Speech Delay- Pros and Cons of Eval/therapy?

Hello! I am a Speech Path in Early Intervention and to be honest I dont see any cons as to getting an evaluation. Obviously, I am most likely biased-given my profession, however, it is an evaluation preformed in the home at your convenience. The "wait and see" approach (if you want to call it that) does seem to "work" for some cases, however, how do we know if your nephew falls into that category or rather in the speech impaired category? There are significant correlations between speech delays and delays in reading, spelling, etc.

At 2 1/2, I also have concerns regarding not pointing to body parts along with the increased frustration. Those two can be considered red flags. I tell parents that to get the eval done and make the decision then (if they qualify). By that time, most parents opt for Speech services.

Hope this helped!

D.

why not get him evaluated there is obviously a concern if you are all discussing it frequently. If he is ok, great, but if not early intervention is key.

I see this behavior with my mom at times, as if she is in denial. If there is no diagnosis then there is no problem. I think grandmas just want everything to be ok.

My son was a late developer in speech. We had him tested by a speech therapist and ENT at age 3. I would recommend you do that. We did it with a local college where we were living at the time. I would definately recommend you do it as the earlier you catch it the sooner he can get therapy. You should be able to hook up with a local school to receive speech therapy if it is necessary.
We also held him back in 2nd grade. We also sent him to a private church kindergarten and then public kindergarten just for the experience. Don't rush to get her into elementary school. Delaying that is always good for the child. Our son is now 19 and I think it was a good thing as he has worked through many of his issues. Just a mom tip as well-- We only had one and I am assuming you do as well. Be sure that you allow him to talk. Don't let him grunt and point. Make him try to say what he wants. I understood every request my child wanted by his sounds, but wasn't letting him actually try to talk. Be sure you are reading and talking to him. He probably is understanding and has no reason to answer because you gratify his needs. Just step outside the box and see his environment and test yourself. Hope this helps.

HI. I am a preschool psychologist; I evaluate 3 to 5 year-olds for developmental delays. It sounds like those ear infections definitely played a part in delaying your nephew's speech, but he may take a while to catch up and make up for lost time. There is also a different speech "learning curve" expected for boys as compared to girls, as boys are more often later to talk. Most of the speech therapists I know would recommend waiting until his 3rd birthday. It's hard to explain, but it can be quite difficult to "qualify" for speech therapy until age 3, when the expectations for speech go up considerably. Since he does say a few words and can follow simple directions, he may not be low enough to "qualify for specialized education." Of course, you can always pay for private therapy, but if you wait until the 3rd birthday and he qualifies, the evaluation and the speech therapy will be free through the public school system. I certainly would not wait after that; contact your local school system's preschool department 4 to 6 weeks before he turns 3.

When my son was around 18 months and not being able to say X number of words his pediatrician said kids his age should be, I started to wonder about speech therapy. While his ped wasn't overly concerned (because he could understand simple directions, never had ear infections, was very social, etc), I felt some concern about getting him evaluated – though not quite sure what that concern was. Was I afraid he'd get "labled" as something if he did need therapy? When it came down to it, I saw no real con for getting him evaluated. If anything, he'd get some help; and since this was through our county's Regional Center, it was something we had already "paid into" as tax payers.

My son did end up getting speech therapy right after he turned 2, and I'm glad we went through with it. I honestly think he did a lot of progress on his own even before we started, but going to the sessions helped both of us. For him, he got to spend a couple of hours a week basically playing one-on-one with his therapist. It was all interactive play, and I never thought she pushed him – when he seemed to resist anything, she backed off. Some days he was more responsive to commands and mimicking, some days he was not. Some toys/activities he'd get into, some not so much, but I never saw her force him to do anything he didn't want to do.

And for me, what I got were ideas on how to encourage speech at home through play and throughout our daily lives. I personally thought that was great.

I'm curious as to why your mom is so disapproving about it. Maybe she had the same concerns as I did? Yes, kids do progress at their own pace, but if you get a good therapist (I'm sure there are those that do push too hard), I can't see any harm speech therapy can do.

The simple fact that not being able to communicate effectively is making him frustrated is a sign to get him tested. It won't hurt anything if he is fine, but if not and he does need help, then it will be great for him.

Just think about the best interest of the child. ECI (early childhood development) only lasts until the child is 3, so you can contact them and have the testing and help provided for free and it can be an invaluable aid for him. It can make his tiny little life happier.

My children were late talkers as well, so the talking isn't the issue I see here, so many children progress so differently here, but the ear infections add more concern as perhaps his hearing could be effected.

He really should be able to identify body parts, and pointing to objects is a milestone he should have reached a while back and have more communication then he is at this point, even if it isn't all verbal.

