Parents who had a 2-year-old with speech delays: what's it like now?
August 12, 2019 8:41 PM Subscribe
That is, what are things like a few years after you first realized there was a problem and started speech therapy and/or early intervention?
When I tell people that my son hasn’t started talking yet, I tend to get these very anecdotal, suspiciously positive, stories. They go something like, “Oh, my coworker’s cousin’s sister-in-law’s kid didn’t start talking until they were 3 and it was in complete sentences and now they are graduating from Harvard so no worries!" I have a hunch that either these kids weren’t really weren’t that delayed or they were just quiet, introverted kids--silently and calmly observing and choosing not to speak.
My kid is not calm. He is not quiet. He is a loud kid with lots of energy, who grunts, moans, whines, growls, babbles, and of course, cries and screams. He’s quite social and extroverted in his own way, charming strangers on the bus with lots of eye contact, big smiles and laughs. He ends up communicating with gestures, dragging you towards the things he wants or leaping on you and giggling when he wants your attention, adores physical interactive play, gives hugs and high fives. But, at 28 months he has a total of 3 words—one of which is “no” and none of which are “mommy” or “daddy.” Does this sound like your kid? Did you ever see any progress? What did it look like? How long did it take?
More details to preempt likely questions: Yes, we’ve tried sign language – with limited success. Yes, we’ve tested his hearing – no problems there. Yes, we’ve contacted Early Intervention and he has been getting all of the therapies—not just speech, but occupational and developmental as well—for almost 6 months now. We also moved him from a nanny type of situation to full-time daycare about 2 months ago. He was a preemie, 2 months early, with medical issues that kept him in NICU for an extra month, but nothing neurological or that would affect his physical ability to make words/sounds. He's been diagnosed with sensory processing issues (sensory seeking), but so far docs/therapists have hesitated to diagnose him with autism. They haven't ruled it out though and we are on a very, very long waitlist to see a developmental pediatrician.
When I tell people that my son hasn’t started talking yet, I tend to get these very anecdotal, suspiciously positive, stories. They go something like, “Oh, my coworker’s cousin’s sister-in-law’s kid didn’t start talking until they were 3 and it was in complete sentences and now they are graduating from Harvard so no worries!" I have a hunch that either these kids weren’t really weren’t that delayed or they were just quiet, introverted kids--silently and calmly observing and choosing not to speak.
My kid is not calm. He is not quiet. He is a loud kid with lots of energy, who grunts, moans, whines, growls, babbles, and of course, cries and screams. He’s quite social and extroverted in his own way, charming strangers on the bus with lots of eye contact, big smiles and laughs. He ends up communicating with gestures, dragging you towards the things he wants or leaping on you and giggling when he wants your attention, adores physical interactive play, gives hugs and high fives. But, at 28 months he has a total of 3 words—one of which is “no” and none of which are “mommy” or “daddy.” Does this sound like your kid? Did you ever see any progress? What did it look like? How long did it take?
More details to preempt likely questions: Yes, we’ve tried sign language – with limited success. Yes, we’ve tested his hearing – no problems there. Yes, we’ve contacted Early Intervention and he has been getting all of the therapies—not just speech, but occupational and developmental as well—for almost 6 months now. We also moved him from a nanny type of situation to full-time daycare about 2 months ago. He was a preemie, 2 months early, with medical issues that kept him in NICU for an extra month, but nothing neurological or that would affect his physical ability to make words/sounds. He's been diagnosed with sensory processing issues (sensory seeking), but so far docs/therapists have hesitated to diagnose him with autism. They haven't ruled it out though and we are on a very, very long waitlist to see a developmental pediatrician.
We were in this situation, delayed speaking and the fact our 24 month old had numerous ear infections and fluid in their ears led to them getting drainage tubes in their ears. Impacted their hearing and as such speech.
