question about speech delay in three year old

[zebramummy]

hi, i have not posted on mumsnet before. i tried posting a few days ago but i did not get a reply so i am trying again hoping that someone might offer useful advice. my ds (3.5 and tringual) was referred to a SALT about a year ago - at the time he was considered to be reasonably but not significantly delayed in both receptive and expressive language (although we disputed the former upon the basis that the words he used at home for which he also demonstrated understanding) were well beyond anything he presented in front of the SALT. infact, she tested him on words which he would often come out with spontaneously at home but he did not respond so she said that she was only able to go on what she had actually heard and seen herself. since then he had two blocks of therapy (half an hour a day/ week) during the main hoildays which is obviously not a lot in total. his speech devt stalled for a few months but since he started nursery in september he is improving everyday coming out with new words and phrases (even though short ones) and almost singing whole songs with minimal prompting to help him along. i do believe that he was tongue-tied as recently he has been stretching his tongue around his mouth at times; really exploring how it moves and he can now blow bubbles which he could not manage before. nursery have highlighted improvements in his social confidence and the fact that he is using single words (it is a huge nursery of 50 children). i just wanted to know whether it is likely that this will eventually lead to normal speech even if he is initially behind his peers and st. a catch-up of some sort. the reason why i ask is that he was meant to attend about 10 hours a week of intensive salt therapy for 2 school terms with 5 other children but our local authority has let us down by casually informing us that he will only get this in september now (was originally meant to start in january). i have the hanen book as well as a few others and i really do what i can to encourage him along but obviously i am not a salt and i do feel quite deflated atm. sorry about the long post but i was just wondering whether there was anything i could do to help him along at this particular stage of fast-developing language acqn. i just feel as though he will stall again without prof. input and ultimately never get there because of lack of support. my SALT contact did mention having him statemented for language delay (he starts school next jan) but she agreed that he would not qualify in all probability.

hi zebramummy, didn't want to leave you unanswered. I've got a 3.6 old ds who has a language delay of approximately a year. We have no dx, but there could be a language disorder / mild ASD / auditory processing problem going on.

We are fighting our own battle with SALT provision but have never been promised 10 hours a week - that sounds fantastic, if you can manage to get it.

Do you feel your ds wants to communicate with you but can't (wondering about oral dyspraxia from your description)? How is he socially, how does he interact with his peers at nursery?

Is English your ds' main language? I wonder if you could maybe focus on speaking this with him as much as possible, so he can get the basics in his main tongue before moving on to others. I don't know your circumstances so forgive me if that's a really impractical suggestion. I think you need to simplify things as much as possible for him while he's acquiring the basics.

Something which helped ds was when I focussed on doing a topic a week with him. We covered the weather, colours, shapes animals and so on, doing painting, reading books and doing jigsaws in relation to the subject while I tried to fill him up with as much vocab as possible. This is paying off for us as he now has a fairly substantial vocabulary to call on but it's slow progress to help him construct proper sentences.

There are some great SALT's on here, hopefully they'll be along to advise shortly!

Hi kettlechip, thanks for answering. Your circumstances sound remarkably like ours actually. ds also has a huge vocabulary of single words but the sentences are really short and difficult to understand. I found out that it is actually 8 hours rather than 10 per week although it would be group therapy, not 1-1 and way too late IMO. is your ds going to be attending mainstream too? as the prospect of school draws menacingly close, i am starting to feel vv scared on his behalf!! yes, english is the main language - my dh speaks italian and is (typically!) stubborn in refusing to drop it - i have explained to him that it could mean that ds never speaks italian even if he acquires english properly after a struggle, but to no avail. what are you doing in the way of encouraging sentence building if you dont mind me asking? i am sticking to the fill in the gap strategy - he has always been really good at this but i have yet to see a dramatic improvement. i know that some people use pecs but i feel it is a whole new game which is rob too late to explore at this stage. do you get much salt input or similar help from nursery? i do feel very alone as our social group from the baby years has pretty much discarded us given that their children were great talkers and much more useful to each other in terms of ongoing develpoment. i feel absolutely awful about the fact that i find myself feeling embarrased when ds babbles loudly in public (he is very tall and appears to be of school age to those who do not know us) - then i have to check myself and remember that it must take such a lot of courage and effort on his part. he is really happy and popular at nursery (has no behavioural issues other than being a messy eater at fruit time although i have not experienced this at home). he joins in the chasing/construction games and knows names of people (almost talks about them at home as best as he can manage with prompting) and he shows affection towards particular people, but the lack of ability to converse often means that this does not exactly progress to playdates or party invites. one thing he has started doing recently is stretching his tongue around his mouth now and again. this is def not continuously and i have no idea whether he does it at nursery. it does coincide with big gains in the ability to make new sounds, and he does have a cold - he is not frustrated when he does it - actually he finds it funny and almost does this so i can ask him to stop! he is fine with bubbles etc

