When would you consider speech/eating/oral therapy? Update post 6 - Page 2

[SeattleRain]

Originally Posted by APToddlerMama 

It has been a long time since I have worked in EI and my own son who had a speech delay is 3.5 now, so off the top of my head, I can't think of exactly what she should have.  I know a T sound should typically be there but can't think of what other sounds.  The SLP who sees her will tell you, though I doubt they'll see any need for speech therapy for speech purposes.  Sorry I can't be more help! 

That must be regional or even more likely, a mistake... EI is a federally funded program with (unless things have changed since I worked for them) a requirement to service children from birth to three.  EI has 45 days to start services after referral, so the EI program I was in took referrals for kids up to 33 months.  After that, we referred to school which is what we had to do anyhow 90 days before the third birthday.

The Denver is notorious for under-identifying kids with speech issues. It tends to find kids with fairly typical motor and social emotional skills "suspect" more than it should as well.  It is really just a screeening tool, not a good evaluation tool.   

I think you're probably right about it being a mistake, the person who told me this (the person at the hearing center) seemed a little clueless about EI which I found odd since it sounds like hearing tests are the first step before speech evals in a lot of cases. So she should probably know more about EI being a pediatric audiologist, but whatever. In any case, I'm waiting for a callback from an EI representative and I'll confirm when I talk to her.

Do you have a better rubric for identifying speech delays? I'm positive something is going on with my son and speech, I'm just hoping it's something fixable.

I'm just talking out loud here, but after a year, is the nursing relationship really as important as a growing relationship with food? I thought the practice of nursing before feeding solids was more from 6-12 months ("Under 1, just for fun"), but that after 12 months the food should come first. Otherwise, the kid is going to fill up on the BM and not have any room for food. If you're not hungry to eat, it makes sense to not be interested in food. I'm not sure a toddler, particularly one who has eating issues, should be encouraged to drink the bulk of their calories. It might become a habit that is even harder to break down the road. I think if a baby is doing fine with breastmilk only and everyone is happy with the relationship, that's one thing. But it sounds like BB's DD isn't nursing well, probably isn't getting enough calories from BM, and isn't eating any food, so something needs to change. 

@BuzzerBeater: What have you decide to do? Does she drink out of a straw? Would she drink high protein smoothies? This might be a way to get her used to different flavors and give her a calorie boost (you can put tofu or yogurt or protein powder in the smoothie) but she wouldn't have to chew. Just a thought.

[homemademom]

Hi Buzzer Beater.  I saw this thread in New Posts.  I was wondering if you'd ever had your baby evaluated for posterior tongue tie?  I ask because low weight gain/supply issues, reflux, eating issues and speech problems can all be linked to PTT. It seems strange that a simple physical problem could wreak so much havoc, but the research I've read shows that it can be a serious problem that effects people even into adulthood.  As an experiment, a ped dentist said to place your tongue firmly behind your bottom teeth and then try to swallow. I did it and it's very uncomfortable, hard to breathe while swallowing, almost like you're drowning.  If a babe's tongue is not moving properly because of a tongue tie that's farther back, solid foods and textures could really be a problem. 

It's an under recognized problem for sure, so if you're interested in finding someone I found this list helpful. I've got other resources bookmarked, too, if you're interested. Just let me know.  (I couldn't get a diagnosis from anyone--the LCs, the Ped, a CST all said he was fine, so I really do recommend someone that's experienced with the problem.)  We had our ds treated at 1 mth old and saw many improvements in nursing after several more weeks, but we had his tongue revised at 6 mths old  and things are nearly perfect now (I felt like he never fully drained my breast, he still nursed for really long periods, I could feel thick fibers under his tongue even though the frenulum seemed insignificant).  Now, no more supplements needed because he's actually transferring ALL of the milk properly. He nurses for shorter periods and less frequently because he's more efficient and his weight gain is excellent. Best of luck to you!

