Ear infections, fluid etc can definitely contribute to speech delays. The good news is that with medical care and speech therapy these kids do very well!
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I appreciate this thread. I think my daughter is doing much of what she sees recommended for her child’s age. She is going to wait and see what the pediatrician says at the next visit. She lives in a tiny rural town and I don’t know if the school district would even offer her anything at 17 months. She understands everything and can follow multiple step directions just no words yet.
Would a speech therapist be someone who would work with feeding and swallowing for a young child with hypotonia ?
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Sometimes. Very often this is done in concert with an occupational therapist.
I would suggest you discuss how these young children receive services in the state where your little one resides. The parents can call the local school district director of special education, and they should be able to give this info to them. Every state also has an info line of some sort, and that info could be gotten there. And the pediatrician should have that contact info also.
Just an FYI, kids don’t really talk all that much at the doctor’s office…so the pediatrician likely won’t have as good a picture of understanding or speaking. But DO ask. They will have the contact info for the parents. Even in rural areas, if a child needs early intervention services, there is a way to get them.
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Thanks. Two different kids, the one with hypotonia is already getting services. I was just curious who provided feeding therapy.
In my experience, feeding issues need to be evaluated by a feeding team, with a plan developed. Feeding teams usually include a speech language pathologist , occupational therapist, a doctor (could be a neurologist or a developmental pediatrician), sometimes a physical therapist, and a nutritionist. These teams can be found at most children’s hospitals.
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Yes sometimes. Sometimes it is OT. It can also depend on what’s available. I practice in a small town, 2 hours from the nearest small city, almost 5 hours to the nearest big city. We just have very few services for kids. Access has been a bit better in the last couple of years as long as the condition is something that can be treated over telehealth, but many services can’t be delivered effectively that way. In those cases, families end up either moving for the child’s sake, or the kid goes without.
(It is the same with senior services. If an elder needs a nursing home, that is 1.5 hours away, sadly.)
And sometimes they co-treat
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In every state and county, speech and language services are very different. Access to speech and language services depends on the child.
We did have a bus that picked up the kids in the rural parts of the county and brought them to rehab services at my hospital. A lot of my low income families needed transportation and couldn’t get to my hospital. A lot of my rehab services were conducted with the rehab team (mostly occupational therapist and the physical therapist).
Mom or Dad (or Grandma or Grandpa) would be at the bus with them and the driver would just pick up both of them. A lot of these families were farmworkers and had been up for hours. I would put together a “lunch box” for the family for the return trip, with a frozen water bottle and cold drinks.
The OT/PT, respiratory therapist and I, convinced the dietary department, to greatly discount box lunches for us.
We all chipped in. The families really appreciated it especially going back to the hot desert.
We realized that services were limited in some areas. Since I was one of the few bilingual therapists in my area, with hospital, private practice, and school experience, I was sent out to conduct an evaluation in the desert (2 hours to Borrego) because there was no one else. Sometimes an LVN would accompany me if there was a question about medical services.
I made sure that I provided a lot of parent education at my hospitals and school sites. I would send out flyers and would make “buttons”.
I had a poster on the bulletin boards with descriptors listed, as well as, my phone number, my classroom/office number, (room 4) and I would screen each preschool and kindergarten classroom when they came in for their assessments before starting school in August/September.
I know that when I worked in my school district my colleagues were just as proactive in what we called Childfind. Did I need more students on my caseload? No. I was overworked as it was, but I couldn’t stand the thought that any child/family was being pushed aside or avoided for lack of services.
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Some of these same conditions here in Appalachia Ohio. We have Childfind too - and host many casual events where parents can bring their kids with any milestone concerns for a screening - low key, family friendly and it sometimes gets the reluctant parent or the parent who has a worry about a delay some peace of mind - or services.
