Developmental language disorder/ specific language impairment. Would like to hear experiences and advise.

[Lucecita]

Hi There,

I have a 2yr old DD. We took her to SALT services and they have told us that it looks like she has a developmental language disorder and not just a delay, like everyone was telling me. I have been worried sick since April but everyone told me I was being crazy. I wish I was...However my partner is a bit In denial and downplaying everything, thinking that with a bit of therapy she will catch up. The issue is that no one knows because she is really young, but most children with these profiles need years of therapy and support. On the bright side, we have spotted it at a critical age and early intervention is key for more optimal outcomes, so I’m really glad I did not take the “wait and see” approach.

We are starting therapy next week privately because the NHS in Camden has a waiting list of 4 months. The therapy in tailored for her but is based on PRT, which is usually used with children with ASD or significant communication/language delays. She is socially motivated and very engaged with everyone, but needs help to start using language to communicate. We will then combine it with the SALT sessions that we’ll get via NHS.

I would be really grateful if you could share your experiences with me and if there is any hope for me to think she’ll manage to overcome her challenges and be mainstreamed without support or little support by the time she reaches primary school.

Thanks!

Hi zzzzz, sorry I didn’t understand the last sentences. re: early intervention, You think it’s not effective to boost language development? I just wanted to know other people’s experiences, outcomes, what therapies you’ve followed, etc...
Thanks

I was told ds1 had a ‘delay’ for years even though I was convinced it was a disorder! We could not afford private but got some NHS. Speech and language are such complex areas that it is hard to generalise. We initially worked on getting him to put words together. His understanding of language was good and he had a good variety of words (although very limited speech sounds and many made up words) so it was focused on playing with him without initiating speech and waiting for him to initiate. When he did we just repeated what he said and maybe added another word. With this approach he was putting 8 words together at the end of pre school. Once at school we started working on speech sounds (although I think research shows that 6 is the optimal age for this). We had to teach individual sounds, then combining sounds, then making sounds into words then using the words in structured sentences and eventually using the words spontaneously. With this approach his speech was able to be understood by the general public by about 7 years. When he was tested again at about 8 his vocabulary was well above average, his grammar was below average, his understanding was well above average and his ability to recall sentences was well below average. It was recognised that he struggled with the social aspects of communication and was diagnosed with atypical autism. Now at 12 he still struggles with combining particular letter sounds and his grammar is still below average but not enough to hold him back.

zzzzz and lorisparkle Thanks for your advise. We have decided to do PRT precisely because we feel that plain SALT is not enough. PRT is focused on developing language to strengthen social communication. We don't know yet if it's going to work, but we feel it it is the right way to go for now. It is also way more affordable than most private SALT therapy that we have looked into. The therapy is play based, we already had a two hours assessment and the consultant told us that she thinks it can help her a lot and be very beneficial as she is very engaging and motivated, and responded well to prompts during the assessment. We also have the report with objectives and targets and they are revised monthly to understand how she is progressing.

Re: Montessori, I agree totally with you. I think it is the best environment in general for any kid. However, we did not find any Montessori nursery near us. She is full time in a local nursery and she is doing great there, very popular amongst staff and children, very happy to go there very day, plays well with the other children and is progressing in her skills. She is now going to be transferred from the baby room to the preschool room which I think is way better for her, she prefers being there than with the babies. And we have also thought of swimming and music, she loves singing and playing instruments and both are greta for developing skills that are fundamental for any children.

I juts feel that every child is different no matter the general "labels" they get, and it's about getting the right support for their specific needs.

Thanks

It’s used to boost communication and functional language in kids with ASD and other development delays/disorders. The leading consultant works with both children with ASD and children with communication difficulties. It’s Blue Sky London. It is one of the few therapies we can afford as it is a charity and prices are very reasonable for being London. We want to combine this therapy with SALT because I have been reading some threads on mumsnet that for these type of disorders ABA approaches can be more beneficial than traditional SALT. What I liked about the therapy is that it is very centered on the individual child. Let’s see how it goes, we are starting next week and the goals for the first month are quite ambitious, but I do feel positive. I myself started prompting DD for her to ask things for me and she took on easily. So now she asks me for raisins, or cookies or water. Slowly but steady...I’ll keep you posted

zzzzz she only has about 20 words and is not yet talking in sentences. She looks at me smiles, and says raisins, or cookies or whatever...She has conversations with us in her own language. I am concerned because I feel she starts to realise she cannot communicate and she will get more and more frustrated, not that she is having any behavioural problems TBH.
We have never been referred to a paediatrician, but I did discuss PRT with our SALT, who told me she was anti ABA, and after looking into it she told us to go ahead, and that they would liaise with them for their SALT sessions. The SALT basically told us that, with her being so young, and how she presented, it was ver difficult to predict anything until she had tried therapy with DD and seen her response.
When she asked us about family history, we realised I have 2 nephews (twins) who did not say a word until 3 and could not be properly understood until they were past 4. Another family member had the same issue. But in these two cases they were premees. More surprisingly my partner had an uncle who stammered and his daughter did not open her mouth until she was 5....and then struggled with language for a while.

