New to EI for speech. Is this normal?--updated - Page 2

[naismama]

Originally Posted by aspeechthx

OK, so I have been reading posts here for a long time ('lurking' as they say!) because, as an EI speech therapist, I want to be in touch with how parents of my special needs kids think, feel... All of you on this site have been very helpful to me professionally. This is the first time I felt such a strong need to respond to a post!

First of all, it is normal for a 2 1/2 year old to leave the final sound off of words. Not all toddlers do this but it usually goes away around age 3 years 3 months. Up until then, it is considered normal. Could it be a sign of something else (hearing loss, apraxia...)? Yes. But in and of itself, it is normal.

Articulation therapy for a toddler is not based on sitting still. It is play-based, fun and engaging! As a PP mentioned, Dr. James MacDonald is a great resource for appropriate EI speech therapy. You definitely can request another therapist or at least challenge her to explain why her expectations are so high for a 2 year old!

And a Behavior Specialist? Hummm...

Good luck!

Thank you so much for coming out of lurkdom to answer my post!

3years 3 months??? Really? After listening to him interact with the developmental specialist for about 5 minutes, the speech therapist told me "this is a problem that does not self correct." So I am surprised to hear another speech therapist say this. His articulation has been getting better and better, I think, but slowly. I am in the process of scheduling a hearing test...

I think the therapist tried to be playful with him, but I think her focus on positioning him wore him down and overshadowed the articulation exercises they were working on. As I mentioned, by the end of the session he had shut down and was curled in my lap sucking on my shirt. He was quiet and withdrawn for over an hour after she left.

[queencarr]

Although it doesn't necessarily sound like this is what she was doing it for, good potsure, sitting up, not leaning, etc. is important for good breath support for speech. She may have been looking for what he could do in an optimum position. I don't find her methods terribly over agressive from your description, but they do sound unacceptable for a first session. If the therapist had physically touched my oldest during a first (or the first several, really) session, it would have been all tears and set us back quite a ways. She needed to build up trust and have him do some easier tasks to reinforce early success and motivitate him to want to work with her. I think I would do as you are considering and ask for a different therapist due to the "time conflict" if you didn't want to ask outright.

[ssh]

My DD had speech therapy form 23 months until about 2.5 when her skills had caught up to normal. Her sessions were fun and play based. The therapist was very respectful of my DD as a person. My DD loved her therapist and looked forward to seeing her.

Not all preschools expect 3 year olds to be able to sit still in the same position. My DDs preschool is play based. They still do circle time, where they are encouraged to sit, but there is always an alternative when a child doesn't want to sit in the circle. Usually it's going to the book area that has a beanbag and some soft stuffed animals. My DD didn't do circle time well until after she was 4 for a few months.

[~cassie]

She sounds too agressive for my tastes. I know if she did that to my son he would have shut down and not cooperated one bit. We always remind him criss cross applesauce, even in therapy, but he only needs the reminder a few times a session. Our therapist is getting more aggressive with my son BUT only just started that after working with him for over a year and he knows her very well vs it being a brand new person is his life trying to force him to do things. I'd be getting a new ST.

[~cassie]

oh, wanted to mention that you can and should approach her about this. Next time you see her, mention that he was very clingy when she left and you felt she was too aggressive with him and it shut him down, therfore not as productive as it could have been.

My son's ST and I talk all the time about things she did that did/didn't work with my son. As mom I know my son very well and it took her a while to read his body language and know if she was being too easy/hard with him but I would tell her and she would back off if need be. All part of the parent/therapist relationship.

[aspeechthx]

naismama,

Thanks for the 'welcome'

Of course it is difficult, actually impossible, to diagnose, treat... speech problems without seeing the child. There are a lot of details about speech development that are difficult to decribe on the internet! There might be other issues that your therapist was paying attention to that made her say, "This is a problem that doesn't self correct". On the list of norms that I use with parents, final consonant deletion (saying coe/comb, bye/bite...) is normally eliminated at 3-3. As another example, stopping (using b/f, d/s...) sticks around until age 3 (dope/soap, bish/fish...) and fronting (t/k, s/sh) ends about 3-6 (tar/car, sip/ship...). If these problems exist by themselves, without apraxia or other language issues, they often resolve w/o therapy. Of course you can find several different versions of what is considered 'normal'!

Keeping a toddler's attention in therapy can be tricky! My philosophy is "A happy toddler learns better than a grumpy toddler." Some adults get wrapped up in getting a toddler to behave, but a power struggle never accomplishes anything, especially in speech therapy. It is an art to be able to follow the child's lead in play/therapy while also getting them to practice new sounds/words.