Go ahead and get the evaluation! Time makes all the difference. We had our son go through speech therapy and he is now a chatterbox! It's much easier to address now rather than waiting later. He will be four this summer and talks about everything around us.

First I need to say that my daughter received speech therapy starting at 18 months. It was fun and she really liked it. She got one on one attention from the therapist who was willing to play silly games with the people and animals with her. She loved it and thrived. She is 2 1/2 now and is no longer in therapy. I see two big reasons to start now. The first is if you cannot get it through insurance he can through early intervention. When he is 3 he will have to go through the school district. Second, I had speech problems that were due to chronic ear infections. These were not addressed until I started kindergarten and I received speech therapy through the school in K-2nd grade. I very distinctly remember my older brother's friends teasing me. They would ask me quesitons with only one answer that were words I mispronounced and then run away laughing.

My son is 2 1/2 and I had to have him evaluated 2 times before he qualified for early intervention. I knew he needed therapy and I persisted - especially when the teachers in his preschool class asked me if he was getting help since the other kids didn't understand him. My son wasn't quiet. He talks ALL THE TIME NON STOP but what you can actually understand is an entirely different story. He is consistent so I think he gave up trying to say things right and just made up his own words for most things.

Now he is getting 1 on1 speech therapy (all sessions are at our home) once a week. They recommended that he have a major hearing test, which I have scheduled. He is also getting evaluated for development (which was recommended from his previous eval) where they will help him on a 1 on 1 basis and teach him to deal with strong emotions and social interaction. We already had a meeting with the school district since they will take over his speech lessons once he turns 3. Luckily his B-day is in August so there won't be a large gap of time when he isn't receiving help.

He has had sessions for 1 month and a half. With the combination of part-time MWF preschool (he started in January) we have noticed a HUGE improvement. He is a normal happy kid and my in-laws -and hubby- thought there was nothing wrong with his speech. I just noticed that there was zero progress in his language between the time of his 2nd birthday and his second evaluation. I wanted to be proactive on this since speech delay/problems runs in my family (brother, sister, aunt, grandfather, cousins).

The evaluation process is very painless. Connor likes it because he is the center of attention and the therapist brings toys to play with him with and he has a fun time imitating her. Anyway, I am glad that I went through the process.

I don't think there is any problem with getting a good evaluation and then getting therapy if needed. The main thing is whether you can find a good therapist who fits well with what you want to accomplish. We've dealt with wonderful speech therapists who have been a huge help, but we've also had some extremely stressful experiences. I think the concern doctors may have it that the referral and evaluation process can be stressful and can start people down the road to many more evaluations and referrals. We have had some that were extremely stressful and turned out to be completely wrong.

So I would encourage you to get an evaluation, but to carefully research where to go and then to get a second opinion if anything doesn't make sense to you. If they do recommend therapy, then find a therapist who you really like rather than settling for someone that you don't. There are different philosophiles about things like whether parents can stay in the room, whether children need to sit at a table during therapy, and about how much parents should be involved. If you can find someone whose philosophy fits with that of your family, then it can be a very helpful experience that can help any child progress more rapidly.

Good luck!

There is no reason not to get evaluated and get therapy. Even if a chid were somehow to get "misdiagnosed" and have no speech delay, receiving therapy cannot hurt. There is absolutely nothing negative about receiving speech therapy. My 8 year old has been receiving therapy for 4 years now and my 6 year old daughter always asks to go too because it sounds like fun. Once in a while the therapist will let her come back and do a few activities with her brother even though she doesn't need therapy, there is no negative effect :-)

I'm guessing that your mother is remembering the "old days" when a child might get labeled with a problem and be treated negatively as a result. Things are handled so much differently now. Chances are if your nephew receives services now he may not even need to continue them once he is school age but even if he does, how schools handle special services is so much different now that the kids are not treated differently other than just receiving the services that they need and are entitled to.

Good luck,
K.

As a mother of a speech delayed son, I can understand your situation. My youngest son has large tonsils and I was told his speech was a problem. Some say boys are slower than girls. My oldest is adhd and didn't talk much when he was 2 years old. Has his ears been checked out? My son with the speech delay had tubes put in his ears when he was younger. My boys are teens now, and my son still has a problem with saying his words. He was enrolled in special ed and had head start at a young age.
Each child is different, they will learn when they are ready, something you hear all the time. Some kids do grow out of it, and others it depends. Some say let the child learn when they are ready. Teaching him things is a good thing, even if he's pointing at things. The ears-nose-throat can be a factor. I hope his speech improves. G.