hi zebra, sorry I didn't reply to your previous thread, I did see it but because I'm not a SALT thought it was better to leave it to a professional.

background - at 3 DS was severely delayed with language and receptive, around 12-18 months behind with both. He had lots of single words (say 100-150) and the odd phrase. More worrying he had lots of "telly talk" - rote repetition of TV scripts. He has never had any speech sound problems.

I've done group therapy with DS, and have found it pretty good, it's been 2 or 3 SALTs with there being 3 to 6 kids in the group. One advantage of group therapy is that they focus on skills kids need in school/nursery, like turn taking and sitting and listening. So although I think 1-1 is slightly better, the groups aren't bad at all.

re:bilingualism. no personal experience, but what I've read on the internet (and what Moondog who is a SALT who sometimes posts here) says is that it doesn't cause problems, and you should carry on using both languages.

PECs - not too late at all! I was very unwilling to use PECs as I felt it was a step backwards as DS had lots of single words and the odd phrase, but I am soooo glad I did start using them - private SLT put together a communication book to get DS saying things like "I" + "want" + "more" + "juice", and then that springboarded on to him being able to generate sentences easily himself, it really made something click in his mind. the other important piece of advice from private SLT was that verbs are the building blocks of sentences, so I had to focus on teaching DS more verbs rather than nouns.

further actions:-

1)ask SALT department if they do a Hanen course (probably it takes two to talk)

2)google verbal dyspraxia/nancy kaufman to see if that rings any bells with speech sounds etc.

3)consider private SLT if you aren't happy with NHS provision. Or if you are feeling more combative, put in a complaint to the PCT.

4)about schooling - you might want to look into whether your area has language units - these are special classes attached to mainstream schools for kids with language problems - they have small classes with teachers who are used to teaching kids with language problems, and focus strongly on improving kids language, with a view to them going into mainstream after their language has been boosted. Also look into whether your city has an ICAN nursery (specialist nursery for children with language problems).

btw - in terms of the future - each kid is different, noone can say anything definite - but it is very positive that he is speaking and that he is learning new words. DS went in the space of about 18 months from being severely delayed, to testing within the normal range on a few of the SALT tests - NB I don't think that means he has caught up, as I think that conversationally he is a year behind.

So at 3 his speech was in 18-24 month range - and at 4 his speech was at 36 month range - my personal feeling is that once speech hits the 36 month level, you can start having little conversations, and your kid can start to tell you little things about what has happened out of your sight - e.g "X hit me!"/"I go on trampoline at Y's house!"., which makes a big difference.

thanks for the good advice.

tclanger - i have emailed you, thanks so much

re:dyspraxia, i have considered it for ds myself in the past and flagged it with a few SALTs but they do not think it could be that as he is good with long names and words of even 5 syllables in all contexts incl spontaneously

totalchaos - i do actually agree with your timeline based on our experience. ds cannot yet provide me with full stories but i get something in shorthand form such as 'sweet, ben's birthday' rather than 'it was ben's birthday today - he gave out sweets at nursery'
i have asked about hanen but they said no - i have their book which i was really into for a while but have not consulted recently as atm ds is so keen to try and talk to me all the time that (along with these types of speech -related discussions and talking to salts) i think i would burn out if i were to read about it too.

re 4) i think the group therapy that he has been promised just before starting school is meant to act as a substitute for a language unit attached to a school. there is a special needs school in our area with a speech section but you need a statement to attend & salt does not think ds would get one