Well one of the things of concern is that though she knows who mummy and daddy are, she can sometimes call daddy if prompted, but has barely called me mummy. The entry point for being referred to community services in my area, for these issues is SALT, not GP. The SALT did not see at this point any string reason for her to be referred to paediatrician or CAMHS....yet. She doesn't point either but follows a point. She said she was not so concerned about the lack of pointing because when she tried to reach something with her hand she looks at us for help...I am concerned about that lack of pointing as it is the precursor of language....yet some people say some kids never pointed and they never had any concerns, or that they were late with gestures...

DD had delayed speech (following delayed crawling, delayed walking)
Audiology tested - all normal
Vision has been tested (numerous times now- all normal)
SALT referral from HV
SALT delivered one to one & within nursery
Never any problems with behaviour or social interactions
Nursery staff and myself were convinced that SALT interventions were not helping, but we went along with everything
Throughout primary constant issues with SENCOs trying to push us down the SEN route, community paed assessment found very little to report. Ed Psych report got her support in classroom. We have coped with the support of teachers who have been happy to let DD develop alongside peers, and at secondary school she has kept up with peers and moved up sets.
That's my experience, my advice would be to stay positive, it just takes some children longer, but the guilt for parents around that is awful.

it was the same for us with the Mummy & Daddy thing
my DD is fab now
I doubt a 2 yo needs CAHMS unless behaviour an issue?

Well SALT said that if it’s not too intensive and evidence based, I should go for it if I think it’s the correct thing. I guess she trusted me being well informed about the therapy as she literally said after our appointment that she had never seen anyone as well prepared and well researched for an assessment before! which probably means crazy mum can’t stop using google...She didn’t say she was not going to refer us, but that at this stage, with what she saw, she felt it was better to give her therapy and give her the chance to see how she does.
dlnex, indeed there are no behavioral concerns. DD is my first one so I’m no expert but I do feel what she has same tantrums as an average 2yr old. Only has big ones when she’s sick and does not feel great and never last more than 5-10 mins. She is a happy child over all, with her personality! DD has meet all her milestones except language. In her case it’s not speech, she can say words and produce all sounds, but no language production....

zzzz , sorry to gate crash the thread. My son is 3 with very limited speech. The speech therapy has done nothing. Both the GP and health visitor seem disinterested as he doesn’t show typical autism signs. Can you tell me how you managed to get your child assessed and diagnosed?

Hi headstone, just to be clear it’s not a diagnose. NHS salt told me that that’s what it’s looking like for her but it’s too soon to say for sure at this age with her profile. I self referred myself after another mumsnet user told me. Look at SALT services in your LA, call and tell them your concerns, they will book you an appointment. Many LA also have SALT drop in in Children’s center. Push for it and ignore your HV and your GP!

zzzzz I know what you mean, and I have thought about this. I know that in my LA it’s not that long though. Also I do feel that the moment the SALT sees how she responds to therapy, if she sees any concern she is going to refer her.

I have read a lot about ABA and have my reservations too, but PRT has a different approach. During the assessment my child was happy and responded really well. I feel I have to try to give her the chance to see if she is capable of developing her language. If I don’t see any progress at all in three months I’ll discuss things with the both therapist and NHS SALT. My main objective is that she reaches school as well prepared as possible and that she has any support she needs when the time comes. I might be too optimistic but I am not naive about the reality of SEN in this country, and most TBH.

Hi there.

In a total nutshell...

My boy only had about 5 words at 24 months, but our local drop in service suggested coming back in 4/5 months time.
We did so, and at that point he did have about 30 words, but a huge amount of those were completely made up (ie 'gee' was 'biscuit',) and he couldn't say mummy. (I was 'mayee' because everything was so heavily vowel based.)
At about 33 months, the specialist SALT (from the early years language unit) said that my son had a specific language impairment.
My son received a block of play based therapy, as (behaviour/concentration wise) he wasn't ready for SALT.
From 36-40 months, my son then received quite regular SALT, and from 40-48 months; sporadic SALT.
I noticed a huge leap in his speech and language at about 40 months. It was at this point he started putting 3 words together and the quality of his pronunciation improved.

He is now nearly 6. His speech and language is 'immature', and I find the odd thing tricky to understand (if i don't know the context,) but in general my son has come on amazingly!!!
I thought at one point he would never say mummy; now its every few minutes!

*My son does have a diagnosis of Autism, but that is because there were/are other behavioural/developmental differences running alongside those speech and language challenges.

Pandyandy1 Thanks for replying! Glad to hear your DS is doing great. My DD is very slowly starting to use words to request things. Yesterday there was a “mummy cheese” and she said poo, and there was one! It’s slow and inconsistent, but the important thing is that we see some progress. For us it’s a combination of guilt and not being patient enough...my partner is still a bit in denial but clearly sees DD needs help.

I can’t wait for her you call me mummy every few minutes. Yesterday we started playing a game where she and dad call me and I appear. Hopefully she will eventually do that spontaneously when she needs something.