B.E. asks from Brunswick, GA on June 12, 2011
Speech Therapy - Brunswick,GA
My 2 year old just started speech therapy about a month ago. The SLP comes to our house once a week for a 1/2 hour. I am just wondering...what is normal for speech therapy? How do they typically work with the child? Are the supposed to try to discover what is causing the speech delay?
Maybe I am just impatient, but I expected more answers by now. Ya know? Like, possible reasons she is not talking...if she has a hearing loss...what could be causing it...etc. I am supposed to be receiving a referral from our pediatrician to have my daughter's hearing tested...
To give you some more details...she is receiving speech through "Babies Can't Wait". But the speech therapist cannot refer for a hearing evaluation. Per my insurance, my child's PCP has to be the one to do that. I am worried that an undiagnosed hearing loss could be causing the delay. Because she is very vocal - even speaking in sentences and questions. You just cannot discern the words usually. According to my daughter's new pediatrician, a hearing evaluation should have been done prior to her starting speech. Her old pediatrician "dropped the ball" on a lot of things, not just this. Thus the switch to a new dr.
Would it be totally obnoxious of me to call the dr's office once daily until they give me one? They said they would last week. I just don't want to have to wait another month! It took months to get my daughter evaluated for speech, then into therapy...we have switched drs since then, so I am hoping this dr will be more on top of things.
So What Happened?™
I called her pediatrician and left 2 voicemails on Friday and 1 today (Tuesday). If I do not hear from them tomorrow morning I will call their regular line and ask. The extension they transfer you to for the nurse, referrals, etc always go straight to voicemail. Very annoying. I know they stay busy, but my daughter needs a referral now, not in a month or 2 months, or however long they plan on taking. I want to get everything checked out with her hearing asap.
L.M. answers from Norfolk on June 12, 2011
A speech language pathologist is trained to work on improving speech, not diagnosing developmental disorders. Sometimes a specific diagnosis is helpful in determining modalities, but most often successful SLPs conform their methods to the specific needs of the patient, no matter the diagnosis. It's somewhat like going in for a teeth cleaning and wondering if the dental hygienist can tell you why your hair is falling out.
Pursue a formal evaluation, but try let the speech therapy "do its thing." Easier said than done, I know.
3 moms found this helpful
R.L. answers from Los Angeles on June 12, 2011
Speech therapy takes time -- it can be several months or more before real progress is made and years before all speech issues are resolved.
The issues you're dealing with with your daughter actually sound a lot like what I had to deal with mine. My daughter received speech services for years starting at age 5 because of dysarticulation (she could pronounce only 2% of all sounds made in English), and then later for dysfluency (stammering). She made huge gains in articulation in the first 2 years of therapy, then improved more gradually for another 2 years. She developed a stammer towards the end of this time. Because we and the therapist felt that the therapy was contributing to the stammer, we stopped therapy for a couple of years, then resumed therapy for both fluency and articulation for a couple more years in middle school. The results have been excellent. She has no fluency issues and is fully understandable (she is also semi-fluent in French, loves language studies, and will be minoring in Portuguese starting this Fall). As far as the hearing issues went, much of her poor speech was due to temporary hearing loss. She had constant colds and congestion from allergies for 6 months out of the year starting as a toddler, and when she was congested had about a 25% hearing deficit.
As for the hearing test referral -- if you feel the Dr.'s office is dragging its heels, I would go down to the office and park yourself there until the Dr. issues one. It shouldn't take long to request the referral -- all the office staff have to do is call your insurance company, and maybe fill out a little paperwork. Make sure the referral is for a full ENT evaluation, as the ENT specialist will also look for structural and/or muscular problems of the mouth, throat, and larynx that could be contributing to the problem. You should also check with your insurance to see what coverage they offer for speech and language pathology diagnosis (most companies don't offer this coverage, except for in advent of an injury or stroke, so don't be surprised if there's no coverage). If your doctor thinks there may be neurological issues involved, you should also get a referral to a neurologist, and possibly an educational psychologist or resource specialist.
Another avenue you can explore for diagnosis if you can't get one otherwise, is to check with local colleges and universities to see if they have speech pathology programs. Most of these won't be free, but they are frequently at a much reduced cost. Some schools will requests fees on a sliding-scale. An advantage to going through a college is that they can often offer more cutting-edge information and services. Therapy will often be at the hands of an advanced student (usually a graduate student), supervised by the program professors and directors.
Good luck! I know how frustrating this can be.
1 mom found this helpful
E.S. answers from Jacksonville on June 12, 2011
Florida has an Early Intervention program called Early Steps. You don't have to be referred by your doctor. The first thing they did was a hearing test for my son, before they offered speech therapy. I would suggest you check to see if Georgia has the same type of program.
Is the speech therapist having you use sign language? Our therapist explained that you can't force a child to speak, but you can move their hands with sign language so the child starts to understand that words have meanings. We started with more and eat. It took about 4 months before my son was using the sign language without us prompting him. We've been doing therapy for a year and he now says those words and others on his own. He still uses sign for some things. He loves the baby signing times dvd's. If you are going to do sign language I would recommend getting one to see if your childs them too. Your speech therapist may even have some for you to borrow.
