonics or group work in Reception as he couldn't make an s sound at all so any sounds and blending approach would be useless without tailoring.
He talks non stop and has great storytelling ideas.