Speech Therapy

[jenmn]

My 3.5 year old was diagnosed in March as having articulation issues, particularly with the 'k' and 'g' sounds. She did not qualify for therapy through our school district because she was evaluated at the 5th percentile and in our school, the kids need to be in the 2nd percentile to qualify.

We did a private speech evaluation in April and she scored just under the average range (80, when average is 85-115). So we did private speech therapy twice a week for 3 months (April-June) and then were told that she was not making any progress and we should take a break for six months.

We recently did another private speech therapy evaluation (in July) and she scored 101 (again, average is 85-115). They noted that she cannot say the 'k' and 'g' and 'r' sounds. They said that she did not qualify for therapy because she scores too high. I asked what her score would be if we were just testing 'k' 'g' and 'r' and they said 0.

I really don't care as much about what sounds she can and cannot say, but it is hard to understand what she is saying frequently. It is really hard to understand her in a conversation sometimes. I can usually figure it out by having her repeat herself and by using context, but many people (including my husband) cannot as easily. I don't want to feel like I need to be her interpreter. I don't want to wait until she is in elementary school and then need to be pulled out of regular class for therapy.

My questions:
- Does anyone have experience with their child being unable to say these sounds ('k, 'g', 'r')? We were told these sounds are all made at the back of the throat. If you do have experience, how was it resolved (on its own, through therapy)? And at what age?
- Is it typical to just stop speech therapy if kids are not making any progress? It seems very counter-intuitive. My daughter loved going to speech, so it wasn't a matter of her causing problems as far as I can tell.
- Why won't the private speech therapy centers let us as her parents decide if our daughter needs therapy and not some number on a chart? Our insurance does not cover speech, so we need to pay out of pocket anyways.
- Any advice on what to do next?

Thanks!

[A&A]

Is there another private therapist you could try?

[Drummer's Wife]

I agree with trying another SLP if you aren't happy with the decision to stop therapy.

My 5 yo has problems with those sounds - mainly if they are in the middle of a word, or part of a two-letter sound, if that makes sense. He can be really, really hard to understand, and it breaks my heart at times. Anyhow, he was first tested a couple months after he turned 4, and at that point was borderline - they decided to wait a few months and re-test. This is through Child Find, BTW, who worked with his preschool. Anyhow, they then decided he did in fact need therapy (which, I believed before the initial assessment). He has an IEP and is starting Kindergarten next week where the therapist will pull him out twice a week for sessions. I don't mind this, as I could see progress and know he benefits from it (plus he is in all-day Kindy, so 30-45 min. out of a day isn't much).

I don't know why they'd stop if they didn't see immediate results - I think it could take months sometimes to hear a difference, but what do I know. Maybe b/c of the age, they assumed it was developmental and would be outgrown - and if not then therapy would be tried again?

Regardless, if your instinct says sooner rather than later, I'd get another opinion if possible.

[kme]

I have a 6 year old daughter who cannot make those sounds and several others as well including -ch, -sh, -l. She scored in the 1%st percentile on her testing. She goes to both private ST and at school.

Some of the sounds they are not even working on because even at 6 they say it is "developmental" and some kids aren't able to say certain sounds till age 7-8.

If you are unhappy with what the SLP(s) had to say, go to another one. You could ask the therapist for a chart of what age each sound should be developed (I had one but don't know where it is - my daughter is so behind it wasn't even relevant to her.)

I think sometimes they take breaks when the child isn't making any progress or when the child is "burnt out" from therapy.

[Rose-Roget]

Here is a chart about speech sound developement (scroll down to where you see the Phonetic Development chart). Keep in mind that these are the ages by which 75% of kids usually have the sound at the single word level. Other sites may show slightly different ages, in fact the ages in this one seem fairly low, but this comes via links on the American Speech Hearing Association (ASHA.org) site, so it can be trusted.

http://members.tripod.com/Caroline_B...quisition.html

I hate standardizations on articulation tests. The ones I know only count the number of sound errors total. So a 3 year old, who may be expected to lack many sounds, will score "high" if she only makes errors on 3 different sounds, regardless of whether those are sounds that she "should" have mastered by that age. So other things should be considered when determining whether the student will qualify for services - intelligibility, social relationships, stimulability, ability to discriminate the sounds, and impact on learning (usually for older kids).

If all other sounds are developing normally, then it could just be that these sounds will too with a little more time, but I can't say that for certain, obviously.

Believe it or not, as frustrating as it is, the private therapists you have dealt with actually sound really ethical. I know that's not what you want to hear, but some places will continue to take your money, whether your child makes progress or not. Also, sometimes a break from therapy will allow some of the learning to sink in a bit and/or allow additional time for natural development. I know this isn't what you want to hear, and it might be worthwhile to get another opinion if you feel there was progress being made or that it would make a difference. I'm sure there are therapists in your area who would take her on. Another suggestion is to wait a few months and get her re-evaluated for speech in the school district. During those few months, her sounds will either start to emerge naturally or she will be closer to the 2nd percentile - which seems extremely low to qualify as having a disorder!

Did the therapist offer you suggestions about how to work with dd at home? Does dd produce /k/ or /g/ in any position of any words? She is really young to "teach" tongue placement to, but you could use hand cues (tap your index finger on your throat when emphasizing those sounds), practice minimal pairs with pictures (have her point to the picture you say - "coat" "tote" or "car" "tar" - each word differs by only the one sound, and this helps them discriminate the difference in sounds; be sure to emphasize the /k/ after she has chosen the picture - "listen again, C-C-Car" and point to your neck). You can also model back the sounds she misses while emphasizing the /k/ or /g/ sounds - dd - "Do you have your Toffee, Mama?" You - "Yes, Mama sure needs her Coffee in the morning!" (point to neck). (You don't have to tell her she didn't say it right, just give her another opportunity to hear it produced/emphasized correctly.)

Hope some of this helps. Good luck!