Best wishes.

[naismama]

Originally Posted by aspeechthx

naismama,

Thanks for the 'welcome'

Of course it is difficult, actually impossible, to diagnose, treat... speech problems without seeing the child. There are a lot of details about speech development that are difficult to decribe on the internet! There might be other issues that your therapist was paying attention to that made her say, "This is a problem that doesn't self correct". On the list of norms that I use with parents, final consonant deletion (saying coe/comb, bye/bite...) is normally eliminated at 3-3. As another example, stopping (using b/f, d/s...) sticks around until age 3 (dope/soap, bish/fish...) and fronting (t/k, s/sh) ends about 3-6 (tar/car, sip/ship...). If these problems exist by themselves, without apraxia or other language issues, they often resolve w/o therapy. Of course you can find several different versions of what is considered 'normal'!

Keeping a toddler's attention in therapy can be tricky! My philosophy is "A happy toddler learns better than a grumpy toddler." Some adults get wrapped up in getting a toddler to behave, but a power struggle never accomplishes anything, especially in speech therapy. It is an art to be able to follow the child's lead in play/therapy while also getting them to practice new sounds/words.

Best wishes.

Thank you! You know, the more I think about it and listen to ds, the more confident I am that his speech is improving--his vocabulary is constantly growing and he is saying plenty of 4+ word sentences ("I hurt my arm," "I wanna ride choo choo train at railroad park.") His receptive language is also better than I thought--but his articulation still really needs work. He relies heavily on "d" and "t" to make up for the "s," "f," and "k" that he does not have ("tar" for "car," "doo" for "juice," "di" for "fish"). And honestly, all the suggestions to get a hearing test scare me, so I think the sooner I can get that done, the better!

I am trying to decide whether I want to try to talk to this therapist and work with her, or try to get another therapist before we get too deep into sessions with this one. I put in a call to my case worker a few days ago, but she has not called me back.

[naismama]

Update

So I talked to the speech therapist on the phone today to tell her the time switch was fine. I also told her how quiet and withdrawn my son was after the session, and that I think it was a little much for him. Her response was "Well, like I told you, I was tough on him, but when I pulled back, he was fine. So I can pull back and make it more play-based." She had initially said that she would come to my house for a month to prepare him for the phonology program (which is at another location; they don't come to the house). But now she is saying that she'll come to my house for as long as it takes to prepare him. She went on to say "Before I send him to the phono program I'm gonna need him to sit still for 30 minutes, and I'm gonna need the behaviors to stop." By behaviors, she meant the hitting.

A couple hours after I talked to her the case worker finally called back and I talked to her about my concerns. She said that if I can stick it out with this therapist for 3 or 4 more weeks, she can then send us to the phono program. When I told her the therapist wanted to work with my son "as long as it takes" the case worker told me that we don't have that much time because my son only has 5 months left to be eligible for EI (he's 3 in October). The phono program is 14-16 weeks. She promised to get on the therapist to push ds through. She also told me that this particular therapist is known for being hard on kids and gave me the names of the 2 ladies who do the phono program--one who is also tough, one who is gentler. So maybe I can keep that in mind when I schedule. I feel better after talking to the case worker. I can work with this therapist to help my son for 3 to 4 weeks.

Ds has a hearing test Friday morning this week. I am scared. Although he has never had ear infections that I know of, he has always been very stopped up and boogery--not snotty, which I think would actually be easier to treat and take care of! But as scared as I am, I am glad the test is sooner rather than later.

[aspeechthx]

It sounds like you have everything under control! Good luck Friday for the hearing test. It is a good idea to rule out any hearing issues, even if it might just be due to fluid... I wish all of my parents were as proactive as you seem to be
Keep us posted! I would like to hear more about the phonological program once you have started.

[naismama]

Originally Posted by naismama

Ds has a hearing test Friday morning this week. I am scared. Although he has never had ear infections that I know of, he has always been very stopped up and boogery--not snotty, which I think would actually be easier to treat and take care of! But as scared as I am, I am glad the test is sooner rather than later.

So ds had his hearing test today, and he passed with flying colors. Thanks so much to those of you who encouraged me to take him. I feel so relieved, and I feel more confident now that his speech will come with time and help.

The OT came yesterday for his first session, and it was amazing. I daresay I have never seen my son so lively and energetic except when he's playing with his sister. The OT had such a good way with my son--I felt by the end of the 45 minute session he would have done anything for her. And they worked pretty hard too. Unfortunately, she's his secondary therapist (speech being primary) and he won't have too much time with her. Oh well...