Evaluation for Delayed Speech & bfing - Mothering Forums
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#1 of 24 Old 11-27-2002, 01:20 PM - Thread Starter
 
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Hi everyone: I have not been around in a while (been working a lot) but a while back, about a month ago, I posted saying that our pediatrician suggested getting an evaluation to see whether ds needs OT or PT because he was 18 months old and not talking yet and also being fairly agressive (mostly biting). I got good responses here from people who'd had it done.

So, we just had the evaluation today: he was observed by 3 different specialists for his play skills, socialization, fine and gross motor skills, etc. And when they talked to dh and me afterward they noted that he is still bfing and told me that the physical therapist thinks that it's likely that it has something to do with his mouth muscles being weak and him not having words yet. I was so surprised, I have never heard of this being a by-product of bfing before at all--and I read a lot of articles and books about child development, bfing, and so on. SO I expressed my surprise (and skepticism) and they were quick to say It's a personal choice, of course you won't be pushed to wean if you're not ready. But it seems to me if they're saying that, it would be obvious they're also saying bfing is slowing him down in the speech department. THey added that bottles, sippy cups too are to blame for this but aren't most kids who are 19 months old using sippy cups and/or bottles, if not bfing? I just need some feedback on this, especially if anyone has done OT or PT with their kid to jump start talking. I am in no particular hurry to end the bfing. DS does it a few times a day, mostly at night, and it calms him down and comforts him alot, and I use it to connect with him because I work full time.
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#2 of 24 Old 11-27-2002, 01:37 PM
 
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I'm not any kind of a medical expert, but sounds like a pile of poop to me!!

If anything, babies usually have to suck harder to get milk out a boob versus a bottle, don't they?

maybe some ask some more questions about what they base their theories on? :
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#3 of 24 Old 11-27-2002, 02:09 PM
 
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Follow your instinct, can you say "making excuses"? That's what they are doing..

Here's my question: Does your son not speak at all? Does he say Dada, Mama? at 18 months old my DD wasn't saying much and it seemed normal to me, she is 5 now and won't shut up! DS is 15 months old and understands well, but has few words. He als obites me alot, out of anger and due to teething (he only has 6 teeths, imagine what they'd say to that?!?!) I am jus tbeing curious. Do you see a problem or do you believe the yare overreacting?

And keep on breastfeeding, that boobie milk feeds the brain!
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#4 of 24 Old 11-27-2002, 02:31 PM
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What incredible silliness! Why is it that, whenever there's some issue or other for which folks don't have a ready explanation, breastfeeding becomes the culprit??? If they can show you several well-executed, statistically significant studies demonstrating a link between breastfeeding and delayed speech, then that would be one thing. But I'd be willing to bet a very large sum of money that they can't.

Maybe you could ask them what they'd suggest if they assumed your child didn't breastfeed? I'm sorry you're having to put up with such foolishness when you're trying to deal with your child's issues!
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#5 of 24 Old 11-27-2002, 03:15 PM
 
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Funny, I had heard that breastfeeding actually strengthens the mouth muscles necessary for speach, as well as helps shape the mouth properly for both speech and eating.

Sounds like they are full of it. Trying to find something to blame because they can't figure something out. How irritating. If you continue to work with them, I would say something along the lines of "this is not an issue, we will not be dealing with this here. Please stick to your area of expertise."

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#6 of 24 Old 11-27-2002, 03:43 PM - Thread Starter
 
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He has a few words--Mama, No, and Da--which is technically behind the curve. After these response I feel encouraged in my decision to question them the next time I speak to any one of the therapists about this. I don't think I'll wean until we're both good and ready to and when that is, I can't say. I asked the same question, shouldn't his mouth muscles be stronger for breast feeding (it sure feels to me like they're strong!) and was told, no, different muscles are used, it's a different action. Well OK, I'm willing to accept that, but don't feel that it really warrants weaning. On the whole, I don't think that 19 months is all that unusual to be not talking yet. If he were two or older, that would be different but what I am hearing from a lot of parents, as in posts here on the Mothering Board, is that ds or dd was a late talker but did eventually talk when they were ready. Still am a little alarmed about him being behind on 'play skills.' I can always request another evaluation at another place or different therapists.

Thanks a lot for replies and I feel like I've been backed up.
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#7 of 24 Old 11-27-2002, 03:45 PM - Thread Starter
 
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And Marlena, I'm going to ask if they can direct me to such studies.
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#8 of 24 Old 11-27-2002, 03:59 PM
 
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can I weigh in? I do this for a living...

Here's the rule of thumb...

1 year of age, should be able to give one-word utterances...

2 years of age, should be able to give two-word phrases...need about 50 single words to do this....as they come close to 3 years of age, three-word-phrases should begin, and they need at least 100 words in their vocabularies to do this.

This is not the "average", but the bottom line in terms of what is needed.

