Moderate/severe speech delay...sharing strategies/ideas and success stories

[lulurose]

In a nutshell DD2 has medical needs but was diagnosed last August 2007 (at 2yrs 4months) with moderate/severe speech delay. She is now 3.

On a day to day basis she gets very frustrated, using Makaton is helping. Her understanding is very good, the problem lies with expressive speech, she has about 30-40 single words, not all intelligable to those who don't know her.

At present we are on the NHS SALT waiting list but she has had a block of 6 sessions privately with a brilliant SALT who has given me lots of ideas...

Anyone else out there going through this? I'm so worried as she starts school nursery in September and it seems like such slow progress.

Bumping for you.

Thankyou....

Hmm, mine both have/had receptive speech delay so our needs are different. But bump! DS2 is now 3 so I know how hard it is.

Can you tell us any more about the expressive speech delay? Details like can she blow, that sort of thing.

Hi Lingle, from what I understand, she knows what she would like to say, understands others and can follow instructions etc...she has been slow to acquire language however.

The words she does have are mainly nouns, she has no verbs to link words together and little functional langueage, ie more, help etc.. In this respect she gets so frustrated and upset. I have become quite good at reading her non verbal signals but she really struggles. Yes she can blow, well she blew her candles out yesterday anyway! What is blowing an indicator of? Thanks for replying. How are your children doing now?

Thanks TClanger, I'll look at your blog. Yes the private SALT is very good but not sure how long we can afford to have her for really...I wrote down all of DDs words at the weekend, there were 40. I'm beginning to wonder if there is actually some sort of disorder there, rather than just delay.

Hi lulurose - I asked about blowing because I understand there are some conditions where the muscles in your mouth and tongue need to develop a bit more before you can speak. But I think your SALT would have pointed that out to you if it was an issue. If you feel it would help to share more information about her medical needs or how the SALT described things, then feel free but don't feel obliged to. You might also want to describe a day or the things that cause frustration. Does she understand where she is going next? Can she make choices?

If it's not a question of a physical barrier to speaking, then the next step might be to perfect your own communication techniques to ease her frustration and build her confidence. The classic book for this is called "It takes two to talk" and it is my bible. I think it was Tclanger's bible at this stage too - is that right tclanger? It has no milestone charts. It requires no appointments (though there is a course you can do) and it does not interfere with family life. It is easy to read - hard writing makes easy reading as they say. It starts from where your child is and shows you how to communicate better and help her communicate back. It stops you from making classic mistakes (too much saying "say this", etc).

Now, on this forum, some mums with children on the autistic spectrum, and some speech therapists who work with autistic children, have noticed that this book doesn't work for their ASD kids because the initial communication doesn't get going - perhaps because the child's real problem is that s/he is feeling a reluctance to communicate or is passive about communication. The book almost assumes that the parent and child are ready to talk to each other. But do you feel that your daughter is longing to talk to you? Because if so I think this could be the book for you. It would help you to have "conversations" with her where you each take turns and her limited words count as her turn but pointing and gesturing can also count whilst you help her change those into words. The publishers' main site is www.hanen.org and the UK distributor is www.winslow-cat.com.

Thanks for asking about my kids. DS1 has completely outgrown his difficulties and has enviable communication skills at 6 years old. DS2 is doing well - things exploded at 3 as with tclanger so fingers crossed. But his understanding is still very limited for his age and his ability to play with other kids at nursery is affected by the language problem. We have a long long way to go.

You have an amazing understanding of so many issues Lingle.

lulurose, moondog is a speech therapist and mum of a child with speech difficulties who helps us all a lot on this forum.

Hi Lingle,

Thanks for the book reference, I have an American book that a colleague of DHs lent us but haven't looked into others yet, good to have a reccomendation. I think she is desperate to talk and engage, she engages fully in other ways but this look of horror crosses her face when she realises she doesn't have the word to give as an answer.

We are working on offering choices and adding on 1 word every time she says something. Also doing lots of repeating back and "scaffholding" of language.

An example of frustration: we were playing downstairs this afternoon with DD1 (4 and very talkative!!) when she suddenly decided she wanted to go upstairs, she sat at the bottom saying "Der" (there)..I said its ok DD2, you can go up....she kept on crying and then came and took my hand and pulled me up there...she went straight to her sisters room and pointed very specificly to a puzzle on a high shelf, again"Der" and pointing. I got it down for her and she was fine but had she just been able to say "Help me"...or "Come up" she would get her needs met so much more quickly.

