If not ASD, tell me about communication/speech disorders or delays? (updated) - Page 2 - Mothering Forums
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#31 of 45 Old 07-03-2012, 10:53 PM - Thread Starter
 
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I do have one question about FORCE.

Not punishment/discipline... but even my girlfriend B said tonight... "maybe you should try to force him to say it correctly"...

 

ie... you will not get said item until you say it correctly.

 

I told her that everything I've read/heard says DO NOT do that until they're at least over 4yrs old.

 

Is that right?

 

She did head-twist and thinking about it... her son didn't utter until 3yo, so it wasn't until at least 4yo that she forced with him. And she recoiled and admitted that while that was part of their therapy, likely didn't start until he was 4+yo. (in her defense, her son is 13, so while she remembers... her time-line is off a lot).

 

But thought I'd ask. I've never been this way. My mother, a very active grandmother, IS this way. And I've actually kept him from her recently because she requires him to say words correctly (which he... well, he just won't.. he's just not there yet). And I think it frustrates him more than anything. And makes him not like his grandma so much. She thinks his speech delay is just laziness, and I'm just not seeing anything in my readings that this is appropriate at not quite 3yo. At 6yo, Maybe. But not this young.

 

Thoughts?


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#32 of 45 Old 07-04-2012, 10:03 AM
 
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Eek, I feel pretty strongly that forcing kids with language disorders to say words in general is a terrible approach.

 

Working with our developmental ped and our speech therapist (with distance input from a world expert on children with language disorders), the general agreement is that we want our DS to feel like a competent communicator and that we should simply recast a word correctly after they say it.  Don't tell them they made a mistake, just repeat the word correctly then pause to give them a chance to say it correctly themselves, then move on whether they say it again or not.  
 

Everything I've read says that forcing correct pronunciation can have very negative consequences.  For example, a child might simply withdraw, or stop trying since they know they can't say it totally "right."  You want to encourage MORE attempts, not less.  That is how they will improve, by trying over and over again. 

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#33 of 45 Old 07-04-2012, 10:26 AM
 
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I haven't read through all the responses so far, but it sounds like he has a lot of characteristics of apraxia. Sounds like he is having trouble with his motor planning, which explains his clumsiness as well.

Also I agree w pp- don't try to *force* him to say the sounds correctly! You might be able to help facilitate accurate production by adding a hand sign to go with a certain sound (bringing his hand up to his lips for the /p/ sound for example) or even touching his lips gently when practicing the bilabial sounds (p, b, m) but don't force it and try to make it a positive experience when you practice :-)

Good luck mama!
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#34 of 45 Old 07-05-2012, 05:08 AM
 
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Originally Posted by JordanKX View Post

I do have one question about FORCE.

Not punishment/discipline... but even my girlfriend B said tonight... "maybe you should try to force him to say it correctly"...

 

ie... you will not get said item until you say it correctly.

 

I told her that everything I've read/heard says DO NOT do that until they're at least over 4yrs old.

 

Is that right?

 

She did head-twist and thinking about it... her son didn't utter until 3yo, so it wasn't until at least 4yo that she forced with him. And she recoiled and admitted that while that was part of their therapy, likely didn't start until he was 4+yo. (in her defense, her son is 13, so while she remembers... her time-line is off a lot).

 

But thought I'd ask. I've never been this way. My mother, a very active grandmother, IS this way. And I've actually kept him from her recently because she requires him to say words correctly (which he... well, he just won't.. he's just not there yet). And I think it frustrates him more than anything. And makes him not like his grandma so much. She thinks his speech delay is just laziness, and I'm just not seeing anything in my readings that this is appropriate at not quite 3yo. At 6yo, Maybe. But not this young.

 

Thoughts?

 

If your son had a broken leg, would you force him to walk on it?  If he was blind, would you try to force him to see?  Both ridiculous questions - just as your friend's recommendation is ridiculous.  If your son has apraxia, dyspraxia or other speech disorder then you could no more force him to speak correctly than you could force him to sprout wings and fly.  More than likely it's neurological in nature.  Your son's mouth isn't receiving the proper signals to form the words just yet.  A good speech therapist will work on your son's oral tone (strengthening exercises) as well as the speech itself.  Now, don't get me wrong, I do correct my son but I don't force him to say it correctly - just to try.  So, at your son's age, if he said "duff" when referring to a duck I'd have him look at my mouth and watch me say duck and then I'd ask him to repeat it.  He would usually just say duff again but you could see he was trying to get the hard "K" sound.  Over time and a lot of speech therapy (he's been getting speech 4x a week during the school year for 3 years - he drops to once a week in the summer), his articulation has improved dramatically.


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#35 of 45 Old 07-05-2012, 08:50 PM
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There have been published studies demonstrating that forcing/telling a child what to say is the least effective method to stimulate speech.  The single most effective method is "maternal imitation," when the primary caregiver playfully, lovingly imitates every utterance that the child makes.  You can look it up on PubMed - I think the title of one study was "When 'Simon Says' Doesn't Work."

 

I have one child with autism and one child who was a late talker - both needed lots of extra interaction to learn to converse, and neither responded positively to being told what to say. 


