Receptive language delay

[Loppyloo5]

Hi all I am seeking some advise/support.

My DS is 2.8 and has and speech and language delay. We are not sure of the cause yet (he has had hearing loss from birth due to glue ear but has grommets in the last 8 weeks but this could be a red herring) we are seeing a development pead and being reviewed every 6 months.

My main concern is his receptive language as I know you must understand first in order to talk. He follows instructions in nursery rhymes (I add new ones in or mix them around to make sure his not doing it from memory) but he doesn’t understand things like where is mummy or get me the ball. Any ideas on how I can help him whilst we wait for a speech therapist. At the moment I am commenting on all the stuff he is doing using one word labels.

Has anyone had experience with speech and language delay can offer me some encouragement as not knowing what the future holds for my son is really upsetting.

Hi All,
My son is just turned 4 (formal premmie) with language delays too, he doesn't have many words at all but does understand 1 -2 step instructions like, go find the remote and give it to mummy, 'go get your pants from the chair and give it to mum', if you close the door you can watch cartoons. etc. he understands bribery etc, knows lots of shapes and colours and numbers and phonics and recognises lots of pictures in all types of flashcards/books and points them out. He loves jigsaws and can do 4 piece ones, and loves peg board puzzles and can do 10 piece ones on his own with only me showing him how to do it once or twice. So he loves learning.

Receptive language is not great in the sense he doesn't know what xmas is and general awareness, it goes far as if he wants to go outside to play or out with me he will just point at his coat and then hand me the keys to open the door and points to go out.

But has bout 30 words max. He's definitely got more interest last few weeks in speech but its still limited and mostly gobbly goop. So he's vocal but is very hesitant to say most words I ask him to. But he does sound out most of the alphabet..
He has ehcp, and speech and language therapy. Wondered if anyone went through something similar and if their child caught up? Any insight would be appreciated

I should add he loves songs and nursery rhymes, he does the actions to most of them but wont try and sing? :/ so frustrating.

I’ve been screaming from the rooftops that my now 3.10 year old has severe S & L delay. He never babbled, would just make a funny noise. Literally only one word at 24 months ‘more’ I was just met by brick walls who all kept saying ‘give it time’
Now he’s in nursery, I’ve been very keen to gain their thoughts. Surprisingly they haven’t approached me first. However, when I asked to set up a meeting with the reacher, the teacher suggested we apply for additional funding for him and set up another meeting with SENCO lady. To be fair, she was very knowledgeable and provided a detailed report on my son. She has suggested ASD and has said if I self refer my son via GP for the ASE referral now, the list is shorter than once he’s 5. Plus he will have everything in place he needs for when he’s starting primary school.
If you’re thinking autism. Just call your Gp and get on the waiting list for a referral. Also you can do an online test called MCHAT. Just type that into google. Then fill it in and email it to yourself and show Gp. It’s free.
With regards to SALT. It differed significantly between areas and with different therapists. Ours was awful. It was patronising, and useless. I kept asking them to speak and work with sons nursery but they didn’t seem interested or skilled.
Now our nursery is in board and they are superb when it comes to SEN. Just be prepared to chip away.

@Ellie56 your message made me cry. So happy to read about your son overcoming so many challenges! Your story gives me hope.

@Ozziewozzie how is your son doing now? could he go to mainstream school after the support he has received in nursery?

Ellie56, can I ask how did you get the intensive speech therapy and from who and what did it comprise of (how frequently and how long?). My child has a receptive speech delay and I am really struggling to get any assistance whatsoever. I suspect intensive therapy is the way forward, but I do not know how to source it. Grateful for your view.

Why does he have that? The problem is that if your child has processing issues no amount of speech therapy will help, you are just throwing money. Itnos therefore important to ascertain why? What is the issue?

@viio Receptive language delay can be a diagnosis on its own and no one can tell you why that is. Same for receptive language disorder. No such thing as throwing money away. As parents we need to help our children learn how to make their needs understood despite these challenges. I find your comment is quite insensitive. No SLT or teacher will give you such advice.

Hi sorry if you took the comment as insensitive it was probably the way I expressed it due to being in a hurry.