Another example, she loves to role play with her sister, princesses etc Everyday she takes on a different character as her sister does, so, everymorning its:

Me: Hello DD2
DD2: Nah
Me: Hello Aurora?
DD2: Nah (getting indignant now)
Me: Hello Cinderella?
DD2: Nah (crying)...

and so it goes on until I work it out!

...I suppose a picture board would be useful here?

Her medical needs are that she was diagnosed at 18months with Type One Diabetes. She took several develepmental steps back at this point as she was seriously ill at diagnosis. The lack of language causes problems here too as she can't tell me if she is feeling hypoglycaemic etc... I have to test her bloods often to get round this. Her consultant has said that when children g through trauma their bodies will be busy getting better and other areas (ie speech/mobilty) get set back. I don't know if this is the case though.

Phew...sorry I've gone on

Hello Moondog, any advice very gratefully recieved!

Hi Lulurose. My DS's language was severely delayed at 3. His receptive language was also delayed. It is a very positive sign indeed that your DD's understanding of language is fine. Now at 4.10, his language is much improved. On formal testing he is now hitting normal range- but in terms of his day to day conversation, I feel he is probably about a year behind his peers. So he has made a lot of progress and is currently in reception in mainstream and doing well there with very little support.

How we got there:-
1)Luck!
2)private SALT help. in particular, she recommended using PECs to help him increase his sentence length. PECs (picture exchange system) is a complete alternative communication system - so in essence we cherry picked a particular stage to help DS. So he had a communication book with picture symbols of toys/food etc, and the symbols/words for basic sentences such as "I" and "want", and "I" and "go". Having a visual of how a sentence was made up really really helped him, and led him on to generating sentences spontaneously.
3)Hanen books and courses. I did "You Make the Difference" at a Surestart centre, and eventually after several months on a waiting list "It takes two to talk". Hanen is very strongly focussed away from formal exercises, and making language and communication boosting activities part of normal family life
4)verbs! verbs are the building block of sentences - so try and encourage verbs as single words and in two word phrases as much as you can.

I think there is some truth to the medical problems delaying language - there was a lady on my hanen course whose DD had come off night time oxygen (she had been born very prem) about six months earlier - she and the professionals had been expecting a language spurt once the DD was off oxygen, but unfortunately this never occurred.

Thanks TC, I am going to ask our private SALT about PECS and do a bit of reading up.

Any ideas for games to play that will reinforce verbs?

Great to hear your little one is doing well at school, I hope school will give DD the reason/motivation/support to talk more...still worried now, especially about socialising with others. She has friends now and tags along with her sisters older friends but is still so limited in to what extent she can join in.

well if you can focus on her interests - so you can have her favourite teddy/doll/character toy sleeping/sitting/dancing around etc. DS loved playgrounds - so slide/swing/jump were early additions to his vocab. and of course eating and drinking. if you focus on her favourite food/drinks that's an added incentive! it's good to have both real life examples and pretend play examples to work in plenty of mentions. DS liked playing with lego toy doors - so that was how I taught open and shutting as verbs...

Thanks, I am going to make a more concerted effort to use those verbs in simple 2 or 3 word sentences when we play together. I'm afraid I chatter on alot and speak quite quickly....I need to slow down!

remember to give her bags to time to respond/give a verbal or non-verbal response to what you say - even if it's just looking or gesturing.

definitely slow it down lulu. it feels like a pantomime at first but it's worth it.

I think in "the book" it says "Stress - Say Less - then repeat repeat repeat".

definitely slow it down lulu. it feels like a pantomime at first but it's worth it.

I think in "the book" it says "Stress - Say Less - then repeat repeat repeat".

the next bit from "the book" - is go slow and show, its the 4 "s's". The other important one is: Observe, Watch, Listen (Owl).

Hi all, have just tried to order the "It takes two to talk" and it is currently unavailable on Amazon...any ideas where else I could source it?

Thanks

Lulu, you can order it from www.winslow-cat.com
that is the UK distributor for the Hanen Foundation, which is based in Canada.

or have a look on ebay.

if you look on ebay it might be the old edition (there are 2 editions). I really don't think there is that much difference between the two, other than a nicer layout with the new one. But just so you are aware there are 2.

btw expect it to cost around £30. But it is really good and worth it.

and I promise I am not on commission