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5yr old speech and language delay Options
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Bianca
#1 Posted : Thursday, January 12, 2012 6:16:00 AM
Rank: Newbie


Joined: 1/12/2012
Posts: 3
Points: 9
Location: Australia
Hi,
Im new to this site and really would like to hear other peoples advice and thoughts... I apologise if i am asking the same thing as everyone else has.

I have a 5 and a half year old son with a speech delay. He has been doing speech therapy since he was 2. Since he was 4 i knew there was something not quite right about him. His speech has improved but it is still quite bad. I believe he has a language delay as well but nothing has been mentioned about that. He has completed kinder and now he is about to start school but my gut instinct is telling theres something else not quite right. Firstly his speech is quite hard to understand and he tends to add an 'n' or a 'd' infront of his words. Secondly i am concerned about his language skills. He will say 'me' instead of 'i', 'us' instead of 'we', 'take-ed' instead of 'took', 'walk-ed' instead of 'walked' , 'jump-ed' instead of 'jumped' etc. When he speaks in a sentence he takes a long time to say what he is trying to say and he often has to think or start again. He sounds like he struggles so much trying to speak in a long sentence. He doesnt use may new words at all and when he talks about something he describes it. He constantly asks 'why' and if he wants something and you tell him maybe later, he will ask around 20 times for it until he gets it. He doesnt have many interests so he doesnt really talk about much but will recall a situation that happened a few days ago and tell me about it and then thats it. He also will wine alot and not tell me whats wrong except saying that he wants me. He is very shy and will get very anxious if someone he doesnt know speaks to him or gets close to him. I am worried that when he starts school he is going to struggle because of this delay and im worried there is something else that they may have missed. I have a 2 and a half year old daughter and she seems too be more switched on than him. Has anybody got any advice or ideas on whats going on with him. He has seen a peadiatric neuropsycologist about some behaviour issues but they said there was nothing to be concerned about, only some fine motor skill issues which have been taken care of. Im guessing the school will notify me of anything they are concerned about but for now i need to know if i am not obsessing over this issue that i believe is just not speech delay. Any information would be greatly appreciated, thanks
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Mary Lou SLP
#2 Posted : Thursday, January 12, 2012 7:08:45 PM
Rank: Advanced Member


Joined: 1/22/2008
Posts: 779
Points: 2,073
Location: Colorado
Hello Bianca,

Your post interests me a lot. I hope my questions and comments help you work with the staff/professionals in your area.

Your son has received therapy for his speech but not for language? This is concerning, because from what you have described, it sounds like he has classic symptoms of language impairment which is very similar to aphasia. (The condition actually used to be called childhood aphasia because the symptoms resemble those of adult/acquired aphasia.) You have described limited vocabulary, word retrieval difficulty, circumlocution (talking around something or describing it rather than using a specific word), formulation difficulty (putting his ideas together and figuring out how to express his thoughts), grammar errors, and so on.

As to your son's speech production/articulation--are you saying that many or most words start with the n or d sound? Has he had a thorough articulation assessment recently? What is worked on in therapy? Are you given daily home practice to work on with your son? It sounds like his articulation is way behind age expectation, and he should be in a very specific, highly focused therapy program with a plan.

Has your son had any treatment using AAC (Augmentative/Alternative Communication) using electronic devices?

It is no wonder he stays close to you! Consider that you were traveling in a foreign country and you had only rudimentary skills in that foreign language. Would you venture very far away from your travel guide? This is analogous to how your son may be feeling.

Has the neuropsychologist completed a full battery of tests with your son? DId he report to you about your son's cognitive skills/intelligence? If so, were you told your son has at least average intelligence? If yes, then, again, your son's profile of speech-language difficulties sounds like a classic speech-language disorder and he deserves very intensive treatment.

Why do you think the neuropsychologist only commented on your son's fine motor skill issues? Do you think the behavior issues you went to that specialist about resulted from his communication difficulties and frustration? How frustrated is he?

I agree with you that dropping your son into school will likely be very overwhelming for him without a lot of supports in place. In the US students like your son receive testing and an IEP (Individual Education Plan--or sometimes it is called an Individualized Educational Program.) Do you have such a thing in your schools?

In my view, you are not obsessing. You are aware that he has significant needs. You are your son's strongest advocate, and he needs a lot of help at this point in his life.

I hope you will write back.

