Requesting a speech eval

[SarahBear]

Since I needed to bring Violet to the doctor and it's not always super easy to get there, I took Leo in early for his two year well child check. His speech is my only concern with him and we brought it up at his appointment. The nurse practitioner felt that at this point he's significantly behind enough that an evaluation would be warranted. I work for the educational organization that would be doing the eval, so rather than having them contact them with a referral, I emailed the woman who does early childhood speech in our area to ask how to get the ball rolling on that. Overall, with the exception of his verbal skills, his communication is actually very good. His verbal skills though? He has a limited vocabulary that developed slowly and I wonder if he has articulation problems. Some of what I've read makes it seem like he's one of those kids who is just slow and will naturally catch up because he has all the other communication skills. However, if there's something getting in the way of actual word production, he's going to need some help. Anyway, it will be interesting to see what happens. I read that a lot of places don't even look at articulation until three. Is that accurate in your experience?

 

[k4th]

I would think that the answer will be that he is a very good communicator (you've said in previous posts that his understanding is good, as is his use of natural gesture, pointing, eye contact etc). They may well assess his articulation to see what sounds he has. Off the top of my head... I think under 2 years the sounds they're expected to have are p, b, t, d, m & w. Other sounds all come later. They will be checking that his vowels sound ok too.

It's unlikely that they will be able to do "sit down & practice" articulation work before three - that's because kids don't want to sit & cant maintain attention but also because they don't understand concepts like front vs back etc that you might need to explain for tongue position. However, you mibgt be given information about auditory bombardment - basically listening to lots of words with the sounds that are difficult - you can google "auditory bombardment" for more info - there's lots of articles on it too.

My ds has some articulation difficulties. I've gone down the signing route. It's functional, decreases his frustration and he can communicate well with it. I've seen research that suggests the part of the brain responsible for hand movements is next to the part of the brain responsible for mouth movements. So moving hands for communication is firing up the neurons for motor speech at the same time.

Hope you get an assessment quickly and get some reassurance. I think a lot of kids at this age do have articulation difficulties & most resolve themselves. I totally understand the worry though

 

[SarahBear]

Well, I made the necessary call and he's scheduled to be evaluated on the 13th of April. They want to wait until after he's 2 and that's the date they'll be in town. They said they will look more at language and won't be looking at speech until 30 months.

 

[sequeena]

Thomas was outside the norm and was referred to speech therapy at 17 months old. Glad to know they're going to assess him. There's no harm in it and you'll get answers to any questions you have.

 

[SarahBear]

Leo was outside the norm at 17 months, but it's so variable that it's hard to say if he's just a late bloomer, or needs actual help. He seems to be otherwise developing well and communicates well with the limited vocabulary that he has, but his thoughts are starting to outpace his ability to express himself and that's starting to frustrate him. They want about 50 words at 2 years and beginning to put words together. I haven't exactly counted his words, but I doubt he has said 50 words. I counted 20 words in December that he had said, but wasn't necessarily actively using. He has gained words since then, but not tons and he's nowhere near putting two words together.

Let's see what I can think of as his words that he uses on a regular basis:

1. This (or sometimes "this is" or "this is a")
2. Mom or mama
3. Dada
4. oash (for water or wash)
5. oash (for orange)
6. oash (for trash)
7. on
8. off
9. bubble
10. ball
11. boop (I thought it meant poop, but he's been using it when pointing to animals in books, so I have no idea if it means anything or what it means, or if it's a real word)
12. juice
13. yeah
14. no
15. toast (My husband mentioned this one... I'm not sure how he pronounces it)
16. at (for hat)
17. up
18. bebe (this one is emerging. He sort of uses it for baby, but then he also doesn't have a solid grasp on what constitutes a baby. He also uses it out of context where we don't know what he means by it. He also was using it for a while to request a drink.)
19. apple
20. nana

If we were to make a list of all the words he has used and all the words he uses less frequently, we could probably double the list, but as you can see, it's not quite to the 50 word mark. We could also add things like panting to say "dog" or all his signs, but this is what his regular word production consists of.