[Buzzer Beater]

Originally Posted by SeattleRain 

@BuzzerBeater: What have you decide to do? Does she drink out of a straw? Would she drink high protein smoothies? This might be a way to get her used to different flavors and give her a calorie boost (you can put tofu or yogurt or protein powder in the smoothie) but she wouldn't have to chew. Just a thought.

I really think you are right about the nursing relationship at this point- her eating is more important. I do encourage her to eat at differnent times, ie right after nursing, a short period of time away from nursing, a long period of time from nursing to see if she will do better at different stages of hunger... nope. The ped says feed her solids first, bf'ing mamas say nurse her first... high protein smoothies sounds like a great idea if she will actually take one. She won't eat pudding- tried a banana/avodcado/coconut oil recipe I found on here and she wouldn't touch it. Got any recipes?

[Buzzer Beater]

Originally Posted by homemademom 

Hi Buzzer Beater.  I saw this thread in New Posts.  I was wondering if you'd ever had your baby evaluated for posterior tongue tie?  I ask because low weight gain/supply issues, reflux, eating issues and speech problems can all be linked to PTT. It seems strange that a simple physical problem could wreak so much havoc, but the research I've read shows that it can be a serious problem that effects people even into adulthood.  As an experiment, a ped dentist said to place your tongue firmly behind your bottom teeth and then try to swallow. I did it and it's very uncomfortable, hard to breathe while swallowing, almost like you're drowning.  If a babe's tongue is not moving properly because of a tongue tie that's farther back, solid foods and textures could really be a problem. 

It's an under recognized problem for sure, so if you're interested in finding someone I found this list helpful. I've got other resources bookmarked, too, if you're interested. Just let me know.  (I couldn't get a diagnosis from anyone--the LCs, the Ped, a CST all said he was fine, so I really do recommend someone that's experienced with the problem.)  We had our ds treated at 1 mth old and saw many improvements in nursing after several more weeks, but we had his tongue revised at 6 mths old  and things are nearly perfect now (I felt like he never fully drained my breast, he still nursed for really long periods, I could feel thick fibers under his tongue even though the frenulum seemed insignificant).  Now, no more supplements needed because he's actually transferring ALL of the milk properly. He nurses for shorter periods and less frequently because he's more efficient and his weight gain is excellent. Best of luck to you!

Believe it or not I have wondered if she has ptt or a lip tie which I posted about a long time ago... and of course in our damn little town there is nobody to help me, nor in our whole state according to your list. The lc's I have seen admit having no expertise in that area, and we saw an OT who works on feeding issues with older kids when dd was around 5 months maybe? She referred us to a dentist here and he said he didn't know anything about TT issues. Sometimes I hate living in a small town.

I'd love your other bookmarked resources BTW. Thanks.

[crunchy_mommy]

Somewhere around 18mos we started doing food first, then nurse -- that did help him to eat more food.

Another thing that helped was reading books to him while he ate for a week or two while we focused on getting him to eat more.

[homemademom]

Here you go: http://www.lunalactation.com/KnoxTT.pdf

http://www.llli.org/llleaderweb/lv/lvaprmay02p27.html

http://www.cwgenna.com/qhcontent.html (the little tests and maneuvers on this are really helpful for identifying ptt)

There's one more I'm still trying to find about gastro and feeding probs.  I'll come back later... babe needs me.. but our ped dentist told us some interesting stories from his own practice.

[APToddlerMama]

Originally Posted by SeattleRain 

I think you're probably right about it being a mistake, the person who told me this (the person at the hearing center) seemed a little clueless about EI which I found odd since it sounds like hearing tests are the first step before speech evals in a lot of cases. So she should probably know more about EI being a pediatric audiologist, but whatever. In any case, I'm waiting for a callback from an EI representative and I'll confirm when I talk to her.

Do you have a better rubric for identifying speech delays? I'm positive something is going on with my son and speech, I'm just hoping it's something fixable.