Best wishes to you and your son.

Mary Lou
Mary Lou B. Johnson, M.S.,CCC-SLP
http://www.helpyourchildspeak.com
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Bianca
#3 Posted : Thursday, January 12, 2012 11:15:19 PM
Rank: Newbie


Joined: 1/12/2012
Posts: 3
Points: 9
Location: Australia
hi Mary Lou,

Thankyou very much for your input.
I will answer some of your questions that you were asking...

About 90% of his words start with 'n' or 'd'. He hasn't had an articulation assessment. The things they are working on in therapy is segmenting the word and prompting him at the start of the word with how to say the sound. For eg. Sometimes they have to tell him that he needs to put teeth onto his bottom lip for the 'f' sound. Sometimes he can say the sound but forgets afterwards or is used to the way he has been speaking and it doesn't come automatic.

I have told them that he struggles with sentences but they haven't even got him to talk in sentences or he wont because he is very anxious/shy.

We do get homework to do at home but can only work on one sound at a time because if we move onto another sound he keeps using the sound that we have just used. eg if we work on 'ch' sounds and go onto 'f' sounds, he will keep using the 'ch' sound at the start of the other words.

He has had no treatment using AAC (Augmentative/Alternative Communication) using electronic devices, im not sure what that is? Now that he is starting school he is unable to see his current speech therapist but will hopefully have speech therapy at school. I would assume they will start with assessing him from the start.

i think you are right when you say that he hasn't had any language therapy, i'm just concerned because they are calling it a delay but I thought he should have caught up or been close to an age appropriate level by now.

The neuropsychologist told me that all the testing was average but in the low average. His fine motor skills were below average and was referred to an occupational therapist. They observed him at kinder and said he was doing fine. They mentioned he was copying alot of the other kids in play without doing his own thing, limited eye contact and less mature than most kids, but since then those things improved.

The behaviour was just bad tantrums and very demanding, I felt that it wasn't due to fustration as I understand around 85% of what he says. He is 5 and a half and going to school but i'm sure the teachers will pick up on something as the kinder gave me no feedback on anything. I am thinking about taking him to a paediatrician, as he has never seen one before. I feel that i need to do something instead of waiting to hear from teachers or the new speech therapist.

Thanks for taking the time to read and reply, anymore new information or questions would be appreciated
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Bianca
#4 Posted : Friday, January 13, 2012 12:59:41 AM
Rank: Newbie


Joined: 1/12/2012
Posts: 3
Points: 9
Location: Australia
I just thought I would just ad that my son doesnt not always struggle with a sentence and its structure, it is just sometimes. Mostly with new information.
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Mary Lou SLP
#5 Posted : Friday, January 13, 2012 7:04:46 PM
Rank: Advanced Member


Joined: 1/22/2008
Posts: 779
Points: 2,073
Location: Colorado
Hi again, Bianca,

I agree with your thought that the word "delay" really doesn't apply to a 5 1/2 year old. I would not expect your son to "outgrow" his significant speech-language difficulties. He definitely needs and deserves help.

I also agree with you that it would be wise to seek a consultation/evaluation with a pediatrician. Do you have "developmental paediatricians" in your area? These doctors are trained to examine children's development closely and not just handle health issues.

So, if your son's measured cognitive abilities are "low average" and not "below average" he can be expected to benefit highly from appropriate intervention.

You described some good features of his articulation therapy (telling him and showing him how to make each sound) but he may do better, as you suggested, staying with one sound for awhile to try to achieve mastery. When he has to attend to too many sounds at the same time, he can't retain the features of any one sound. I'd suggest staying with one sound in one position in a word (for example, the b sound at the beginning of words) for a full week, extending this to another week if he really needs more time to get it, then move on to a different sound and try to achieve mastery. See if any therapists use a phonological processes "cycles" approach. In my opinion, your son should have a thorough articulation test, and it should be repeated every 3 or 4 months. Without an objective measure, how can you and his therapists monitor his progress and continuing needs?

I am glad you added that your son does fairly well in expressing himself in routine interactions. So, he has language skills, but he struggles with adding in new words and forms.

I hope you find an experienced and talented speech therapist (speech-language pathologist) who can help your son succeed within the next few years.

Mary Lou



Mary Lou B. Johnson, M.S.,CCC-SLP
http://www.helpyourchildspeak.com
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