Now a precocious five year old speaking / listening at level.
posted by nickggully at 9:22 PM on August 12, 2019 [2 favorites]
Now a precocious five year old speaking / listening at level.
posted by nickggully at 9:22 PM on August 12, 2019 [2 favorites]
Yes. No1 grandson had ENT issues, very slow speech development. Daughter took him to pathologist, not much help, did a bit of therapy. Daycare people said don't worry till he is 4, he's a boy and boys can be slow to develop. On a big camping trip in last month or two at 3 and half almost exactly, a switch flipped and bingo the sentences just started flowing, and with words never heard before. Now, the question is how do we shut him up lol.
posted by GeeEmm at 12:05 AM on August 13, 2019
posted by GeeEmm at 12:05 AM on August 13, 2019
My son also has a sensory processing disorder and had some medical issues at birth. We've also done multiple types of therapy. He's five now and doing really well.
My son has different needs than most kids. He's a wonderful kid filled with life and personality. He's also very smart and charismatic.
He's never going to be just magically be fine and go to Harvard with no supports. I mean maybe he'll go to Harvard but he would need some accommodations. He just needs different things to function well throughout life.
I would consider my son very high functioning. Finding resources for my son (and sometimes just in my own life), I've also met a lot of other people who function very highly but needs some accommodations or are living with what a lot of people would consider disabilities. And it's a lifelong journey to do the best you can, although I suppose it is for everyone. I expect my son to need different therapies and different help throughout his childhood. I also expect him to make friends and find a career that he loves. And I expect to slowly shift the burden of accommodation to him as he becomes an adult. And there's a relatively large community of people who are living good lives this way.
It's ok to have a child that is going to need extra help indefinitely. We've adjusted to it, and I couldn't imagine our lives differently now.
posted by Kalmya at 2:30 AM on August 13, 2019 [2 favorites]
My son has different needs than most kids. He's a wonderful kid filled with life and personality. He's also very smart and charismatic.
He's never going to be just magically be fine and go to Harvard with no supports. I mean maybe he'll go to Harvard but he would need some accommodations. He just needs different things to function well throughout life.
I would consider my son very high functioning. Finding resources for my son (and sometimes just in my own life), I've also met a lot of other people who function very highly but needs some accommodations or are living with what a lot of people would consider disabilities. And it's a lifelong journey to do the best you can, although I suppose it is for everyone. I expect my son to need different therapies and different help throughout his childhood. I also expect him to make friends and find a career that he loves. And I expect to slowly shift the burden of accommodation to him as he becomes an adult. And there's a relatively large community of people who are living good lives this way.
It's ok to have a child that is going to need extra help indefinitely. We've adjusted to it, and I couldn't imagine our lives differently now.
posted by Kalmya at 2:30 AM on August 13, 2019 [2 favorites]
My son had some slight delays around 18 months and he was tested through the local public school program (we are in the US). They call it Child Find here, but basically it is a department that provides developmental screenings for preschool children (2-5 years old). They had a specialist test him for personal/social skills, adaptive/self-help skills, motor skills, communication skills, and cognitive skills. They also did some vision and hearing testing. My son tested within normal for everything, but was on the borderline for speech skills. Through the program he attended speech therapy 2X a week during the school year for about an hour each session. The sessions were with 2-3 other kids at the same time and led by a speech therapist. We also got homework and skills to work on at home. He took ST for about 2 years before he tested out.
At around the same time, my husband and I decided to bring our son to get his hearing tested beyond what Child Find and his pediatrician did. The audiologist did a number of tests (booth test, ABR, etc) and they found that he has moderate loss, specifically at the high frequency range. He got hearing aids at that time and hasn't looked back since. If you haven't done so already, I highly recommend seeing a certified audiologist. They are able to do specialized testing and they can also diagnose other issues such as auditory processing disorder. This testing is especially important for kids like my son who are in that in between range. Even as a toddler he was able to compensate for his hearing loss and even fooled the evaluators at Child Find.