In my personal and professional opinion, blaming lack of speech on sippy cups, bf'ing or any other type of drinking device is a pile of poop. I can see a child who has a pacifier in his or her mouth all day not talking because they simply never practice, but the other things are ridiculous!

Both my kids bf, bottle-fed with EBM, and use sippy cups. They also used pacifiers at daycare because I feel consolation is better than crying. They both talk. DS had fantastic language early on. DD is still questionnable, her language is certainly not where his was at the comparable age, but she's still doing fine. I mostly get one words, or phrases she's previously heard, and she's almost 20 months. Don't let them scare you.
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#9 of 24 Old 11-27-2002, 05:42 PM
 
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did they give you any evidence? such as a study? or article?

as for bottles and sippy cups.

all the babies/toddlers that i know used sippy cups for at least 3 years.

and the people i know that bottle feed usually do so for around 2 years.

i'd like to see their "proof" really. it sounds fishy.

ps. i bottle fed only, and my oldest son was 2 years before he said many words, then all at once started speaking in paragraphs. i think it is rare when it is a problem...at that young of an age.
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#10 of 24 Old 11-27-2002, 07:30 PM
 
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Sounds like a pile o' poop to me too, to quote the others. And quite frankly it is irresponsible to spew that kind of garbage when you supposedly are a "professional".

I would honestly reevaluate whether you would want to continue there - I think they've given you a reason to mistrust their professional opinions already!

Good luck, I'm sure DS is 100% fine. I cannot tell you how many kids I know who have gone through the early intervention thing and each and every one of them has begun talking and been fine.

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#11 of 24 Old 11-27-2002, 07:44 PM
 
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If I got that response...the negative twist on nursing from those 'experts'... I would RUN and I mean RUN the other direction at about a hundred miles an hour.

If they are blaming nursing than why the hell does the world health organization support nursing until 2 years.
that would mean children all over the world are delayed.....

I agree that I would do something to get to some potential answers but the fact that nursing was brought up at all..would be a red flag that they are LAME.

very lame.

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#12 of 24 Old 11-27-2002, 08:07 PM
 
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I came back because I've been thinking about what they said to you all day....

Another thing about evaluating children who are this young is that the evaluations are really unreliable. Your child could come out with totally different scores on another day, and I'm not talking about 6 months down the road, I'm talking tomorrow. A lot of it depends on what your child is willing to show a stranger. And if they completed a parent questionnaire with you, then it partly depends too on how they worded the questions, how they interpreted your responses and how rigid or flexible they are with their own scoring.

I see kids down to about 2 1/2 years for evaluation, and if I have a kid come out in the "delayed" range, I NEVER say the child is retarded unless the child has a syndrome that retardation would be associated with (not that they said this about your ds). The reason I would never say that is that things change so quickly and dramatically with young children, that until you've seen the same pattern over several years, it could be any number of things that are going to allow that child to "catch up", so to speak.

anyway, I just wanted to hopefully make you feel even a little better about the results. I'm sorry they said those things.
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#13 of 24 Old 11-27-2002, 08:57 PM
 
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OK, I am comin from the BTDT camp with two kiddos who have been through evals, therapy, etc. Blaming delayed speech on nursing is (unfortunately) very commin among SLP's. I would take that prized piece of horsepucky and toss it. HOWEVER, and especially since they are seeing delays in his play skills, I would continue the process and get that kiddo into some therapy pronto. Don't discount everything these therapists say simply because of the nursing comment, but also don't be afraid to ask for a new therapist if the one you get just isn't someone who you feel comfortable working with your child.
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#14 of 24 Old 11-27-2002, 11:22 PM
 
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Ask them to support their opinion with sound medical research, in the form of studies/articles/whatever. You can be nice and say "I've been thinking alot about what you told me and I'd like some more infomration. Do you have any articles about breastfeeding and delayed speech" or something like that to be non-confrontational if need be.

I think of it like this, if a toddler was meant to nurse, you wouldn't be lactating, they wouldn't be able to suck, etc. and anything I have ever read discusses how it HELPS the palate, muscles develop and enhances speech, not inhibits. And it isn't like your son is walking around (or dd sorry) with boob in mouth like a pacifier or sippy anyway. A nipple is anatomically correct and made to be that way for a reason.

