| I'd try to get more information first. If you bring a general 'She's not talking much' concern to your pediatrician, you're unlikely to get a response that's especially helpful. But if you can be more specific, your Dr. will have a much clearer sense whether or not *something* should be done, and a better idea of what that should next step be. First - Take a sound inventory. Set aside some quiet time for just you and your 3 year old, and with an old children's book (Dr. Seuss would be great) that you don't mind writing in, read her a series of short sentences (one at a time) and ask her to repeat them back to you, exactly the way you read it to her. In this test, you're looking to see what sounds she can make correctly. At 3, she's not supposed to have all her sounds down, but knowing what she does will be helpful. When choosing a book for this exercise, choose one that has a variety of sounds rather than a lot of repetition. In the book, underline what she says reasonably well, and circle the sounds she misses, and write down what she does instead. It may help to tape record her and supplement your notes later. But this exercise will give you a good idea what sounds she can produce. Her articulation at 3 will NOT be perfect, but it there are many sounds she's not even close on, then tell your Dr. you have reason to believe she has problems with articulation. Then do some simple tests of her receptive language -- what she understands. Ask her to put the ball under the table, then on top of the chair, then beside the bear. Have her show you the blue car or the small dog. Play with her and use lots of smiling to keep her engaged and having fun. Be careful NOT to use any gestures - if she often doesn't understand your words, she'll already be adept at picking up your non-verbal clues. Then try two-step directions- "Please bring me the ball and the bear." "Please close the door, then open the book." If she has a lot of trouble with this, tell your Dr. you have reason to believe she has problems with receptive language. Then see how she uses the verbal language she does have. A lot of professionals will jump right to the "Chances are the 7 year old does the talking for her" line as a reason to wait and do nothing. You need to know before you go in whether this is true or not. Talk to your older child, and tell her you'd like her help in getting little sister to talk more. When little sister uses a single word or gesture, prompt for more verbal language. If she points to a cookie, look confused and wait. (Even though you know what it means.) If she says "cookie" (or something close) ask "Do you want a cookie? Can you say 'I want a cookie' ?" and wait to give her the cookie until she does her best to ask. Manners later - this is a speech test ;-) Try to get her to use as much language as she has. If her speech and language is developing normally, this will not be very difficult for her (mildly frustrating, perhaps). If this causes a lot of difficulty or tantrums, particularly if she just grabs your hand to get the cookie instead, tell your doctor you have concerns about her expressive language. If you still have concerns after doing your own tests, the first steps should be a referral to an Audiologist for a hearing test, and to a Speech Language Pathologist (SLP) for a speech & language evaluation. It's usually pretty quick to see an Audiologist, but often there are long waits (several months) to see good pediatric SLPs. If you have concerns, politely insist that your Dr. refer you. The last thing you want is for your pediatrician to "Let's wait and see" then a six month wait for an SLP appointment. (That's what happened to us, and my son ended up having very serious speech and language problems and was more than two years behind when he was first seen at age 3.) |