My child has had extensive slt for a few years, never made any improvement. We were desparare, teachers and others said its just the way it is. However, fast forward few years my child has made a huge progress after we have figured out that all his issues were actually processing issues. We had a Dr (audiologist and slt double qualified) assess my child and then had theraphy. The results speak for themselves as the improvement is incredible.

So what I was trying to say is that if your child has processing issue (which I think expressive language dely is) you need an audiologist assessment to determine what sort of therapy they may need. Should you need the name of audiologist and you think that may help pm me.

@viio Thank you for sharing your experience. We've had severe receptive language delay diagnosed last year. I do not think he would get the same diagnosis now as he can understand most basic things said to him, although he is still behind his peers. My son has very good vocabulary now, although he is not fully conversational yet. He had no words age 2. At 3 and a half he has really good vocabulary (drawbridge, propeller, rocket booster, sparkly, magical, etc etc.). Things can change over time, but as you say, sometimes there is more investigation required to understand the root problem. As parents we really need to push things as specialists don't always know better. I hope your child is thriving now! This is after all what we all want for our children!

Thank-you. Yes my child is now incredibly. We must have spent 1000s on slt and various things and he would never get much better if we didn't find the cause of his issues. Made me really crossed that slt’s don't advaise parents to seek further answers if a child does not improve, and not just taking money week after week. There is no accountability at all.

But ultimately yes we as parents know best and must seek answers to help them. Children often do well when they can and are ready... And we all develop differently. Good luck

@viio I so happy for you and your child! I hope you continue to share your experience with others!

Does anyone have an update please?

The 'More Than Words' book is excellent. Pricey but there's nearly always 2nd hand copies on EBay.

I would also consider using PECS cards or visual images to help underpin what you are trying to communicate. This was a game-changer when trying to help our son.

@atay27 My son will be four next month. Age 2 he could not understand or say anything. His understanding has been improving slowly over the past couple of years and will now follow one step instructions. He can also say what he wants and where he wants to go and actually has a very good vocabulary although not yet fully conversational. His understand and speech are significantly behind his peers but he has been makong progress. It is not all bad though. He is quite clever and his memory is really good, he can memorise whole books. He is most likely neurodivergent but this does not scare me like it used to. It was really the fear of the unknown.

Thank you so much for your reply. That’s great news!

That’s not strictly true. DD1 had a massive auditory processing problem, leading to a severe receptive and profound expressive disorder. She was in specialist speech and language provision from age 4 - 16. Speech therapy did wonders for her language. I don’t think three specialist speech and language schools would have assessed her and offered her a place, if they thought they couldn’t help her; and the LA certainly wouldn’t have paid for them, unless their own professionals thought so too.

@BlueandWhitePorcelain what were the signs for the processing disorder?

I knew from the day she was born, there was something wrong, although it was probably the dyspraxia, that made it harder for her to catch on to breast feeding, than my other two. She was diagnosed with a significant language disorder at 2y 10m. She got no speech therapy on the NHS, until she got her statement. We paid for it weekly until age 5.

Receptive language:

1. even as a baby she didn’t understand me, as a baby does
2. she still didn’t understand us, at the level her twin sister did, as a toddler - I didn’t know this then, but she was only at a one key word level. Within 6 months of private speech therapy, she was at a 4 key word level
3. No eye contact - apparently she hadn’t realised it’s importance
4. she didn’t pay attention long enough to learn the language - she thought we all spoke jargon
5. she only learnt nouns by herself - I had to spend a lot of time, demonstrating verbs
6. I had to teach her concepts like colours, big, little, in, on, under, etc with teddies tea parties and lego
7. a speech therapist spent a whole term, teaching her the meaning of “because” and then “while”. They did it, because they are such high frequency words
8. impaired concept formation - she can only understand simple, concrete language. Not abstract language unless words were taught specifically.
9. Takes language literally such as common sayings, like it’s raining cats and dogs.
10. Doesn’t understand sarcasm, puns, etc
11. higher level language disorder - doesn’t recognise a speaker may have a hidden agenda, as in stranger danger.
12. The syntactical expressive disorder - as she never processed the sounds for instance like -ed, -s, -ing, etc, she never worked out their importance in grammar, which meant grammar in her expressive language was poor

The head of therapy at her specialist speech and language school said there was a problem in her auditory processing within her psycho-linguistic system, so the representations of words in her lexicon were vague, causing her expressive disorder and dyslexia. If she’s not too sure what “cat” sounds like, she’ll struggle to read and spell it.