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#36 of 45 Old 07-05-2012, 11:48 PM
 
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It's good that you sought an outside specialist for an evaluation.  I am in Oregon too and Ive found that EI/ ECSE tends to see need only when it is almost an emergency.  Their cut off scores I am guessing are pretty low.  I had to get them to screen my DS multiple times before they agreed there was a problem and even then it was because the last time around the SLP was more in tune with parents' concern and based on that gave us a referral.  I suspect that my DS might have Auditory processing disorder but I have to wait until he is elementary school age to know for sure.  Like others have said trust your instincts.

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#37 of 45 Old 07-07-2012, 08:36 PM - Thread Starter
 
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Originally Posted by Azik's mom View Post

It's good that you sought an outside specialist for an evaluation.  I am in Oregon too and Ive found that EI/ ECSE tends to see need only when it is almost an emergency.  Their cut off scores I am guessing are pretty low.  I had to get them to screen my DS multiple times before they agreed there was a problem and even then it was because the last time around the SLP was more in tune with parents' concern and based on that gave us a referral.  I suspect that my DS might have Auditory processing disorder but I have to wait until he is elementary school age to know for sure.  Like others have said trust your instincts.


And this is my question, that you asked for Multiple Screenings, whether or not had to, you did.

I mean... what does that even mean?

EI's goal is not to diagnose, but to merely get them ready for school. I didn't know you could even dispute. But again, what would it matter? they will not diagnose... they will simply re-evaluate to see if they're eligible for services, right?

 

So if you're looking for more, you HAVE to go outside of EI right?

 

I can say that I'm not over EI yet, because I will give them faith on the "almost-3" evaluation and see what comes from that. Yes, I'll do what I can privately too. I'm not closing any doors, and I am not a believer in anything yet.


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#38 of 45 Old 07-09-2012, 08:47 AM
 
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JordanKX~ I only work one day a week in the summer so sorry for the delay in getting back to you but I haven't checked the website!

 

I am DEFINITELY against the "force him to talk" idea! Here is a quote from my previous post: "Younger kids need to target imitation skills in general in a fun, interactive way. Definitely target activities that take the pressure off of speaking at first. Some children learn that it is easier to play alone than to be unsuccessful in their communciation attempts."

Working with 1-3 year olds is very different than 4-5 year olds.

 

Here are some prompts to use...and some to avoid:

      Tell them "watch my mouth" then, at first, reward them for ANY attempt ("you were trying" or "Good job, you were watching my mouth.") Even reward them for trying the same mouth shape, even if the word is not said correctly, "You opened your mouth really big like mine!"

      Use cues they can feel or hear such as clapping the syllables for "buh-bol" or stomp your feet while saying "boom boom..."

      You may need to simplify a word so they can be successful:  hoho/santa, buh buh/ bubble, appo/apple...

      Be aware that some errors are normal for toddlers (simplifying blends such as nake/snake is OK, also goggie for doggie, dump/jump... and many other errors are just to be expected.)

      Therapy should NOT be a power struggle or adversive. I use the rule of three: if I have tried three times to get him to say it and he hasn't, I move on and try to think of a better, easier prompt that would make him more successful next time. They have to experience success early or they will shut down, just like it sounds like your son has done with g-ma! Getting ANY toddler to imitate can be tricky business!

       After I have built a relationship with a child and they are willing to try to imitate me, it is important to get several repetitions of the targeted word. ie: if they say a word that you are targeting with them, hold up three fingers and encourage them to practice that word three times. Repetition helps train the brain for the correct movement (remember that Apraxia is a motor coordination issue)

 

These suggestions are easy to do and easy to make fun. So I tell parents of toddlers to put away the flashcards and drills and just act silly, be overdramatic and repeat familiar words in play. The more you engage your child in playful back and forth interactions, the more they will want to interact and learn from you!

 

Have fun, be accepting of any attempt and, most importantly, be patient; it takes awhile to see improvement with toddlers with Apraxia!

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#39 of 45 Old 07-11-2012, 09:52 PM - Thread Starter
 
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Originally Posted by aspeechthx View Post
So I tell parents of toddlers to put away the flashcards and drills and just act silly, be overdramatic and repeat familiar words in play. The more you engage your child in playful back and forth interactions, the more they will want to interact and learn from you!

 

 

Have fun, be accepting of any attempt and, most importantly, be patient; it takes awhile to see improvement with toddlers with Apraxia!

 

I really appreciate all your words, insights, ideas!! Thank you thank you! Thank you for being up here and offering your insights to this board.

 

And this really stood out to me because I am very relaxed, (i hope) encouraging, and Yay all around. That's just my nature anyway, but also because I DO read (everything I can get my hands on) and that seems to be the general consensus.

 

The flash cards stood out because this is So my mother. Ugh. She just brought over yet another packet the other day. I mean, he'll do flash cards and puzzles and word books all day long. Thank goodness the kiddo likes things like that. But watching her with him was painful.... not chastizing, but so In His Face, say it again, listen to the ESS sound, just over and over again. I felt very uncomfortable this last time and I won't let her do it again. The last thing he needs is any negative feelings about his attempts - his happiness so far through this all is an amazingly wonderful aspect. He doesn't get Too Terribly frustrated... yet.


