Speech Delay Question - First Words/Phrases

tiffanyirene · October 2014

Hi There,

I have a three and half year old girl who has a speech delay. She's in a fantastic special ed preschool program that started in September. A little back story on her, we started her in private speech therapy when she was 2.5 and we’ve bounced around a lot due to insurance issues. She started talking (words) right before her third birthday and that was also when we reached out to the school district (required age was three). After her assessments and IEP were formed it was the end of the school year so we were unable to utilize their therapy services until this new school year. Like I mentioned above, throughout the summer we had three other evaluations before finally finding a place that would take our insurance. Coincidentally this was also around the time school picked back up so she started seeing a therapist there as well and then she was recommended for the preschool program.

She’s doing great since starting in the preschool and is saying multiword phrases like “open door please”, “mommy help please” (on her own) and singing songs like the ABCs and Twinkle Twinkle Little Star. However my question (which I’m considering asking her teacher but feel I might just be neurotic, because they think she is doing so great, here’s me focusing on the negative) has anyone else had a kid with speech delay, what was the communication process like in the initial phase? I’m concerned my daughter is more or less memorizing phrases that will get her what she wants because to me it sounds rehearsed and a little unnatural. Like she emphasizes weird parts of the phrase, not sure how to describe it. I’m wondering if this more or less typical and I’m just over thinking it? Also, aside from the speech delay she has not been diagnosed with any other conditions.

hopecounts · October 2014

Has she had a robust developmental evaluation?
I would want to see a Developmental Pediatrician given what you are describing as a safety measure to make sure she gets the most appropriate and effective therapies and a Dev. Ped. can give you some solid info on if there is just speech or more going on and put your mind at ease.

Scripted speech can be a normal phase of speech development that fades as 'real' speech develops and is NBD but it is also common in kids on the spectrum a specialist in development

tiffanyirene · October 2014

-auntie- said:

usually I tell moms to trust their guts, in your case it should be trust you ears.

If her speech sounds "off" to you, it probably is. Going forward as a preschooler, it could impact her socially as typical kids will immediately pick this up. It might be worth having this conversation with her SLP to start. If you haven't had her hearing checked, this might be a good thing to rule out as well. If that doesn't bring some clarity, and she has other quirky behaviors related to sensory issues, engaging with peers, difficulty going with the flow or is an otherwise "intense" kid, you might want to see a dev pedi team. - I'm likely going to bring it up at her quarterly meeting with her teacher and speech pathologist, if it's still a concern then. I go back and forth on it because just when I start to have my doubts we have nights like tonight where she's on it, using her words spontaneously and in a variety of situations, some of which we didn't even teach her (example, tonight she said "Mommy pugs in", while I've said it things like "Let's let the pugs in" she's never repeated or asked me, in fact I thought she was saying pumpkin at first (whoops) ). We have not had a full development test done on her, she's had two pediatricians, neither recommended it. Her current wants to "watch" her to see how she develops and get a feel for whether her delays are primarily due to her lack of communication, which is also what her school thinks.

The scripting could be a stage as she acquires more spontaneous speech. Or it could be a form of functional echolalia where she does a learned scipt because it gets her needs met. This is sometimes more of a ASD associated behavior though other speech glitches sometimes result in echolalia. - She learns the script definitely from us, we make her say things for example instead of just saying "help" I'll say "You need to say, I want up please" and she'll normally take her best stab at that. Although phrases are new for her.

The intonation piece is concerning. It could be she has learned scripts verbatim- perhaps from a SLP who emphasized a certain word as part of the instruction. DS often mimicked teachers at this age when he picked up words and phases picking up odd phrases and regional accents along the way.

A piece of what you're describing sounds a bit like a glitch in prosody- the pitch, speed, rhythm and emphasis put on speech that conveys additional meaning to it beyond word choice. -This is my concern a little bit, I just don't know if it's just me. My husband is not concerned and her teachers/therapist also do not seemed concerned, they are always saying how great she is doing. You might also be hearing a flat affect in her voice where her speech might sound flat and devoid of emotion. These kinds of speech glitches are more often associated with an ASD.

Just curious Auntie, I troll a lot on here, what is your experience? Your input is always very detailed, I'm just curious

.

kcisthebombdotcom · October 2014

I agree with auntie. I'd probably start with the slp and move on to a developmental pedi if other things are ruled out like hearing issues. My son with an isolated speech delay that Is now resolved didn't do this. He has some issues with stuttering/word retrieval/artic when his language finally exploded but they went away. My daughter speaks a lot with scripts with glitches in prosody (though she does have lots of spontaneous speech as well). She has autism.

tiffanyirene · October 2014

Thanks everyone for the responses

. I pinned down her teacher today and discussed my concerns with her. She told me it's very natural to "script" and have some glitches in tone/emphasis because DD is still figuring out words, phrases and how it all fits together. The only thing they are now concerned with is that she was clenching her teeth when she was excited making her look a little aggressive (even thought she wasn't trying to be) so they worked with her to stop that. However, now she has started to rub her chin (hard) on people when she hugs them or around us (her dad an I) she'll play with us and rub her chin on us. They think she may have some oral sensitivity she is trying to meet. An Occupational Therapist is going to meet with her to determine what we can do for her.

Speech Delay Question - First Words/Phrases

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