 

[sequeena]

If it was just his speech that was outside the norm that's not too bad and hopefully it's something that can be easily sorted. You might find he has a speech explosion at 2 apparently that's quite common

 

[SarahBear]

If it was just his speech that was outside the norm that's not too bad and hopefully it's something that can be easily sorted. You might find he has a speech explosion at 2 apparently that's quite common

Yeah, I've heard all kinds of things about late talkers. I've also found a variety of opinions about when it's time to get help. But it doesn't hurt to get the ball rolling on things. I'd rather get started and have them tell me to wait or to not worry than to not do anything and have it have a greater impact on him. I have the feeling though, that his general learning style involves a slow uneven start. The same thing happened with walking. He pulled to stand, then stopped for weeks. Then he took forever to start cruising. Then when he finally started taking independent steps, it took him a full month to really start developing the skill further. With talking, he keeps hitting these phases where it seems like he's going to take off with it, and then he just doesn't... he'll gain a few words, but not really take off. Violet suddenly gained a bunch of words around 17 months. Leo at the same age appeared to be entering a similar phase... but at the end of it, he had about 3 words. Recently, I though he going from "not really talking" to "starting to talk." I suppose he's in that "starting to talk" phase, but since he's plateaued instead of continuing to progress, it feels like his status is more "hardly talking."

I think it will be sorted fine in the long run, but I also feel like if it's his general learning style, he'll also be slower with certain things like reading or writing. If this is the case, I think he'll really benefit from homeschooling rather than the public schooling system.

 

[embo216]

Connor has severe speech delay, he's 4 next week and still can only say a few words, even before his 2 year check I requested a meeting with the HV and got the ball rolling, we managed to get him into a fantastic speech and language nursery and they're fantastic with as he get's intensive therapy everyday.

At his assessment they did say they don't usually offer sit down speech therapy sessions for under 3's but Connor really took well to it and sat down and enjoyed, usually up to about 20 mins at first so they made an exception. It was a real fight to get the help though.

 

[Gym knickers]

Both of my nieces had very little speech at 2- and their understanding wasn't great either. I remember asking my eldest niece to point to a dog in a book and she looked at me totally blankly. They both did (and still do) use dummies a lot which I doubt is an issue for you. However by 2.5 they both had a speech explosion and by 3 they both were talking and although they both struggle with pronounciation now (5.5 and 3.5) they've never been identified as speech delayed. My friends little boy is also two and has maybe 30 words, no one is concerned as he can communicate well but his
Mother finds she compares him to his elder sister and also my dd2 (born 2 weeks before him) who both used sentences by 20 months. She's brought it up with hv who isn't concerned at all. I think there a huge variation of normal with speech and I'm sure it all come for Leo- all the signs are positive. Also, I've read that speech can tend to come later for boys than girls.

 

[catty]

At my sons 2.5 year check up he was only expected to say 2 words together such as red sock. They didnt even seem to care that noone else understood him they said as long as parents do thats fine.
So at 30 months he would say 2 words together and that was about it but deemed 'normal'

Now he is 3 years 7 months and has been put forward for speech therapy by the nursery. It is frustrating because i feel it should have been picked up at 2, 2.5.

My daughter has been saying quite long sentances since before her 2nd bday and now at 2 years 7 months she is pretty much fluent i cant really think of anything that she cant say and she has a very scottish accent but my son has no accent

 

[SarahBear]

OK, so I thought of several more words that he says. Maybe he is closer to that 50 word mark than I thought. He did recently add words to his vocabulary though and his pattern seems to be that he gains a small amount, and then plateaus for a long time. We'll see if he starts putting two words together anytime soon. If he isn't doing that by two, I think it's still worth the eval.

 

[SarahBear]

At my sons 2.5 year check up he was only expected to say 2 words together such as red sock. They didnt even seem to care that noone else understood him they said as long as parents do thats fine.
So at 30 months he would say 2 words together and that was about it but deemed 'normal'

Now he is 3 years 7 months and has been put forward for speech therapy by the nursery. It is frustrating because i feel it should have been picked up at 2, 2.5.

My daughter has been saying quite long sentances since before her 2nd bday and now at 2 years 7 months she is pretty much fluent i cant really think of anything that she cant say and she has a very scottish accent but my son has no accent

Yeah... They don't do anything about articulation until 30 months, but they do work on language development sooner than that if they're not increasing vocabulary or putting words together as expected.

 

[JumpingIn]

Zach is 20 months now and did have an 'explosion' but his articulation is still terrible and I barely understand him. Most words sound the same.

He says:
1. Minny (mummy)
2. Diddy (daddy)
3. Cup
4. Takdah (tractor)
5. Diggy (digger)
6. Powuw (puddle)
7. Boo (boot)
8. Gup (get up)
9. No
10. Yeah
11. Ohhhwoah (oh no!)
12. Uhoh
13. Chee (chip)
14. Mih (mix)
15. Nuhmuh (No more)
16. Muh (more)
17. Mumumum (dummy)
18. Gat (cat)
19. Gak (Zach)
20. Baby
21. Tea
22. Car
23. Boo (spoon)
24. Boo (poop)
25. BUHbuh (soft play...only know by context and intonation)
26. Yummy
27. Bubble
28. Guyguy (Viola, our cat)
29. Minny (money)
30. Gigar (guitar)

People still remark that he is a little delayed...normally those who have had more verbal toddlers...So I think as Leo has fewer functional words you're absolutely right to get him seen, even if just to put your mind at rest. Although you did say he signs consistently which is brilliant. I'll be following closely to see the outcome!

