5yr old - lot of mouth movement when speaking/accent

[nathansmum]

Hi

My dd (5.5) has previously had speech therapy for delayed speech. She is no longer receiving any since she turned 5 and the therapist felt that she was developing ok and never flagged any other issues as being the cause (she did have glue ear for some of that time which we think caused the initial delay).

I "feel" that there is something else going on for her, but not too sure where to start looking.

One thing I have noticed (and a friend pointed out today) was that she has an "accent" when she speaks. I don't know if I would have called it an accent, but I do think she has quite a harsh/gutteral sounding voice and it sounds a bit "odd" to me. She also seems to use her tongue and it rolls around a lot in her mouth when she's speaking. My friend pointed that out too which was interesting as I'd also been noticing it (she mentioned it without prompting, and that was within about a minute of seeing her).

I also find I need to rephrase a lot of sentences for dd, such as...she will say to me at dinner time when she's letting me know she's hungry...

"dinner is ready yet?" rather than "is dinner ready yet?" and often seems to get words in the wrong places and it's almost as if she's knows what needs to go in there, but not where they all go - she tries to remember where words go rather than listening and thinking whether it sounds right (maybe too young to make that connection?).

She also often drops the first sound off words and adds an "a" in there (ba)anana, (to)amorrow, (to)aday but will say them correctly if I ask her to repeat them (although I've noticed she's just started to self-correct herself). She can say all the letter sounds, but doesn't always use them fully.

She seems to be developing ok elsewhere. She knows most of the alphabet names and their sounds, and can sound out words well (isn't reading, but can do the sounding out easy enough although often forgets the first sound she sounded out by the time she gets to the end ie. h-a-t and will say "at").

So, does anything jump out at anyone on what we could be dealing with? I have wondered about auditory processing disorders?

Thanks!

[LynnS6]

I would take your child to be evaluated again by a speech language pathologist. A different one than you saw last time. How old was your dd when she stopped going? If she was 3, I might think it was OK. But if she was 5 and doing the things that you described, I'd say she was still delayed and your SLP did you a disservice.

On the surface, your daughter is dropping unstressed initial syllables (the 'ba' banana). That is a common developmental thing for children to do, but at 2 1/2 or 3, not 5 1/2. It sounds like she as other articulation issues as well. It sounds like she's getting there, but this is something that she should have mastered a while ago, and so it would concern me, especially since her pronunciation is still 'off'.

She also is having definite issues with syntax (the question formation) and so needs a language evaluation in addition to a speech evaluation.

It sounds to me like she has a speech/language delay. Specific Language Impairment springs to mind, general language delay due to reduced hearing could be another. You didn't note any difficulties in understanding language, so auditory processing wasn't what I first thought of. But whatever I think, she needs to be evaluated a real professional.

[nathansmum]

Thanks Lynn.

She last saw the SLT when she was 5. I think we got 'dumped' from the system basically because she dealt with pre-schoolers and when we hit school age we fell out of the system since we're homeschooling. I asked about what would happen if she were in school and she felt that she wouldn't receive a therapist since she wasn't 'bad' enough. That is the state service, so I'm needing to go elsewhere I guess. I will also contact our HS association and see if there are some resources I can tap into.

On my dd's timeline, I'd say she's progressed quite a lot over the years, but yes, I agree that she is definitely delayed in certain things she says and the way she says them. She clung to calling herself "me" instead of saying "I like cats" for example for Loooooong time. But finally she figured it out.

Then she'll have a lovely conversation with me....mum, can I put on this CD? I will try this one. It's worked. Look he's lying in the sun (the dog). What is a CDRom? I just sitting on the couch listening.

So, often leaves out am/will and still switches her/she. "Her playing in the sun."

My friend who saw her yesterday (and doesn't see her that frequently, so it's not like she "knows" her way of saying things to predict) said that she understood everything she said, bar one word. But then there was all the tongue movement and the sound of her voice.

Thanks for the lead on Specific Language Impairment and her requiring a language evaluation as well as the speech assessment (and that the syntax that is off). I will do some hunting around to see where I can find someone (I'm in New Zealand and don't live in a main centre, so they are a bit harder to find without a lot of travel).

Thanks for your help!

