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Socialworkgirl
member
Speech Therapy Questions
Socialworkgirl
member
Today, DD (turned 2 about a month ago) had her assessment with Early Childhood Intervention. She was at age level or above for everything except expressive communication, for which she had a 20 percent delay. Here in Texas, they use the Battelle Developmental Inventory and to qualify for services, she needs a 33 percent delay so we don't qualify. The person assessing her told me that the Battelle gives a lot of weight to the fact that she can communicate her needs through gestures and that is why she didn't qualify. Our insurance does not cover speech therapy.
I am looking for recommendations about what to do from here. My main concern is her speech. She only speaks about 9 words and only uses about 5 of them (Mama, dada, yaya--which is what she calls herself, bye bye, and wawa--for water) unless specifically asked to say the word. She uses lots of signs and gestures and understands what we say very well. My only minor concerns outside of speech are that she is anxious around other kids her age because she does want them to touch her or get too close and if she gets really upset, she can be very difficult to calm down and is likely to throw up. However, these things are getting better with time.
We have her 2 year well check up on August 22 and will of course discuss my concerns. I am thinking that we will try to find a speech therapist who will be willing to see us on a monthly basis to give us strategies to work on at home and we will pay out of pocket.
Here are my questions:
- should we push for a referral to be assessed by a developmental pediatrician?
- are there other questions we should ask the pediatrician when we meet with her?
- any recommendations of books or other resources that might help me work with her at home on speech or just understand speech delays and/or how to advocate for DD
- any other recommendations about steps I should take.
Thank you in advance!
This discussion has been closed.
Re: Speech Therapy Questions
We moved across country and DS was not so lucky. Did the people who tested your child not give you information on how to work with your child at home? If not, I would call and ask for some tips from them. I got a lot of information to help from both states at testing. Also, when DS didn't qualify a teacher friend of mine suggested looking at area colleges to see if there were any SLP students looking for experience. Also, there is a ton of speech therapy activities for expressive delays on pinterest. I used to have a board full of stuff, but I deleted it after DS's expressive language improved.
Oh, Texas. We have been in that exact situation. Sounds so familiar. By 2 my daughter had less than 10 words and hadn't really added any new ones in months. I knew something was wrong. I started worrying around 18 months and finally called EI at 22 months. They came just before her second birthday. Her expressive language was very behind but her receptive was so ahead so it cancelled each other out. They basically said yes, your daughter is behind on expressive speech but we can't help you. Good luck. It was the most frustrating thing ever.
We were lucky and have insurance that covers private speech. So, we started that a few weeks later and eventually ended up with an apraxia diagnosis. 6 months later I called EI again and they STILL wouldn't help me even though her delay was significant enough to qualify at 2.5. Why wouldn't they help? Because it would be a duplication of services. They also would only come twice a month whereas we were doing private two times a week. So, no. The early intervention program here is SO flawed.
In retrospect, I should have fought their decision. I didn't know I could. When you have your pediatrician appointment at the end of the month I would ask your pedi to make a call on your behalf. I would also get an assessment done with a private SLP. That report can help you make your case with the powers that be at ECI. It may be fairly expensive OOP, but not too bad.
The good news is that the school district has been much, much easier. They pushed us through the system super fast when they found how out how much ECI dropped the ball.
playingwithwords365 is a great blog that I looked at a lot in the beginning. You can work on speech at home yourself (I still do) but you want to make it fun. Pinterest has great ideas, too.
Good luck!! If you have any other questions please ask. If speech is your only concern and the only area there is a delay you don't need a developmental pedi.
Oh, I will also add that school has been amazing. We did a MDO program 3 times a week last year and she made so much progress. She learns best from her peers so her speech really started to take off when she saw how much her friends were talking. In September, when she was almost 3, I was still counting words. By May she was getting in trouble for talking to her friends during naptime. I hope you have the same success. Speech has kind of stalled this summer without that social interaction so I'm ready for school to start again!
I did want to mention something about the expressive vs receptive delays. When DS was 18 months, I began to get concerned about his lack of expressive speech. Many people told me that because he had great receptive speech (he understood everything we said), there was no way he would qualify for speech services. I still went ahead and had him evaluated through EI at 23 months. He was in the normal range for receptive but had an expressive delay of 45% (he maybe said 5 words regularly, did point or pull me to something that he wanted, and used a couple of signs - more and milk, I think) He did qualify for speech therapy and he will likely exit the program soon with expressive language skills beyond his age. I realize that is not the experience of OP, or of other posters here, but I wanted to mention it in case other people are reading this and thinking their non-speaking toddler can not get services because they have great receptive speech. I'm sure it depends on what state you live in, their EI program, and the extent of the deficit. I was almost discouraged from getting him evaluated, and would hate to see others discouraged as well.
I didn't speak until three either...except I didn't catch up magically, needed speech services through third grade and it had a negative impact on my early school years. Obviously I don't hold my parents responsible since things were much different back then. In something like 10-20% of kids late speech is a sign of language disorder or learning disability. I will never understand the wait and see approach or people being so lax about issues significantly outside "typical" development. Better to have kids seen by a specialist that's unnecessary than let some kid go undetected in such a critical window of brain development.
I think its a common myth that an autism dx is oh so easy to get. I'm sure there is somewhat as doctors use it for kids who they're not sure on to gain access to more services. And yeah, 10% of people dx with autism young lose the diagnosis and certainly some are misdiagnosed. The thing is these people are not neurotypical. They still struggle socially and communicatively, just not to a degree where they meet the dx criteria. Many go on to get diagnoses of other neurological disorders they may not been able to identify at two or three. There's no epidemic of treating neurotypical kids in our country. My son barely spoke until 2.5 and not a single doctor/therapist recommended that I have him evaluated. Heck, they didn't even for my child who is on the spectrum.
I've been lucky with ei/insurance and it seems to be a 50/50 mix of what I read on bump boards throughout the past couple of years.