We do have a friend the same age as Zach who has far fewer words, I'm guessing around 8, although he has been consistently delayed with all his other milestones too

 

[SarahBear]

Zach is 20 months now and did have an 'explosion' but his articulation is still terrible and I barely understand him. Most words sound the same.

He says:
1. Minny (mummy)
2. Diddy (daddy)
3. Cup
4. Takdah (tractor)
5. Diggy (digger)
6. Powuw (puddle)
7. Boo (boot)
8. Gup (get up)
9. No
10. Yeah
11. Ohhhwoah (oh no!)
12. Uhoh
13. Chee (chip)
14. Mih (mix)
15. Nuhmuh (No more)
16. Muh (more)
17. Mumumum (dummy)
18. Gat (cat)
19. Gak (Zach)
20. Baby
21. Tea
22. Car
23. Boo (spoon)
24. Boo (poop)
25. BUHbuh (soft play...only know by context and intonation)
26. Yummy
27. Bubble
28. Guyguy (Viola, our cat)
29. Minny (money)
30. Gigar (guitar)

People still remark that he is a little delayed...normally those who have had more verbal toddlers...So I think as Leo has fewer functional words you're absolutely right to get him seen, even if just to put your mind at rest. Although you did say he signs consistently which is brilliant. I'll be following closely to see the outcome!

We do have a friend the same age as Zach who has far fewer words, I'm guessing around 8, although he has been consistently delayed with all his other milestones too

Leo has actually been adding words recently, but I'm pretty sure it's still on the delayed side. The nurse who did his well child check said that he did seem delayed with his language. Of course she didn't get a full look at his language, but she did observe his general communication. Violet always talked less around other people, but Leo isn't that sort of kid. He communicates just as much, regardless of where he is, or who's around. He was busy and interactive while we were there. There were puzzles and toys and he was interested in toys in one of the other rooms. He also was interested in various items around the room including a light, an odoscope, and paper cups and the sink. He also was interested in the nurse's earrings and didn't like her leaving. So she got a pretty good sample of what his communication is like.

I feel like he does also have trouble with articulation as well, but we can't really confirm that until about 30 months. I suppose if he's starting to put words together before our scheduled meeting, then I won't be too worried, but I've been somewhat concerned about his communication since about 17 months. Progress is happening, but it's soo slow!

Also, here are some new words he's starting to add to his vocabulary:

* Light (Sounds a bit like "at," but I can recognize it because it's paired with a sign I taught him).
* On
* Off

 

[lau86]

I haven't read all the replies but my ds1 was quite delayed, he was pretty much non verbal till over 2. My dd has a lot of words but most of them are just copying me rather than understanding. She understands some things e.g. She can pick up a sock and say the word. But I could say to her 'jug' and she would say the word but wouldn't have a clue what a jug was. Not sure if that makes any difference but with my first son being so late I never noticed that with him

 

[SarahBear]

I haven't read all the replies but my ds1 was quite delayed, he was pretty much non verbal till over 2. My dd has a lot of words but most of them are just copying me rather than understanding. She understands some things e.g. She can pick up a sock and say the word. But I could say to her 'jug' and she would say the word but wouldn't have a clue what a jug was. Not sure if that makes any difference but with my first son being so late I never noticed that with him

Leo definitely doesn't have that sort of delay and for a while now I've wondered if the issue is more of a speech problem than a language problem. However, the feedback I got was that he also sounded like he had a bit of a language delay. We'll see what skills he gains by April and what the SLP has to say at that point. Hopefully he starts putting two words together and won't need anything. But if he does need something, I'll be glad we got things started.

 

[Boo44]

My now 4.5 year old son was speech delayed, at 2 he had a list of words shorter than your son's, and he tended to favour 'sounds' over words like he would make the noise of the animal, or invent his own sign language to mean things. His language was always amazing and he was very on the ball, he just couldn't speak! We had private SLT as I found the waiting so stressful and she identified that he had completely missed the sounds 'p' and 'b' from his development and so had stalled completely. After a few sessions he would say the sounds and then he just exploded. It was amazing. He's now very bright and reading comprehension and writing all above his age at school. It was always in there it just needed unlocking!

Out of interest my second son was speaking in two word sentences before his first birthday and fluently speaking before his 2nd birthday. It was so different for me after DS1! However DS2 is now 3 and at nursery and although he's a chatty little soul, he has no interest in anything to do with books or words or anything like that lol