Speech Delayed

ninosJuly 28, 2007

My son is 4 and will be 5 in october. He has been behind in speech since he could talk. When he turned 2 i took a class called "It takes two to talk." Being he is my third child i was already doing the right things and the class did not help much. I stuck with it to keep my foot in the door for further help. At age 3 he started the Early Childhood Speech program. Luckily he has a late birthday and will not begin kindergarten till next year. He will spend this coming school year in his speech class. I never was worried about him. I have to admit that he is the baby so their is a part of me that likes his baby talk. I am becoming worried now. When i watch him interact with other kids(especially boys), they are not always nice to him. Most of them dont realize that they are being mean. However some are just plain mean. They say things to him when they here him speak like "Whats wrong with you" or "Why cant you talk" and many others. I am becoming the mother hen. I rarely let him out of my sight when we are around people that we dont know. His feelings get hurt and when he crys i have to be there for him. I pray this year we will see great improvement. He is very smart. He speaks in complete sentences. The hard part is uderstanding the words especially letters F,C,K,S,and H. I guess what concerns me most is his social skills. They are actually pretty good even though he is a bit shy at first. What scares me is his feeling getting hurt with other kids and eventually it tears down his social skills. Any thoughts or suggestions would be great.

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Is he is speech therapy with a licensed SLP? I know you said 'Early Childhood Speech program -- but the quality of those programs can vary widely, and an ineffective program or one that's geared toward a problem your son doesn't have won't do much (if any) good!

My younger son had a great deal of difficulty with speech, but luckily for us, a good friend put me in touch with our city's best resource -- so my son's speech problem was diagnosed quickly and correctly (childhood apraxia of speech) and we began appropriate treatment right away. Within a few weeks, it was very clear that the treatment he was receiving was effective, and we began to see good results.

But then we moved, and he was enrolled in our local school's Early Childhood Speech Program. It took me several months to ferret out that their "treatment program" was what is called a "language enrichment" model -- In a nutshell, they assumed that the child had been language-deprived at home, and that all he needed was lots of exposure to good language models, a little encouragement, and time to develop. WRONG! It took 3 meetings, finally bringing in the district's head SLP to get the school to provide appropriate treatment -- at which point, positive progress resumed.

Ninos - I've seen your writing, and it's clear you're able to provide your son with good speech and language models, so just being around more good speech won't cure your son's speech problem. If the other kids his age are teasing him because of his speech, your son needs speech therapy. If it's just a few sounds that are problematic and he's speaking in complete sentences, then it's probably not as serious a problem as my son's, and just a few months of good therapy should be able to really help.

I'm linking to a site called Apraxia-Kids.org. I'm not suggesting your son has Apraxia (unlikely) -- just that this site has the most incredible resources for early childhood speech problems.

Here is a link that might be useful: Apraxia-Kids

    Bookmark   July 28, 2007 at 10:35AM
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Saying pretty much what sweeby says....get him to a speech therapist....or at least work with him at home. I am sure he doesn't like to "talk funny". Can't you help him know where to put his tongue to make the consonant sounds?
Also has he seen a dentist? And have you talked with your pediatrician about that? There could be something else going on here...hearing problems?
A speech problem is really debilitating for a young child, I hope you can get to the root of this very soon.
Linda C

    Bookmark   July 28, 2007 at 1:49PM
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Thank you for your thoughts and advice. My sons teacher is a licensed therapist. She was greatly recommended by another teacher whom i greatly admire. His hearing has been checked and is fine. I am beginning to wonder about apraxia. My sons speech seems to be the worst in his class. I noticed that last year when we had play dates with the class. Alot of the kids seemed to speak very well. School begins in September and i plan on meeting with his teacher and bringing up the idea of my son having apraxia. Thank you sweeby for the link. It was very helpful.

    Bookmark   July 30, 2007 at 11:26AM
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Just a caution -- I'd hold off on bringing up 'apraxia' if I were you. It would be like going to the doctor with a headache and telling him you think you have meningitis. You might be right -- but you'd damage your credibility from the start. Apraxia in children is very rare and very hard to treat, and the schools consider it seriously over-diagnosed. Hence, their first reaction is likely to be over-anxious mother, which you really don't want. If they consider you over-anxious, they'll discount everything you say. (Informed and assertive is good -- over-anxious is bad.) Better to go in suspecting an 'articulation disorder,' which basically just means he has trouble pronouncing words. He'll still need speech therapy - but leave the diagnosing to the professionals.