He's 14 months?  What is he doing?  Babbling at all?  Any "words" that aren't real words?  Honestly, if he is doing some babbling, makes decent eye contact, and is starting to point at things, I would not be concerned at all at 14 months.  I think it is great you're planning on seeing EI, but chances are, they will probably tell you to call them back around 18 months if he doesn't have around 10 words by then.  They'll probably leave you with some ideas on things you can be working on in the mean time.  I have seen a ton of kids in the 12-18 month age range doing very little speech wise and then things picking up around 18-21 months.  I really wouldn't bat an eye at no words at 14 months, but I think it is great that you're on the ball.  I don't think you have any reason to worry at this point at all though.  I hope your eval goes well! 

[Buzzer Beater]

SeattleRain I just went back and read your other post. Georgia does not say mama or dada either but she has other "words" she uses, though they wouldn't be understood by others. She also makes animal noises. I hope you get your callback from EI- we got ours today and are scheduled for Sept 9. They also suggested we be on Pediasure in the meantime.

Holy cr#p my dh just got back with a six pack of Pediasure and it was $13.79. 48 ounces almost 14 bucks wow.

I hope she'll drink it.

[SeattleRain]

Originally Posted by APToddlerMama 

He's 14 months?  What is he doing?  Babbling at all?  Any "words" that aren't real words?  Honestly, if he is doing some babbling, makes decent eye contact, and is starting to point at things, I would not be concerned at all at 14 months.  I think it is great you're planning on seeing EI, but chances are, they will probably tell you to call them back around 18 months if he doesn't have around 10 words by then.  They'll probably leave you with some ideas on things you can be working on in the mean time.  I have seen a ton of kids in the 12-18 month age range doing very little speech wise and then things picking up around 18-21 months.  I really wouldn't bat an eye at no words at 14 months, but I think it is great that you're on the ball.  I don't think you have any reason to worry at this point at all though.  I hope your eval goes well! 

He does some babbling and makes great eye contact, but no pointing. He doesn't even follow when I point to things. He has two syllables, "ma" and "ba" and a high pitched shrieking sound. He also has a vowel sound that he does where he flaps his hand over his mouth. He uses a lot of vowel sounds but not a lot of consonants. He doesn't seem to really communicate specifically with us at all, he just babbles to himself. Our eval is September 7th. 

I know I'm obsessing over this, and I don't quite know why. It's really bringing out the worst in me as a parent and is totally consuming my relationship with him by trying to get him to talk or point or whatever. I think I have an underlying fear of autism, and his speech issues are bringing those fears to the front and I'm having to confront them. There is no reason to think my son has autism other than his speech issues (or non issues, as it might be), but I'm becoming paranoid. I need to get past it. 
 

[SeattleRain]

I make myself a smoothie with a handful of frozen strawberries and a handful of frozen mangos and a few scoops of yogurt and a cup of water every morning. It's delicious and easy. I'm not so creative though. But you could definitely get some more filling recipes by adding avocado or coconut oil to the smoothie.

[APToddlerMama]

Originally Posted by SeattleRain 

He does some babbling and makes great eye contact, but no pointing. He doesn't even follow when I point to things. He has two syllables, "ma" and "ba" and a high pitched shrieking sound. He also has a vowel sound that he does where he flaps his hand over his mouth. He uses a lot of vowel sounds but not a lot of consonants. He doesn't seem to really communicate specifically with us at all, he just babbles to himself. Our eval is September 7th. 

I know I'm obsessing over this, and I don't quite know why. It's really bringing out the worst in me as a parent and is totally consuming my relationship with him by trying to get him to talk or point or whatever. I think I have an underlying fear of autism, and his speech issues are bringing those fears to the front and I'm having to confront them. There is no reason to think my son has autism other than his speech issues (or non issues, as it might be), but I'm becoming paranoid. I need to get past it. 

Hugs, mama.  I've been there too. We were actually told that my DS had an ASD, although after changing his diet and doing the whole gluten free casein free thing along with fish oil, he no longer even comes close to meeting criteria and is really doing fantastic.  At his two year evaluation, he tested at a 6-9 month level for speech.  One year later, his speech was on track and age appropriate other than some articulation issues (working on saying S, L, J, Z, F, etc sounds...he'll substitute other sounds, some of which is age appropriate).  Kids can develop and change rapidly. 