Why wait? There's no reason not to. I think the older generation feel there's a stigma if a child has special needs. But the earlier it's starter, the earlier the problem (if there is one) can be stamped out. And if there isn't a problem, then you get that peace of mind.

Has he had his hearing checked? I wonder if he can't point to body parts or follow multiple step directions because he can't hear them that well. Just a thought!

C.
www.littlebitquirky.blogspot.com

.

ok when i did speech on my first one it was because foot ball came out hubababall. he had problems with his r's like elmer fudd. his w's came out wrong. several other letters too I cant remember which ones. If he is hard to understand he will get fustrated which will cause temper tantrums. How well can you hear underwater? his vocabulary will increase with speech. at least have him evaluated to see how far behind he is. wether or not to do it now or wait is a judgement call on your sisters part. if he isnt too far behind other kids his age and is getting clearer. I would say he might be able to wait. but he has to have speech before he starts kindergarten if he needs it. mine did it for a year and a half. so he has to be there before he is 4.

maybe have him evaluated and reevaluate in 6 months. The only thing mine got out of speech was clarity but he was 4 when he went into speech. my youngest has tubes his speech is delayed. he says complicated words for his age and most of them are clear. I may have passed by speech by insisting he got his tubes done early. I don't think my youngest will need speech but it is too early to tell and it has to be ajudgement call. I love the expression trust your gut.

HI. My youngest daughter didn't speak more than a few words until after she turned 3 yrs old. I really wasn't concerned because she could follow multi-step directions (go to your room, get the pink bear, take it to daddy then come get mommy). She was very eloqunt with her face, body and hand gestures and you would feel as though you were having a complete conversation with her without her saying a word. In other words she always got her point across (and no, she didn't shreek!). None of my girls ever suffered with ear infections (thank goodness) and 10 years later it's hard to believe that she was so quiet....LOL I can't get her off the phone!! It just seemed like over night she decided it was time for her to talk, and she did talk in complete sentences when she started. She could say large words like Monongaheala (sp?) but would stumble over sprite. Yes, I had her speech evaluated at age 4 and again at age 5 and both times she tested at the low end of normal for her age. She never recieved speech therapy.

With all the ear problems your nephew has suffered with and knowing that kids are so resilent I would wait until age 4 before really becomming concerned if he can follow simple directions and is progressing normally in all his other growth landmarks. It is too easy to fall into the trap of pushing kids to do things before they are ready...from walking to potty training, to talking. Sometimes it is better to wait...kids are little for such a short peroid of time...we should let them be little while we can, when we can. Best wishes.

You should never wait an see when it comes to development. In answer to your question, we "waited" with our oldest. I knew that there was something different about her, but she had the ear infections, and fluid and the pediatrician wanted to wait, and antibiotics sounded better that tubes. When she was three, we go the tubes, and she could suddenly hear, and she started talking much better ASAP! The bad news? She did not just catch up. She turned out to have a high functioning form of autism, but we were so focused on the speech as a hearing issue, we missed our chance at early intervention. All the delays were chalked up to her ears, but we were not even on the same field we were so far off base.

Never, never wait. How do you know that the only issue is his ears? What has he missed that he will never, never, never have a chance to gain?
Been there, done that. If your sister is in the same boat, she will regret waiting, we do. Time is the one and only thing she has that is free. Tell her not to waste it.

M.

Hi Rachael,
Your story sounds so similar to mine! My son had chronic ear infections and tubes put in. He had fluid in his ear most of the time for about 8 months and was on about every antibiotic they make during this time - nothing would clear up his infections. During this time he stopped making progress in his speech and his personality changed. The very outgoing, flirtatious little boy that I knew preferred to be alone in the dining room..

Because at this age, this is how autism shows itself, everyone wanted to rush to diagnose him with autism. the school board here wanted him to be labeled this on his third bday after knowing him for one hour...

He is 3 1/2 now and we declined service with the schools for now and have him going to an OT and a speech therapist twice a week. He also is in a research project at Vanderbilt. Still noone can decide. One is focusing on Apraxia and one is focusing on sensory integration, and Vanderbilt is just saying it is an expressive delay. We took him off dairy because does a little stemming and has eczema and they sent us to a DAN doctor and that consultation blew our mind! We went to a regular allergist and he is not allergic to anything.

Everything is such a mystery right now. We just keep going to therapies as he is making much progress.. He is imitating everything we say and is finally starting to express a thought every so often. He likes to run and hide and lock himself in places when we tell him no about anything... And he has many tantrums and throws things.. We are told that this is normal with a child so delayed in talking. He has reasons and thoughts in his head and wants to respond but cannot. Please keep me updated on your son.