Does my child need speech therapy? What to expect

So it’s official. The diagnosis has come through. Our little girl has a speech delay. Confirmed by a real qualified speech therapist. And she’s going for speech therapy. I’m only delighted.

Not delighted that she has a delay in her speech of course, but that she is going to receive care. It feels like a good outcome after all the niggly worries for the past year or so – because really, that’s how long it’s been on our minds. At 18 months she wasn’t showing the speech signs she was supposed to and that has carried on until now at almost two and a half.

To give a bit of history and especially for other parents who might be going through the same thing, I wanted to outline what we noticed, what we’ve tried, what’s working and how our first speech therapy appointment went – because I had no idea what to expect and I presume, if you’ve never been through it either, you will be wondering the same. I hope to check back in then when we’ve completed our course next year and to look back on her development.

Overall Mammy view
First off, I’ve never been massively concerned about this issue as a whole. It wasn’t something that kept me awake at night, like say, when she’s ill with a sky rocketing temperature or even in pain with teething. I’ve always felt that she’s developing at her own pace and because her understanding of things is very good, her speech is something that will follow when she’s good and ready. It’s been a concern yes, but as she is happy and healthy in every other way – I think in a year or two’s time, we’ll be right up there knocking all those speech milestones out of the park. At least I hope.

We haven’t identified a reason for her speech delay. She crawled and walked very early and her balance and motor skills are very good – at our speech therapy appointment the therapist noted that these were ahead for her age, so it could be that she’s been concentrating on other skills and not speech. Who knows?

What we do know is that while other children are uttering almost a hundred words, making conversation with their parents, asking why over and over and stringing together the start of full sentences, we only have a handful of words, never the question why and no attempts in most cases, to copy us when we speak.

You know when you hold up something and say to a child ‘doll’ or whatever and they copy it? She never did that. It’s like she can’t be bothered. She looks at you as if to say ‘so? I know what it is Mammy. Now get it out of my face.’

This has had the grandparents ultra concerned. They couldn’t understand the complete silence. Creche and playgroup were suggested and shortly after her second birthday I got her into childcare for two afternoons a week. We’ve noticed a bit of an improvement, but not very much.

What we’ve noticed
Apart from the delays as outlined above, I’ve noticed that we have learned to communicate in other ways. Sometimes, I’m so proud of myself as Mum that I get to the bottom of what she wants simply by the tone of her whine. Or point. Because she barely uses words, most of our communication is through body language.

‘Gone’ is her word for everything. It usually means – I’ve left my doddy down and can’t find it, please go and get it for me or these crocodile tears are going nowhere. She doesn’t have a word for ‘doddy’ so gone it is.

You have to be patient with her and go with her into the kitchen or wherever she wants and go through things in a process of elimination. I’ve learned that ignoring her wants or needs is not fair on her and you have to do the talking for her – because she simply can’t. She does get frustrated with her communication, but not greatly. Most of the time, she’s a very happy little girl. Only recently I’ve started talking to her more and more in conversation and explaining things to her because I’ve realised that she does understand a lot more than she can say. I think I’ve been holding back from talking to her because I thought she wouldn’t understand. I kind of feel bad about that.

Things we’ve tried
We’ve done a few things over past few months to try and get her talking. Her Daddy arrived home with flash cards, which were fun for a while, but we ended up playing Go Fish if we’re honest about it. She learned to recognise things and animals, but she still didn’t speak them. I spent a lot of time reading her books and getting her to point out what we were reading – where is the tractor, where is the farmer, where are the duckies, what do the duckies say?

She’s brilliant at animal noises, she’s been snorting like Peppa Pig it feels like since the day she was born, but again, these haven’t translated into words. She can say wuff, but not dog. She can say quack, but duck. Miaow but not cat. While she’s happy to point things out, it wasn’t encouraging her to speak. That’s why I’m looking forward to our speech therapy in the new year, to learn how we can enhance our games and techniques into getting her yapping.

One game I’ve been playing with her lately is a little bit of roleplay and it involves the phone. (Either the shower head in the bath, or our mobile, she isn’t fussy). I tell her I’m ringing someone – nana, her cousin, her older sister and pretend I’m having a conversation and hand the receiver over to her. She really thinks there’s someone at the other end of the phone and she’ll say Hi, wee wees, bye. This is her telling her story about how she’s potty training now. It really is such an advance for us!

A big thing that has helped is switching the TV off and playing games with her and her toys. She just loves when you take an action figure and pretend it’s talking to her or go weeee and make it fall down. I’ve been trying to introduce words along with this, so that she associates it with fun. We’ve had marginal success – but hey we’ve had the craic doing it.

How to get referred for speech therapy
Even though I’d felt there’d been an issue with our little girl’s speech from 18 months on, there were no check up appointments scheduled until two years old and this is where we raised our concerns. I do know of other Mums in my area who had 18 month appointments with their children and some of them were noted that there may be an issue and were brought back at two years for a check up. I guess it depends how your local health centre operates.