Truly, I would not be worried at this point at all.  I have a feeling his evaluation will put your mind at ease.  Intervening early is fantastic, but there is a certain point in which the "wait and see" approach is actually called for and I think that is what EI will probably tell you unless they see something you haven't mentioned.  Does he bring you stuff?  Toys or whatever?  Have you tried any signs with him?  I would start some simple ones like more, milk, etc...whatever would be helpful.  If he starts getting those, at least you will be reassured that there is an intention to communicate with you.  I'd keep a close eye on him, and would want to see him start pointing in the next few months and trying to babble with you, but think you can feel fairly reassured that there aren't any red flags so huge at this point that you need to do anything more than have that evaluation and then sit back and enjoy him. 

 

[SeattleRain]

Originally Posted by APToddlerMama 

Hugs, mama.  I've been there too. We were actually told that my DS had an ASD, although after changing his diet and doing the whole gluten free casein free thing along with fish oil, he no longer even comes close to meeting criteria and is really doing fantastic.  At his two year evaluation, he tested at a 6-9 month level for speech.  One year later, his speech was on track and age appropriate other than some articulation issues (working on saying S, L, J, Z, F, etc sounds...he'll substitute other sounds, some of which is age appropriate).  Kids can develop and change rapidly. 

Truly, I would not be worried at this point at all.  I have a feeling his evaluation will put your mind at ease.  Intervening early is fantastic, but there is a certain point in which the "wait and see" approach is actually called for and I think that is what EI will probably tell you unless they see something you haven't mentioned.  Does he bring you stuff?  Toys or whatever?  Have you tried any signs with him?  I would start some simple ones like more, milk, etc...whatever would be helpful.  If he starts getting those, at least you will be reassured that there is an intention to communicate with you.  I'd keep a close eye on him, and would want to see him start pointing in the next few months and trying to babble with you, but think you can feel fairly reassured that there aren't any red flags so huge at this point that you need to do anything more than have that evaluation and then sit back and enjoy him. 

 

Thank you for this. I tried signs when he was probably 6-9 months but not consistantly, and only me and not my husband. Perhaps if we both did it then it would stick better. He brings me things, but not if I ask for them. He'll just be eating string cheese and offer it to me, lol. He interacts with us great, he just doesn't seem to communicate, if that makes sense. My doctor says he's absolutely on track for his socialization and all his other benchmarks. Up until this point with the speech, we hasn't hit any of the other soft or hard markers so the truth is that I don't have any reason to really worry. It really is my own issues with feeling like there my son has to "measure up" to some benchmark, which I need to get past in order to be a happier mother.

[D_McG]

My son is now 5 and I WISH I had gotten him eating help as a toddler.  I don't know how to say this without sounding obnoxious/ungrateful but I think I just selectively read advice from breastfeeding enthusiasts and ignored my own common sense.  My son would happily have nursed 50 times a day and it was just not healthy for any of us.

Anyway NOW we get help and he's doing much better (also as a toddler I weaned him and that helped too but I don't recommend it necessarily.  I was just done for a million reasons).  

So, good for you for getting the referral and let us know how it works out!

[APToddlerMama]

Originally Posted by SeattleRain 

Thank you for this. I tried signs when he was probably 6-9 months but not consistantly, and only me and not my husband. Perhaps if we both did it then it would stick better. He brings me things, but not if I ask for them. He'll just be eating string cheese and offer it to me, lol. He interacts with us great, he just doesn't seem to communicate, if that makes sense. My doctor says he's absolutely on track for his socialization and all his other benchmarks. Up until this point with the speech, we hasn't hit any of the other soft or hard markers so the truth is that I don't have any reason to really worry. It really is my own issues with feeling like there my son has to "measure up" to some benchmark, which I need to get past in order to be a happier mother.

Bringing you stuff is a great sign, even if you're not asking for them. I would guess he'd be more ready for signs now that at 6-9 months.  We all have our own hang ups over different parenting things.  I hope you are able to find peace with him developing at his own pace and not worry too much.  It sounds like he is really doing great.