A.Y. answers from Detroit on June 12, 2011
Michigan has an early intervention program for kids under the age of 3 called Early On. You make the referral yourself. An evaluator comes to the home to do tests, sets up a hearing test with the county, and assigns a case worker. Once my son was 2 1/2 they had him in a 5x per week speech/preschool that made a huge difference. During the summer, I hire a speech path 1x per week but on the other days she gives me "homework" to do with him since 1x per week won't make a huge difference. They need a lot of practice. He has been receivng services for a year now and has made progress but still has a few more years of speech therapy to go. Also, see an ENT - your child may need tubes. Can be hard to get into the specialist but your pediatrician could call on your behalf & have better luck.
L.R. answers from Washington DC on June 12, 2011
Regarding getting a referral from the doctor's office: A week, or two, is not at all unusual for a wait to get a referral. Then you will have to wait AGAIN because the minute you get the referral, you'll call the hearing specialist's office, and they'll tell you "Our next appointment is in three weeks" or whatever.
So I would definitely hound the pediatrician's office a bit for that referral if it's already been a week. We have had to bug our doctors (not peds, but for us adults) repeatedly for referrals in the past -- referrals get lost or they mail it when we specifically requested that they call and let us pick it up in person, etc. Find out if ONE person is the point person for all referrals going out of the ped's office or if several different folks could have handled it -- having more than one person on that job means confusion, I think. It may be sitting there on a desk "because we thought you wanted to pick it up" or it may be stuck in the mail instead "because we thought you wanted us to mail it" etc. etc. Yeah, I'm not a fan of waiting for referrals, especially because once you have them in hand, you must begin the process of making an appointment with the specialist and the wait for the referral really backs that up.
Some specialists will let you go ahead and book the appointment even if you dont' have the piece of paper from your doctor yet, as long as you have the paper when you walk in the specialist's door. If you know who the hearing specialist is, maybe they will let you do that to speed things up. But if they won't, or you are waiting for the ped's office to give you the name, keep reminding the ped's office.
L.G. answers from San Diego on June 14, 2011
We started the process of my daughter getting evaluated for speech therapy when she was about 4 or 5 months shy of her 3rd birthday through an early intervention program and children's hospital. By the time we got the evaluation completed (and they hadn't done a hearing or vision test yet) she was already 3 and therefore would no longer be covered under the intervention program and would have to receive services through the school district. Possibly because you are going through medical insurance, like most other medical processes, it takes a bit longer because of the red tape. But then, we thought we would have to go through a lot of red tape having to deal with the school district and budget cuts, but we have had no problems, they evaluated her, tested her hearing and vision all on the first meeting and began speech therapy 2 times a week within a few weeks of the first meeting.
The entire speech therapy process does take a long time, I remember being almost heartbroken when I found out that most kids go to speech for at least 5 or 6 years.My daughter was going for 2 years and we decided she had been making good enough progress that we stopped it this year, per the therapists suggestion. Well 6 months later, I can see that she needs it still/again and so we are back at it beginning this fall.
I would continue to be persistent but also realize it probably just takes awhile because someone above someone else has to have the final say and approval.
On a separate note, my daughter had the same problem. She was very vocal and spoke in complete sentences but left out many of the sounds, she most often substitued "h" for most sounds, but regardless, you couldn't understand most things she was saying. She ended up not having any hearing loss or any other medical problem. Good luck.
S.H. answers from Honolulu on June 12, 2011
My son had speech therapy, from 19 months old until almost 3 years old. He was simply delayed in speech.
They were from our local Early Childhood Intervention organization. Came to our house.
I called them myself. I did not have to get referred by our Pediatrician. It was free. Because it is for kids up until 3 years old.
ALL speech therapists, have different styles of working with the child.
But, they go according to YOUR child's, needs/situation.
It is not a generic template they use.
Your Daughter has JUST started speech therapy.
You need to give it time.
It is not instant.
It is not like 'something' is causing the speech delay. So don't expect that.
It is just development or motor skills. In my son's case. Or yes, IF there is a hearing problem, then that can cause it too. BUT, the child still needs to be worked with, per speech development.
Per the assessments they do on the child, they know what areas needs to be worked on.
In my son, he was just speech delayed. NOTHING 'causing' it. It is just developmental. But, in all other developmental areas, he was advanced.
He just took awhile to master speaking.
Einstein, did not talk until 3 years old. And he was a GENIUS.
Do not get impatient.
It is a process.
No kid, talks instantly.
My son had speech therapy 1 time per week for 1 hour.
The frequency of the sessions, depends on YOUR child's, condition.
Each child's schedule/session length and frequency, will vary.
Just ask the Speech Therapist, questions on this.
They should be able to tell you.
Not the Pediatrician.
The Speech Therapist is the one you ask.
In my son's case, the Speech Therapist does an OVERALL developmental assessment. Then based on that, they know what is 'wrong' with the child.
AND they then go over the assessment with the parent, and tell you of their findings. And how they work with the child.
In some cases, hearing problems may cause speech delays, or somethings like "Apraxia" or "Dysphagia." But again, the Speech Therapist, per their assessments, can evaluate this.
D.B. answers from Charlotte on June 12, 2011
I don't blame you for being impatient about getting her hearing testing. What's up with the delay? Do you just need a referral from the doctor? They're really dragging their heels! Bother them til you get the referral, then get the soonest appointment you can with the ENT.
It's a shame that you don't have two half hour appointments per week. That would be better. It may be too early to know the REASON why she isn't talking for the SLP - let her work with her longer. She will write up a quarterly report on what all she has done with your daughter and test her for how much better she can do things since the last time she tested her.
Are you working with her every day, twice a day, on your home program? That is essential, without fail, or speech therapy itself will not work.
Get that ENT appointment - that part is very important. Ask for a tympanogram to be done as well - that looks at the pressure in her ears.