Sheesh.
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#15 of 24 Old 11-28-2002, 02:12 AM
 
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The thing here is, that if you had not said you were still nursign him, they would have blamed it on something else or had soem other reason for it.
A woman I know had this experience with her 16 mth old dd- though it wasn't for speech. Her dd has had problems with her muscle tone or something like that and had some intervention to help her with that and she is now crawling and pulling up. She has also had a problem with gagging on food- she still occasionally gags but can eat most soft, mushy foods.
They blamed this on BFing! She talks above average for her age and cognitive is great- plus she has always been a good eater, as in she eats a lot of food and has since before 6 mths old!
So I agree that it is a load of crap- they are grouping BFing with bottles and sippys.
And even bottles and sippys only cause problems when they are constantly sucked on, all day long (and even then I don't think it is too common, maybe even not related?)
I think your boy sounds totally fine- I know a lot of kids who said very little understandable words until after their 2nd Bday.
Actually a Mom I know personally has a son that says only a few words and he just turned 2.
Good luck! You sound like you've got it under control!
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#16 of 24 Old 11-28-2002, 03:18 AM
 
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My ds is 18 months and doesn't say any words. He understands a lot, too much sometimes! He is very coordinated, bright, active, etc. etc. And he still nurses. Like the other posters mentioned, I can't think of any way that nursing would be responsible for late speech development. I keep hearing of many kids who don't talk much or at all until 2 or so. What were the other "play" areas that they were concerned about? I would most definitely not be thinking of weaning.

I also have to strongly agree with one poster that mentioned how an evaluation can differ one day to the next at this age. Ds can act totally differently around certain other people than he does around dh and I. When I tell him to get a book, he runs and picks one out. If there are some other people around and I tell him to get a book, he acts all shy and non responsive. And even though he doesn't talk, we can say a line from one of his books and he will pick through them until he finds that particular one. But he just isn't interested in talking yet.

One time he was petting a cat, and said clear as a bell "kitty." Only said it once. We don't have a cat, so I don't even know why this would be the one word he said, but there it is. He makes mama and dada sounds, but doesn't refer to us directly. My gut tells me that everything is totally fine, but sometimes I get myself freaked out by reading a baby book or something that says he should have 50 words by now. What does your intuition tell you?
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#17 of 24 Old 11-29-2002, 12:39 AM
 
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As a speech pathologist working in early intervention for the past five years, I do not think breastfeeding is a factor in speech delay. Even sippy cups and pacifiers, from what I've read, are only harmful when a child has it in his mouth all the time. When I am working with toddlers who use pacifiers I ask the parents to please not let them have it while playing and interacting with others, but of course continue to use it when the child needs it for comfort reasons such as falling asleep or when upset. If toddlers have something in their mouths constantly, they are not practicing/experimenting with speech sounds (but I have met several children who can talk clearly through a pacifier!). And I doubt that your ds walks around the house with the boob in his mouth!

I would suggest staying involved in therapy because of the possible delay in play and speech skills, and the therapists might be able to give some good suggestions regarding aggressive behavior. Sometimes toddlers are aggressive because they can't communicate as well as they want to. Have you tried introducing baby signs? This might help to reduce some frustration on ds's part.

I agree with some of the others that it may be, in fact probably is nothing. However I feel it is better to begin intervention early instead of waiting until three years old and saying "I guess it's not something he'll grow out of" because then valuable time has been lost - so much brain growth occurs in the first three years. I guess I'm saying as long as therapy is fun for your son it can't hurt to go just to be on the safe side.

Good luck with this, and keep following your instincts!
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#18 of 24 Old 11-29-2002, 03:01 PM
 
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Am I missing something? I sware your description is that of my 15 month old son, who we see as advanced in many ways! He says a few words but comprehends well (If I say "go get your sneaker" he will). He is aggressive ( was pushing a kid yesterday-ugh!) but he isa baby, I try to redirect him and it works sometimes. He is late on getting teeth ( he is up to 6 teeth now) and I belive he has teething pain often, because he has sporadic biting outbreaks. Realize, I have a DD who was the exact opposite of the above (besides the not talking much at this age) and DS's actions still seem normal to me. He is a handful no doubt, but most kids are.

Your son sounds normal to me!
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#19 of 24 Old 11-29-2002, 03:53 PM
 
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i worked in child care for a few years, at a daycare for toddlers. i am no expert by any mreans, but i observed alot of kids, plus i used to babysit all the time. it seems to me it is common for boys to talk later than girls, and to be more physically expressive instead. boys *tend* to be more action oriented, and will be way more into physical expression rather than verbal. of course not always, and if your intuition is telling you there is something missing in your sons development then by all means investigate it and get help for him. i have known alot of boys who didnt talk till after 2, and they were rambunctious and all, but really, just normal kids. it is hard when you read the "development guidlines" to not freak out, but as you can see in real life many little boys your sons age are at the very same level of development, breastfeed, and turn out to be huge talkers a year later.
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#20 of 24 Old 11-29-2002, 05:49 PM
 
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The therapy may or may not be useful, but the breastfeeding advice is, I agree, about as useful as the contents of your child's diaper.