That is, unless, from your reading on Apraxia-Kids, you become convinved that apraxia is, in fact, what he has. If that's the case, you'll need a private SLP to back you up, and probably private speech therapy in addition to what the school provides to get sufficient treatment to produce good results. (My son had 1:1 therapy 6 times per week in the beginning!)

    Bookmark   July 30, 2007 at 9:51PM
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Can I ask you about your son's small-motor coordination? My 5-year old has a speech delay (articulation) and has been seeing a speech therapist since he was two. I have noticed that his small-motor coordination is very poor. He has trouble drawing (can't draw a face correctly)and he has trouble writing letters and numbers. He can not write his name. I am delaying kindergarden and I am having him evaluated by an OT specialist tomorrow. Lately I have been wondering if he has apraxia. I thought I would mention it to the OT person tomorrow. What do you think?


    Bookmark   July 31, 2007 at 11:37PM
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Our daughter, now 26 yrs old, was diagnosed with both speech and motor apraxia when she was a toddler. She not only had the tell tale verbal apraxia but was unable to do simple motor activities without a lot of practice. We had to do many excercises with her to help with the motor apraxia. For example, we had to swing her a lot, had to do patterning excercises where you would do an excercise on the right side and then immediately do the same on the left side, etc. Her right and left sides of the brain didn't "talk" so we had to build the nuerons to "make" them talk to each other.
Speech apraxia was a different set of excercises. She started both therapies at 18 months and was in both private speech classes, private motor apraxia classes, and also in a special pre-school for kids with apraxia.
She's now 26 yrs old and her speech is pretty good...has some problems with a few sounds such as the SH, CH, Z, and J sounds. Her fine motor skills are not what they should be, but she finds ways around them. There is no lifetime cure for this, but lifetime therapy does certainly help!

    Bookmark   August 1, 2007 at 3:13AM
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Hi Babs - Yes, my son's fine motor coordination was also pretty terrible, and he had years of OT. It's good that you're getting an evaluation for your son. When ours was first evaluated by an OT (or maybe it was a PT, come to think of it), his diagnosis was "developmental coordination disorder" or "clumsy child syndrome." That was later ammended to Global Dsypraxia by his neurologist and his SLPs and OT agreed.

Since your son is 5 and will soon be learning to write, let me share what worked WONDERS for our son. It's the program Handwriting Without Tears and it was taught to him by his OT. Within 6 months, our son, whose fine motor skills tested at below the 2%'ile, was printing at the 70-80%'ile. He is still (5 years later) regularly complimented on his beautiful handwriting. I cannot praise this fabulous program enough --- Any good pediatric OT should know of it.

Anyway -- I guess your real question is whether or not your son might be apraxic? My advice would be to spend lots of time reading the Apraxia Kids web site and see what your gut tells you. Since he's had 3 years of ST and also has fine motor problems, I think it's a possibility that should at least be ruled out. Your OT may or may not be able to diagnose -- ask her. And also ask her about the population she works with. The best therapists to treat apraxia will probably work with a lot of young children, many of whom will have autism spectrum disorders, cerebral palsy, perhaps Down Syndrome, Disorder of Sensory Integration, and of course, dyspraxia or apraxia.

Good luck - And let us know --

    Bookmark   August 1, 2007 at 9:53AM
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Thanks, Sweeby.

I did take my son to be evaluated, and the specialist is recomending OT. I didn't mention Apraxia, but I will mention it to whoever he is assigned to this fall for OT. I have looked at the Apraxia website (stumbled across it while searching for fine-motor problems) and I'm not possitive that he has it but like you said, it should be ruled out. My son has always had very good large-motor coordination, has never been clumsy, so that's one reason why I'm not sure he is apraxic.

The preschool he is attending this fall uses the Handwriting Without Tears program so I am glad to hear that your son had so much success with it.

Thanks for all your help!

    Bookmark   August 3, 2007 at 11:54PM
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"My son has always had very good large-motor coordination, has never been clumsy, so that's one reason why I'm not sure he is apraxic."

My son also has very good large motor coordination, though he is clumsy. Riding a tricycle and bike were the only milestones he reached on time. Not sure how that can be, but it is...

Any updates?

    Bookmark   August 31, 2007 at 2:03PM
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