[momtoalexsarah]

I would have her seen by and ENT, or ask your GP/Pead to get a referal to the nearest Childrens hospital (in NZ you will likely have to go to Aukland I would assume) and have her looked at by Velo-phrangial innsuffiency team (or a cleft palate team - they often work together)
The gutteral and the dropping of consentent sounds are a red flag for a submucus cleft or other palate malformation and she is getting to much air flow through the nose.
Couple questions though
- does her speach sound better when she has a head cold (stuffed up nose)
- does she have a bubble or high arch palate
- did she have nursing issues as an infant (even if she overcame them with time)

[nathansmum]

We were under an ENT when she had her glue-ear issues and they never identified anything out of the ordinary in regards to her palate - unless they weren't the right ones to be looking?

I just had her and DS stand next to each other and open their mouths - both appear very similar in structure and DS doesn't have these issues, so I can only assume that her mouth is normal? Initially when I looked I was suprised to note that there appeared to be quite a circular "up" area (bubble perhaps??) into the top of her mouth that doesn't feel the same in my mouth (but could be that I'm an adult) but then upon looking in DSs, his is the same as hers.

Haven't noticed her sounding different when she has a cold.
Didn't have any nursing issues as a newborn.

Will check out the terminology you have used later and see if anything there sounds like her.

Thanks so much for your reply!

[5gifts]

Hey, your description really jumps out at me, since this is exactly what my 14 yo ds was like at 5yo. I always said he sounded like a little french guy trying to learn english & getting his words all in the wrong order. I attribute it to the fact that he couldn't hear natural speech clearly until 2.5yo. So he didn't have the proper grammer playing in his head, so to speak - he was learning like a foreigner. You said she had glue ear - I don't know if that is the same thing ds had (a fungus that is usually white guck with black flecks, but his ears were so dry that the fungus just irritated them & caused rock hard plugs of wax constantly) Anyway, if that muffled her hearing for a long time when she was very young, it may have had that affect.

He did all those 'a' sounds too. Like 'abook a read a me?' 'alice a car' (police car) I just remember that the 'a' punctuated every word it seemed. He sounded funny when he talked - its been so long, but I know it was high pitched, and that persisted for sooo long even after his sentences flowed better. I kind of worried about him sounding like a girl (he did get teased) until sometime between 8-10yo...I don't remember. Then he sounded just like me for a long time - even DH would think he was me on the phone! His voice changed this summer and he definately has a deep voice, he has no speech or language issue at all - I hadn't even thought about it in forever. I would say he is very clearly and well spoken.

We also homeschool. And did not get any services/therapy other than a couple months when we first got his hearing cleared up. Even then I felt like we did alot more for him at home than what he got out of ST. His brother is 3 tears older than him, and could coax more language learning out of him than anyone else. On a side note, when it all came to a head at about 3yo, we also found out he was gluten intollerent. During that time he couldn't hear,1.5 - 3yo, he acted VERY autistic. (they really started to key in on that when he went for hearing & speech eval at 2.5yo - but I just felt that wasn't the prob.) For a few years, he did have trouble in a classroom setting,being able to understand when the teacher is talking to the group or talking fast. He had some sensory quirks too (and big melt downs), but of my 4 boys he is the least quirky and completely socially at ease & confident. I have just always 'coached' them along in whatever areas they needed help in. I had to work with my oldest so intensely from the start - he is VERY 2E - that I didn't realize how 'different' they were til I had a normal baby/toddler/preschooler LOL!

[nathansmum]

Thanks for sharing your story!

Her glue ear was within the middle ear - so a blockage of gluey substance that hasnt' drained due to facial structure (not sure what that is called in the US?) - they tested it by finding that the eardrum didn't vibrate when sound waves were directed in there with a tympa...thingy. Often it's put down to ear infections, but she only ever had one. Although, now that you mention the fungal thing your ds had, my dd often had chunks of hard dry waxy stuff in her ears, but I just put that down to her type of ear wax? It was never mentioned during her ENT appointments either.

Actually, thinking about dd's gutteral voice, it's only in certain situations that it's more evident. When she's playing on her own, role playing with her little dollshouse bits, baby dolls etc and telling stories, singing, chattering to herself she's got a lovely little "sweet" girly voice - and also yesterday she answered the phone for the first time with a sweet voice too. It's when she's telling a story or recalling an event to the rest of us or talking to others that her voice sounds more deliberate and awkward and harsh. Almost a bit British in accent.

Anyway, I've got a bit of follow up and leads here, so thanks again! We're away for a week from tomorrow, so I will catch up with this thread again when we get back home.

[fairejour]

Just a thought, make sure to have a complete audiological exam. Hearing loss could cause all of this.