Breastfeeding is NOT the cause of speech problems.
Breastfed children are LESS likely to need speech therapy or braces because breastfeeding is the PERFECT exercise for little mouths and jaws. (Sadly this does not mean that NO breastfed child will have these challenges.)
(try http://www.askdrsears.com for references, or it may have been one of the "101 reasons" to breastfeed article at
http://www.promom.org
)

The American Academy of Family Physicians,
The World Health Organization,
and UNICEF
ALL recommend nursing AT LEAST two years for optimal health.
(if you need the references to these just respond to this post and an email will be sent to my box.)

This therapist is IGNORANT about breastfeeding. Sadly in our culture this is not surprising.

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#21 of 24 Old 11-30-2002, 05:24 AM
 
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Bottlefeeding, sippy cups, and pacis are cited in studies as causing speech delays, and many SLPs (not all thank goodness) generalize that to bf. IN most coursework, it is simply never covered as a separate dinstinct way to feed. However, bf is very good for jaw and muscle development. I can think of one paper about how "training" a baby with down's syndrome to bf
actually prevents the tongue protrusion that is considered "standard" in babies and toddlers.


My son is a 30w preemie, now 4.5y, and has mild CP and most of his obvious problems are with articulation. I heard the "you need to wean" from one SLP only (ECI, brand new out of school), and was able to defend against that by citing WHO recommendations for bf for 2 years. Everyone else was very encouraging. Our current (male) SLP is a strong advocate for bf, and asked me for advice for his then pg wife on how long should babies nurse. I told him Jimmy still does, and we have had several good conversations about it. He credits it with a lot of Jimmy's progress.

I am also the family liaison for our ECI program, and have been able to use my experience to help train the rest of the staff as well. You have the right to request a different therapist if you do not feel comfortable with the one(s) you are seeing, it may just take making a little noise. As long as your child enjoys the therapy, it certainly won't hurt to do it, and it was fun, to me anyway, to sit back and watch my son interact from an outside perspective. Much of what the therapy will involve will probably be things you do anyway.

Carrie
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#22 of 24 Old 12-02-2002, 03:40 PM - Thread Starter
 
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Thanks all of you. I just read through every post and feel completely sure now that the bfing thing is just plain misinformation. It does shake my confidence in this particular agency, and I plan to be honest about it in the upcoming meeting. We plan to go forward with the intervention but also plan to dismiss the bfing thing. We can use another agency of course, it's just kind of time consuming. Also, a lot is going on in ds's life right now in terms of transitioi (moving out of the family bed, we'll be moving in the next few months) and I don't think it's smart to completely wean at this point.

LiamnEmma, you are absolutel right about the whole evaluation process. Wouldn't you know, the day after the evaluation, ds placed a puzzle piece in the correct shape and during the evaluation it was pointed out to me that he couldn't do it. And since then he's said 'dog' a few times and is now saying "No mama" instead of just 'no' and 'mama'. I read these posts twice, and also had a good talk with my sister who is a wise mother and a social worker who works with children and decided that ultimately, whatever we do, I will not let it interfere with how we are instinctually and happily raising him, which includes breastfeeding. The more I thought about it, the more it didn't make sense. As a couple of you brought up, wouldn't that mean that most children worldwide would be speaking late? As I said I have NEVER once heard this anywhere before and I do keep up with bfing stuff, both pro and con.

Anyway, thanks again, it really makes me feel grounded to get real feedback.
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#23 of 24 Old 12-02-2002, 09:08 PM
 
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Just wanted to add onto the end of the discussion here. My breastfed daughter is now 22 months old, but at 18 months she didn't say that many words, just dada and mama and dog, that sort of thing. By 19 months she could repeat a number of words, but not use more than a handful appropriately. At around 20-21 months, her language skills began to really explode. Now at 22 months, she can make simple sentences and use possessives and things like that. Compared to some of her peers, she was late in her speech development, but I always thought it didn't really matter when I saw other kids "saying" more, but not using words appropriately. A 16 month old who calls anything round "ball" is no more advanced (IMHO) than a child who says nothing till months later but then labels more things correctly. I think it says more about the personality of the child.

I do think it's wise to take note of delays in a child's skills, but not to worry too much about it. I walked at 7 months, but you don't see me in the Olympics! I bet you could find a huge number of Olympians who were "late" crawlers and walkers, though. And a whole lot of scholars who were "late" talkers, too.

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#24 of 24 Old 12-22-2002, 11:59 PM
 
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oh please !!!!!!!!!!!
i am late but what the hell does bf have to do with it?
my first didnt talk atlot till she was 2. at 18 months she di say thing like me up me down simple things. she self weaned at 15 months.she explode at 2 to 2.5. she speaks great now.
my second is 25 months and speaks almost as well as his 3.5 year old sister. he started at 18 months and I think has 100 0 word voc.he is just a talker and the funny thing is, i read more to her than to him cause he doesnt sit still
he nurses 8 times a day at least.
nuff said.
i hope u get it taken care of but try not to worry dont think its the bf..............
angel
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