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sarbwah
#1 Posted : Tuesday, June 26, 2012 12:47:36 PM(UTC)
sarbwah

Rank: Newbie

Joined: 4/16/2012(UTC)
Posts: 2

I posted a while back (http://www.speechdelay.com/forum/default.aspx?g=posts&t=1558) about my son who was about 17 months old at the time, and is now 20 months. His initial consultation/assessment is coming up on July 9, although because of the wait list, we have been advised this week not to expect him to receive actual service for upwards of 12 months, depending on his level of need.

I realize that only assessment can determine diagnosis etc but one thing I'm hoping is that you could give me an idea of whether he is speech or language delayed, or both, and whether or not it 'sounds' like he is at a high need level? Here is where he is at right now:

Words: started to say 'ah bah' ('bye bye') at 18 months exactly, accompanied by a wave (which was brand new as well). Said it about 1 - 3 times a day for the first week or so, then gradually less and less, and I haven't heard it nor seen a wave for about 2 weeks, despite our continuing exaggerated and enthusiastic use of it ourselves, when appropriate. When he does say it, it is more often than not in context. Seems to be starting to say 'hi' in the past week or so, it sounds like 'i' and is not in context save one time when he was holding something to his ear like a telephone.

Does not mimic us with words nor will he say bye bye or hi when prompted. When he says either word we repeat it multiple times and make a big show of praising him and being enthusiastic.

Gestures: started to wave at 18 months when saying 'bye bye'. Will occasionally wave lately but less often than before. Started to point (primarily at day care) in the past two weeks. Does not point at home despite very conscious use of pointing and waiting to give him the opportunity to etc. Claps when excited, we are seeing that more, he started that around 12 months old. Sometimes will put his arms above his head like in the song "If you're excited and you know it shout hooray!", because when I sing that line I put his hands up above his head. He very rarely does this.

Understanding/receptive: has improved, he seems to understand more like 'want to have a bath?' etc but generally all things that are part of a routine that he is used to. I think more of his understanding comes from body language and visual cues. We make a point of labeling everything with one word or sometimes with one word and then repeating and adding an adjective, i.e. "ball! red ball!". The only labels he understands or responds to are "milk" and "sucky" (soother). He also seems to have realized that when he points to a fire truck in a specific book, I will sing a song about fire trucks. He does not seem to have a clue what we mean when we say 'where are your shoes' or give him instructions beyond 'no touch' and 'not right now', although he does understand that shoes go on his feet and hats go on his head.

As I've mentioned, we make a conscious effort to use clear, simple labels with enthusiasm, and we have also been using the tips you gave me previously re: talking a book etc and that has helped keep his attention when reading, etc. He enjoys looking at the pictures in books but beyond the fire truck song he doesn't ever bring a book for me to 'read' or want to really 'hear' a story. He'd rather look at pictures, turn pages and flip flaps etc. It's a start!

I hope this gives you some basic idea and I of course realize that I'm asking you for something you can't really give me, I guess I'd just like a general idea of things I may want to ask the SLP at our assessment about, and/or things I may hear from her so I can do some research and be educated enough to know what questions to ask. Unfortunately, if a second assessment is required it will mean going back onto a wait list and if we don't require one we will be on a long wait list for service (unless his need is considered great) so I really need to make the most of the appointment :)

Thanks for ANY info/suggestions/recommended websites or reading/feedback you might have!!!!!

Cheers,
Sarah
Sponsor
mom2payton
#2 Posted : Wednesday, June 27, 2012 9:12:26 AM(UTC)
mom2payton

Rank: Advanced Member

Joined: 4/23/2004(UTC)
Posts: 226
Location: Wisconsin

Hi Sarah, I can't really comment on what to ask your SLP but I did have some ideas...and our son had receptive/expressive delays at the very same age. You mentioned that the only book your son brings to you is the one in which you sing a song. How does he respond to music? Initially our son had no response to words at all but learn quite a bit if we sang things to him. We made up songs for everything. I have to admit my tunes were not original - you can sing a lot to the tune of three blind mice! And three blind mice is a nice three word sentence - Brush your teeth, comb your hair, get your shoes...you get the idea. Additionally, we used some music cds called Time to Sing which are traditional American children's songs with the words sung at a slower rate...the music is still peppy but the words are sung so there is a pause between each word. I tell this story a lot but I can remember when we put them on for him and how his eyes lit up when he realized that there were words with the songs. I think we played them constantly for months.

Additionally, I'm not sure where you are but music therapy, done by a qualified therapist, is a great partner with ST and OT. You can find a therapist in the US by visiting the national association website and they do offer suggestions for how to reach therapists internationally.

I hope this might be some help to you. Best wishes.
Mary Lou SLP
#3 Posted : Friday, June 29, 2012 5:32:06 AM(UTC)
Mary Lou SLP

Rank: Advanced Member

Joined: 1/21/2008(UTC)
Posts: 860
Location: Colorado

Hi Sarah,

That is good that your son will get an assessment on July 9th.

From what you have described about your son's current abilities, I'd suggest you include the following in your questions to the examiner:

1. How well is my son hearing? Definitely get his hearing tested thoroughly.

2. How well is my son understanding what is said to him?

3. What is the age equivalent of my son's ability to express himself?

4. What techniques can be used to help my son imitate sounds more readily? What speech sounds does he make currently? Is there any concern about apraxia of speech?

5. What is my son's developmental play level? Is it higher than or the same as his language abilities right now? Should my son receive an overall developmental assessment (by a developmental pediatrician or clinical psychologist)?

6. What are the possible reasons why my son is behind in his ability to understand language and express himself through spoken language?

7. Should we be using some augmentative communication techniques such as sign language or picture symbols along with spoken words?

8. Please explain the process for receiving therapy service or additional testing for my son.

Sarah, I agree with mom2payton about incorporating music/singing as much as you can if your son responds to that. You mentioned that you talk a lot in single words. To keep building your son's comprehension, I advocate my Upside-Down Pyramid method of making a full, natural sentence, and then systematically reducing it to a phrase and then down to a key word. The context of the other words can help build understanding; the single word can provide a potent model for an imitation attempt.

I hope you will post again after the evaluation.

Mary Lou



Mary Lou B. Johnson, M.S.,CCC-SLP

http://www.HelpYourChildSpeak.com
honeybee
#4 Posted : Monday, July 02, 2012 7:33:32 PM(UTC)
honeybee

Rank: Newbie

Joined: 7/2/2012(UTC)
Posts: 5
Location: England

Hi Sarah,

Please do post back, as this sounds really quite similar to the issues my 20 month old daughter is having. I live in England, and they refuse to refer child until they are least 2 years old. I am wondering whether to go privately as I am constantly told this isn't a real problem at this stage, and she is probably just a little delayed and will likely have some language explosion any day now.

I am not convinced at all, and look forward to your findings ~ I hope you get some answers and thank you for posting.

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