Our public health nurse agreed with all our worries and referred us to the public waiting list. We got a letter soon after to say we were on the list and roughly where we were in the queue. It took a little under four months to get our appointment – this was an ok time for us to wait, as it meant our little girl was getting older and with the introduction of crèche we could see if socialising her would improve her.

Our nurse gave us some good advice, like making sure we limited dummy use and limiting the amount of TV she watched. I think up until then, because I hadn’t been overly concerned, I hadn’t noticed how many hours of gogglebox we were totting up. Our new rule became ‘doddy is for nighttime and naptime’ and when I say that she phlegms the doddy out of her mouth into my hand. She thinks it’s hilarious, and so do I to be fair, but at least she gives it up. She will usually find a way to sneak it back in at various stages of the day and sometimes I give it to her too if I think she needs comfort but hey, I’m a Mammy – stop judging me.

We did consider going privately for therapy too, but because I don’t feel that things are too urgent – it’s not like she’s showing other signs or problems, we didn’t go down this route. I do have some lovely speech therapist friends however who sent me on some worksheets of things to do and we tried these also. Again, with my mammy hat on, I think the ages of two to three are so variable and it would really only be if she was older and not speaking at all, that I’d been going for intensive private therapy.

Speech therapy appointment
You should probably go into your speech therapy appointment a bit better prepared than I did. You’ll need to remember a lot about your child and with my current baby brain, I struggled with some of the answers. We found the room lovely and packed with toys, so it kept the child busy, while Mammy and speech therapist got to work. In our interview we looked at things like:

-Overall health

-Diet and sleeping

-Babbling as a baby

-When first word was spoken

-When first walked / crawled

-Motor skills

-Use of words and languages

-Types of words and language

-Frustrations

There were a lot of questions to answer and some of them I really couldn’t remember when or at what stage she did things. I didn’t feel judged in any of these questions, they were really to assess at what level our little girl was at and to see if she needed further help. This took up the majority of our time – almost an hour for the interview part.

Next we went to play some games. The therapist asked our little girl to do some simple tasks, checked her speech prompts – could she say what the therapist encouraged her to say and to identify and carry out a more complicated action.

She diagnosed that her understanding of language was very good, but that her expression of language was way behind this and so she needs to have therapy to bring these levels up to more matching levels. My understanding from what the therapist was indicating, was that sometimes children don’t have an understanding of language and that’s why their speaking would not be good. I think in these cases further tests may need to be carried out or other health checks other than speech therapy – but don’t quote me on that.

Speech Therapy
We were referred to a group programme, which lasts six weeks and involves Mammy or Daddy bringing our little girl into an hour’s class with other children to learn techniques to bring on our child’s language skills. It’s free and we’ll have an appointment afterward to check how we’re doing. I love the sound of it and I hope it’ll really help us as parents, help our little girl.

Speech Homework
We were also given some techniques to work on at home. I can’t stand over these for your child, but here is what we’ll be doing for our almost two and a half year old to encourage her to speak.

• Adding words on. Instead of saying duck, quack quack, we’ll be saying – Look at Duck. Duck Goes Swimming. Duck is Yellow. Whatever we’re saying we’re trying to add words on all the time, especially doing and action words.
• Using short sentences. I noticed how the therapist spoke loudly, clearly and in short sentences to our child so that she easily identify and pick out the words. Up till now, I don’t think we were even bothering to try and talk to our little girl as we just presumed she wouldn’t understand or wasn’t interested. (That sounds terrible, doesn’t it) Now I give a running commentary on what I’m doing or what she’s doing. I sound mad, but I don’t give a hoot.
• Prompting. There are techniques to get your child to say a word – you almost set them up. So for instance, you might say… Ready… Steady… and your voice is in a sing song, so you’re waiting for them to say GO! If they don’t say go, you say g-g-g and try and get them to copy you. Our little girl did this with the speech therapist at our appointment. You can use numbers too – One.. Two… Three… Jump! And you’re waiting for her to say jump. Or the other day she wanted to brush her teeth and I said, We’re brushing our teeth. We’re brushing our… (pause) and she shouted teeth! First time she’d ever used the word. So it definitely works, we just need to use it.
• Giving a choice. Instead of saying – do you want bread, do you want cheese etc, you should offer a choice so that the child has to say the word to choose – would you like bread or cheese? In fairness our little girl is still pointing and saying ‘this’ for whatever she wants, but it’s a technique we’ll be working on.

So there you have it. That’s our speech therapy journey so far. I can only imagine that I am one of many thousand Mums out there who worries about these difficulties with their children and is looking for information. I can’t tell you how many times I’ve googled ‘how many words should a [insert child’s age in months here] have’. I always got frustrated when I saw where we should be. I also used to get very depressed when we had playdates with even younger children and watched them babble away.

I’m through that now. We’ve done something about it. And I know, that things will work out, even if it just takes a bit longer.

What’s the betting we’ve a yapper on our hands and I’ll be back in a few years bemoaning the days of silence?

Here’s hoping.

This is my account of our experience with speech therapy based in the North East of Ireland. I hope our experience is helpful and informative for you but please make sure you have your own child assessed for their own needs. Have you had any issues or worries with your child’s speech? I’d love to hear from you.