So people can also see if you have Childfind events in your area (check your local early intervention , Help Me Grow or Family Council websites)
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Our middle son had chronic otitis media. Our pediatrician alerted me to check on his hearing/speech and he was tested at our county center at age 3 but his hearing was fine and I guess so was his speech (long time ago) so he did not qualify for services at that time. But eventually he persisted with the Elmer Fudd syndrome: the wascally wabbit wan down the woad. Apparently if this doesn’t self correct by age 7, they need therapy. I think it was only a year of it, success. He was in parochial school but by extreme good fortune there was a public elementary school right across the street. I went once a week to escort him and a classmate to their therapy.
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It’s even easier now. The local education agency where your parochial school is located can provide services using a service plan. Where I am, districts with parochial schools within their boundaries just send a therapist to the school.
R can be pesky…and linger. As can TH.
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Where I am…the school district where the child resides would send a speech therapist to the parochial school, as long as the parochial school was located in the county. I did this a lot.
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I was also sent to local private schools when there was a need for therapy.
My school district had me on a four-day work schedule on-site, and then the 5th day, I traveled to the local preschools , parochial schools, and home school public sites (library reserved rooms) on my side of the freeway.
We had several therapists covering the district. They had similar schedules as mine. The district didn’t want one therapist to be overwhelmed, (with “living out of her car” to provide services) so they “divided and conquered” the students according to where our each of our sites were located and where the child resided.
Each preschool or parochial school had a separate area for me to do the therapy. Sometimes they forgot, so I got into the habit of calling their office and saying, “I am on my way. Please make sure that the therapy room is clear.”
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I am excited that DGD, 2yrs 2 months, will be getting assessed for speech and overall development this week. I have been watching lots of videos created by pediatric speech and language pathologists, and have my armchair diagnosis ready. Her receptive language is good, and she was/ is hypotonic. Signs a few words, and makes the beginning sounds of a limited number of words, but she isn’t consistent with the sounds she produces. She drools quite a bit and has a very loose and relaxed jaw. She is a darling, AND, I believe she needs frequent speech therapy sessions, and that we will need to be trained in how to help her with her speech therapy. Best tips from the online videos- work on copying games so that she gets the idea to copy/ repeat sounds, make it short, fun and meaningful.
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@anxiousmom sounds great! Early intervention with the very little ones can make so much difference. It’s wonderful that your whole family will be on board to offer reinforcement. My bet is that your GD will have a lot of fun! The early intervention therapists are awesome!
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That was my son’s issue, qualified at 18 months, weak mouth muscles (wore a bib at all times). It was tough having the ST come to the house, only because his twin sister wanted to play with Miss Janine and all of the toys. A good friend is an EI ST and loves seeing her “babies.” Crunchy food!
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DGD is not a fan of crunchy foods….but she is still nursing a little bit. I am sure that her nursing history was helpful in so many ways for her oral development.
My 8 year old grandson’s teacher just recommended speech therapy for him to my daughter as she now notices a slighter stutter from him. When he was pre-kindergarten, I noticed some stuttering but he has improved over time and now in 3rd. Now he does get hung up over several words.He’s been a very quiet child and now she’s hearing him speak up more and notices his stutters.
What kind of speech therapist should my daughter look for?
Typically your on-site school speech therapist can do the job. There are some therapists that specialize in stuttering or what we call “dysfluent” Speech (dysfluency).
What I have found that worked for a lot of my students was changing their pitch level. (a lot like what James Earl Jones did for his therapy). But every child is different, so we also incorporated some self-esteem exercises. I made sure my Children’s groups for dysfluency got into really strong support systems for each other.
Also, there’s a poster put out by the American Speech Language Hearing Association (ASHA). It shows all the celebrities and national athletes who had a history of stuttering along, with our current President.
We tended to “shower” our dysfluency groups with fun short plays and role-playing games and scripts. Lots of sincere praise, and making my room extremely comfortable for them helped a lot!
In the high school, I had my students participate in drama. The teachers recognized that this would be really opposite of where these kids wanted to be, but they gave them jobs behind the scenes and had my students help the actors run their lines. It worked really well because most of the time they just had to listen. But because they knew the lines, it was rehearsed repeatedly, their fluent speech appeared and improved. My students were praised often by their drama coaches and other students.
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Your school based therapist should be able to guide you. I’d start there.
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