Sensory concerns linked to Speech Delay?

NoelBird · November 2014

Hello, I was hoping to get some advice from you ladies.

My son just turned two, when he was 18 months old he was identified as having a speech delay (no words then), we put him in EI and has been working with the same instructor since. We have seen a lot of progress but he is still behind. Outside of his speech my DH and I do not see any other concerns, he seems like a typical 2 year old. About a month ago DS started throwing tantrums when the EI instructor shows up, personally I think he doesn't want to be interrupted and have to sit down for an hour. He tantrums for a few minutes and then works with her just fine. The instructor thinks that DS is showing sensory and self regulation issues and is pushing us to put him in occupational therapy. She has talked about it for the last couple sessions and gave us a weighted vest to have him wear to calm him down. I am not convinced the vest is making a difference. She is convinced that if we got him into occupational therapy for sensory concerns that it will help his speech. While she is the professional it is hard for me to see any sensory concerns when she isn't around. He is perfectly happy and has no problem with other kids, family, strangers. He does throw tantrums but not excessively, he is also very active and has a hard time sitting still.

The only other people he acts like this around is the doctor or the dentist. Understandably these are not fun places for children. I did make an appointment for a consult with an occupational therapist for a second opinion but I can't get in for a month.

So in the mean time, do you guys have any advice? Do you guys think it sounds like my son may have sensory concerns or is this typical two year old behavior?

bumpuser511563 · November 2014

I am glad you are going through with an OT eval to see if there are concerning issues.

What credentials does the instructor have if she takes it upon herself to put a weighted vest on your child?

Only a OT can prescribe the right weight for a weighted vest or blanket and when to use it on your child.

NoelBird · November 2014

Hm, I didn't think about her credentials in occupational therapy. I know she is only classified as a speech instructor for EI.

I did some research online about weighted vests and I didn't see any negatives to trying out the vest. The vest was only a trial, I have to give it back at his next visit but I will discuss this when I go to the consultation.

I don't know think I have seen a difference in John's behavior since using the vest and unless it is prescribed by the OC I won't be getting another one.

hopecounts · November 2014

Agree with Sailor.

What qualifications does the person delivering speech have to 'prescribe' a weighted vest? The use of weighted items should be directed by an OT who has worked with the child and has a comfortable grasp of their particular presentation of sensory issues.

She may be seeing things that with her experience are indicators of sensory issues but the appropriate way for her to address that is to suggest/recommend an OT eval and leave it to the specialist to report any findings.

She isn't qualified to diagnose sensory issues at all unless she is is broadly qualified and even then she should let a specialist handle it.

As for whether he has sensory issues or not, it's hard to say.
Just from the mild resisting of ST I would say iffy BUT she may be seeing other things that you aren't picking up on so I don't think we can say.

NoelBird · November 2014

Thanks for all the advice, I do wonder if she is seeing other behavior that she deems atypical but so far she hasn't shared any with me. I also feel it is hard for her to get a true sense of his behavior when she only sees him once a week. But on the other hand I am not a specialist so I can't determine the difference between typical two year old behavior or something else. I am really curious as to what the OT will determine.

kcisthebombdotcom · November 2014

I'm guessing she probably notices some things you are probably writing off a typical toddler behavior. I remember thinking like you when someone suggested sensory issues with my then two year old. I thought he was just a busy high energy kid. He did have mild to moderate sensory differences and we did a year of ot. The ot definitely allowed him to attend to speech therapy. By 3 his expressive language was caught up and by 3.5 the sensory stuff had dissipated. He is still energetic but has zero issues with focusing and persisting in the classroom with less preferred tasks.

Micelle78 · November 2014

The long answer or the short one?

My son uses compression garments (like the vest but a high-tech very expensive shirt $250) but at the age of your son he still looked very typical. If she suggested this at all, I would be willing to bet she noticed some things and is not technically able to say because it is not her area. KWIM?

From someone who was in your shoes a little over two years ago, I would take the advice and have him evaluated. As DS has aged the things are more obvious or have just appeared as of late. When he was 24 months, we were not sure. Now there is no denying it. I do not know your son of course, but the worst that can happen is that they tell you they have no concerns at this time. Its hard to say what is normal at this age and what is not. She probably saw a few red flags and felt she needed to guide you that way. If you have any more questions, please ask!

FTR-- my son is 4, he gets private speech, OT, and vision therapy weekly. It all started with a concern with his speech

NoelBird · November 2014

-auntie- said:

This is a pet peeve of mine- the professional who crosses boundaries into areas beyond their expertist. The teacher who tells you it's time for meds, the SLP playing at OT, the OT who sees everything from tantrums to toenail fungus in the context of sensory integration.

That said, as a person who works intensively with people your DS's age, she has a perspective that you don't. I don't love her dabbling in the use of a weighted vest, but I know plenty of moms on this site and IRL who have done the same. The worst it could do is acclimate him to the weight so it becomes less effective as a tool. It's the schedule that matters as much as the actual weight- if she's there an hour I wouldn't expect this to be an issue.

That said, I'm a little surprised he protests his SLT. Most littles enjoy things like OT, SLP and PT at this age because it can look like a 1:1 playdate with an indulgent adult- most kids love that kind of attention.

You said:

The only other people he acts like this around is the doctor or the dentist. Understandably these are not fun places for children.

Unless your son has some sort of condition that requires a lot of unpleasant procedures, I don't get this. Most kids like their pedis, some even like the dentist. DS enjoyed the attention. Are the other kids in the practice similarly unhappy? It might be a clue that you need a more childcentric practice. Or maybe you're projecting.

TBH, it sounds like maybe your DS has trouble self regulating and has trouble being in a situation where he needs to do something that isn't his idea of a swell time. That could be a function of being a two year old or the SLP could be seeing behaviors that are beyond typical twos. It's hard to say.

I believe my son does enjoy the time he spends with his SLP once he gets over the transition. After his initial tantrum he is his happy self and plays very well with her. Luckily the transition time has decreased for each of the last three sessions, 20 minutes, 5 minutes, 3 minutes this week.

As for the doctor, luckily DS hasn't been very sick so he has only had to go to the doctor for well child check ups. As an infant he was fine but 15mo/18mo/2yr he cried the entire appointment. He has also gotten shots at every appointment so I always attributed his behavior to being scared because he was in an unfamiliar environment and he knew he was going to get shots. His doctors have always played it off saying this is normal behavior, that at this age they know just enough to be afraid. Besides dreading taking him to the doctor I never thought anything more about his behavior at the doctors. I do think that the doctor/dentist is more of a frightened cry vs. the speech therapist which is more a transition issue. At his two year appointment he was frantically waving 'bye bye' to the nurse to try and get her to leave and not give him a shot, it was heartbreaking.

It sounds like determining if this is normal 2 year old behavior or something else is what the OT will have to tell me. Thank you for your input.

NoelBird · November 2014

HoneyB1993 said:
My DD is a thrill seeker with SPD. Her OT has her wearing a weighted vest 2x daily for 30 minutes, but she only wears the vest while we are working on excersices.
DD does have a speech delay that we believe is related to her SPD. At 12 months she had 20+ words, but by 13 months she stopped talking. Her OT is letting us work with her at home until she turns 18 months, but at almost 17 months she uses no words.
Hope you get the answers you are looking for!

What do you mean by "thrill seeking"? I would call my some spirited, he is always mobile, would spend all of his time outside or at the play ground. He can climb anything and shows little fear of getting hurt. He has never done anything to test his boundaries such as jumping off high items though.

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