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#40 of 45 Old 07-20-2012, 04:53 PM
 
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I"m not a professional, so take this for what it's worth, but to me, so far this sounds like dyspraxia of speech.  Especially this statement:  Main kicker was his clumsiness... that he falls All.The.Time.

 

For more info, try http://www.dyspraxiausa.org/resources/links

Since your son is already in EI, ask them what they think about that possibility...

 

These behaviors are not typical with autism:

 

He is very social

loves all types of activities

doesn't have fixations

doesn't tantrum

no sensitivity issues

fantasy play

 

(I am thinking with the new hand-movement, that he might be a good candidate for signing... something we've never tried before, well, not since the few things as an infant).

 

If he has any kind of speech delay, signing won't hurt a bit!  It'll help a lot to encourage more communication, actually.

 

 


 

 
 
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#41 of 45 Old 07-21-2012, 09:47 PM - Thread Starter
 
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So I've now met with speech therapist #2 twice, not a huge fan. but whatever... SO MUCH BETTER than the first time we met with her. She didn't have any blanket statements of "he is this... he isn't this..." just more, they had fun together. she recorded the 1/2hr because she learned she didn't have time to write down all the words.

 

I'm thinking she's new to EI or practicing speech therapy in this way. Maybe that's just my judgement.

 

Enyhoo... one more with her. And then he'll be evaluated for the over 3 group.

Plus will have a formal eval with the hospital speech therapy group beginning of August.

Absolutely moving forward.

 

I've had a handful of statements over the past few weeks... my neighbor who works in special ed says "well now that you mention your concerns, yes, he could have some aspergers"... and other friends... "he is so much more coordinated recently, look at him on the pedals!"...

 

I love friends/family/neighbors... I'll take their words, but I'm not processing them. It's not affecting me. He is learning, where he should be right now, and I'll know more after the more formal eval.

 

Hate waiting. But having a great summer regardless. That's the point... right?


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#42 of 45 Old 07-23-2012, 04:58 AM
 
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Great attitude Jordan and yes, you are right.  You can choose to sit and worry or you can choose to sit and enjoy your child.  The later is definitely the better choice for all :)


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#43 of 45 Old 08-04-2012, 10:37 PM - Thread Starter
 
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Just have to post here about the formal eval that we had here....

 

"articulation disorder" is what she ended with and how she'll code her request to OHP for future therapy sessions. 

 

She said he's very advanced in his vocabulary (much she didn't expect for kids under 4yo); all correct on his pronouns, lots of -ing words. Has lots of CV combinations, although not consistent from word to word, however his pronunciation (or mis-) of words is consistent... which to her, ruled out apraxia.

He is not consistent in the consonants he can/can't say... he will say Purple, puppy, pop.... but drops the "p" on most other words. So it's not that he CAN'T use a P, he just most often uses a hard-G sound for everything or drops the consonant entirely, especially if at the beginning of a word. All of which she said can be remedied with therapy, although it might take time.

And time, I'm OK with.

 

She had zero concerns about overall development and anything processing; that he understands, can hear, and can respond... you just can't understand his response. So that means... Articulation.

 

I'm OK with all that for now.

It was so good to hear something more formal, and to hear her response that OHP will cover private therapy for him 2x a week for 6 months, likely continued after that, but they initially only give 6months at a time. That's fine too!

 

All very positive. So.... moving forward :-)


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#44 of 45 Old 08-06-2012, 05:09 AM
 
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That's wonderful news!  Good for you for pushing the issue and getting your child the help he needs.


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#45 of 45 Old 08-06-2012, 07:30 AM
 
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I picked up on this thread late, but I just wanted to encourage you to hang in there, and keep pressing to get your son what he needs. My son had an articulation disorder that is almost cleared up at this point (he's seven and will soon enter 2nd grade). He received speech therapy through our state's early intervention program from 2-3 at home and then moved into public preschool at 3 where he received speech therapy twice a week for 1/2 hour. The therapy helped him and he made progress, but, even so, his kindergarten teacher said he was the hardest to understand of all the kids she'd had in her 12 years of teaching. What made the biggest difference was finally having his tonsils and adenoids removed between kindergarten and first grade. If you haven't already had that checked for your son, make sure you do that. My son still struggled with speech after that, but he made much faster progress. There were all kinds of sounds that his huge tonsils were stopping him from making, that he could suddenly learn to produce with relative ease.

 

This may not affect your son, but I wanted to give you a heads up that speech disorders are often an early indicator of eventual reading disorders. This was true in my son's case, and our big battle has moved from teaching him to talk to teaching him to read. This may not affect your son at all, but it's something to look our for when he's beginning to be taught to read. 

 

Also, I know from experience that random friends and relatives who know a little (or even a lot) about ASD just love to "diagnose" a child with speech disorders with ASD even if he shows absolutely no other signs (or they manufacture the signs from something else, for instance, my son was noted as exhibiting "flapping" behavior when he was pretending to be a bird :)). Trust your instincts, not random friends and a relatives. 


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