A receptive disorder has more serious implications than just an expressive disorder because of the impaired concept formation, that goes with it.

@BlueandWhitePorcelain How was ASD ruled out? Everyone seems to be jumping on this bandwagon these days. Was it the SLT who ruled it out? How was she with other children and adults when her understanding was lagging?

DD1 hadn’t realised the importance of eye contact. The speech therapist told me how to teach her - by making eye contact with her myself and if necessary moving her chin, so she was making eye contact with me, as I was talking. We always had to use her name, so she’d realise we were talking to her.

The speech therapist told me, any signs of ASD were due to linguistic deficits, not the socio-cognitive deficits of autism and as her language improved, those signs of autism disappeared. She never had the other two strands of the triad. She had great imagination in play and story telling. Her problems with reading were with bottom up processing of the sounds, not top down with understanding the story.

She was under the consultant developmental paediatrician at first at the CDC. They never mentioned ASD. Once, she had a speech therapist and OT, they were all we saw.

Once her language improved, she was the most outgoing of my three DC. Her social skills were great - she was the most popular in the language unit, and later in a speech and language school. Every child wanted to sit next to her at school. She was a favourite with the staff too. Her speech therapist thanked us, for the opportunity to work with her, because she always did her best. She was like the sunshine in the room.

Eventually, a MRI scan showed a congenital brain abnormality in the right frontal lobe, which caused the language disorder, etc. The former head of therapy told me, she’d always known there was a brain abnormality, because DD1 was so sociable as children with language disorders go!

Parents always seem to assume speech and language disorders go hand in hand with autism. They can, and many of DD1’s friends at school had autism too. However, it’s like a Venn diagram with two overlapping bubbles - one bubble for speech and language children, the other for autism. Some children lie in the overlap. There are some children with social communication difficulties, but not achieving a full diagnosis of autism.

Statistically, children with speech and language difficulties are about 10 in a 100 children, although some may be mild or moderate (not all are severe, on the 1st percentile of every subtest of CELF, like DD1 and the children, she was with at school) whereas autism is what 1 in 60 these days? It is wrong of people to assume speech/language disorder = autism.

@BlueandWhitePorcelain Thank you so much for sharing all this. I really appreciate the insights you’ve provided.
Our Speech and Language Therapist noted in her report that Max has a significant receptive and expressive language delay, which impacts his social skills. He’s also a sensory seeker, although this isn’t always immediately obvious. When he’s particularly excited, he might jump up and down or occasionally mouth objects, but it’s not something that affects his learning. He doesn’t display any repetitive behaviours.
I’ve read that around 90% of autistic individuals experience sensory processing differences or disorders, while only about 16% of those with sensory processing differences or disorders are autistic. There’s definitely an overlap, much like a Venn diagram.
At home, Max is very sweet, cuddly, and chatty. However, he tends to completely ignore people he doesn’t know. When he first started kindergarten, he acted as if the staff were invisible for weeks, but now he shows them affection and actively seeks contact.
I find myself feeling quite confused about it all. Some days I’m convinced he’s on the spectrum, and other days I’m not so sure. It’s a lot to process, and I’m still trying to make sense of it. I've read that children with Sensory Processing Differences/Disorder (SPD) often develop in atypical ways. For instance, my son is behind with his language skills, but he has an excellent memory and can memorize entire books.

100% agree with you: It is wrong of people to assume speech/language disorder = autism. There are unfortunately so many people who do.

It seems your child has other issues and not just adp, and it is great to hear that SLT helped her. They did not help my son who only had apd (so no dyslexia or dyspraxia or asd). My child was tested by the doctors at gosh, Portland hospital and then referred to double qualified audiologist and SLT specialist who really understands both speech and auditory issues. So the doctors confirmed to us why despite of years of SLT he could never get better. In our case apd meant he needed specific therapy.

This is what our doctors have confirmed who are highly qualified in this area but if they are wrong …. I guess they are wrong. I know from our experience that SLT did not help at all. Apd therapy did…

How much SLT did DC get?

DD1 got it, on average three times a week in school from age 4 - 16 in term time.