As a parent who has been through something similar, my advice is to try not to worry too much about "what ifs" (easier said than done, right?) Instead, try to focus on what needs to be done. You know your child the best and if your gut says he needs more testing/support, don't be afraid to search it out. This is the time to do it. FWIW, my son graduated top 5 in his high school class and is now studying computer science in college. Best of luck!
posted by jraz at 6:09 AM on August 13, 2019 [1 favorite]
At around the same time, my husband and I decided to bring our son to get his hearing tested beyond what Child Find and his pediatrician did. The audiologist did a number of tests (booth test, ABR, etc) and they found that he has moderate loss, specifically at the high frequency range. He got hearing aids at that time and hasn't looked back since. If you haven't done so already, I highly recommend seeing a certified audiologist. They are able to do specialized testing and they can also diagnose other issues such as auditory processing disorder. This testing is especially important for kids like my son who are in that in between range. Even as a toddler he was able to compensate for his hearing loss and even fooled the evaluators at Child Find.
As a parent who has been through something similar, my advice is to try not to worry too much about "what ifs" (easier said than done, right?) Instead, try to focus on what needs to be done. You know your child the best and if your gut says he needs more testing/support, don't be afraid to search it out. This is the time to do it. FWIW, my son graduated top 5 in his high school class and is now studying computer science in college. Best of luck!
posted by jraz at 6:09 AM on August 13, 2019 [1 favorite]
Your description is very close to my youngest. He was diagnosed with "delayed language development" - I'm not sure of the exact English term (I'm Norwegian and we live in Norway). He had all kinds of other tests for hearing, vision, neurological disorders etc, and other than being clumsy but not to a medically concerning degree, nothing was found. He was also very cheerful and social, but had difficulty expressing himself and understanding the rules of play and other social interactions. This made his social relationships with his peers difficult and frustrating, and he started to prefer the company of adults.
Luckily we caught it in time, and he got tons of speech therapy, physical therapy and other help in kindergarten, but just a tiny bit in school. He's now 8. His speech is good and he has an extensive vocabulary. He's excellent with reading and math, and handles other school subjects well. He's still quite clumsy (but up from 1% percentile to 16% compared to his peers), but the biggest thing now is that his social development is still lagging. He comes off as a bit childish, and is having trouble with managing some social situations. He's very suggestible, for instance. This works as a magnet on some of the more, ahem, adventurous class mates, as it's easy to get him to do stuff he shouldn't, either for shit and giggles or as a handy companion when breaking school rules.
An example of the social rules he had problems with up to recently was when when it's proper to hug people and when you shouldn't, which was difficult for him as he basically wanted to hug everyone he thought seemed nice. We had to talk about this a lot over the years and make very clear, simple rules to keep him out of trouble with his class mates.
I'm thinking these issues are holdovers from getting a very late start with age-appropriate social interactions due to the language issues. I haven't really got any professionals to commit to one explanation or another, though, so take it with a grain of sand.
If you would like more details or just want to talk, shoot me a MeMail.
posted by Harald74 at 6:33 AM on August 13, 2019
Luckily we caught it in time, and he got tons of speech therapy, physical therapy and other help in kindergarten, but just a tiny bit in school. He's now 8. His speech is good and he has an extensive vocabulary. He's excellent with reading and math, and handles other school subjects well. He's still quite clumsy (but up from 1% percentile to 16% compared to his peers), but the biggest thing now is that his social development is still lagging. He comes off as a bit childish, and is having trouble with managing some social situations. He's very suggestible, for instance. This works as a magnet on some of the more, ahem, adventurous class mates, as it's easy to get him to do stuff he shouldn't, either for shit and giggles or as a handy companion when breaking school rules.
An example of the social rules he had problems with up to recently was when when it's proper to hug people and when you shouldn't, which was difficult for him as he basically wanted to hug everyone he thought seemed nice. We had to talk about this a lot over the years and make very clear, simple rules to keep him out of trouble with his class mates.
I'm thinking these issues are holdovers from getting a very late start with age-appropriate social interactions due to the language issues. I haven't really got any professionals to commit to one explanation or another, though, so take it with a grain of sand.
If you would like more details or just want to talk, shoot me a MeMail.
posted by Harald74 at 6:33 AM on August 13, 2019
Sounds a bit like my daughter, who is now 3.5. She had some early intervention speech therapy, but honestly, after all the hype about early intervention, I found it a bit disappointing; it just wasn't so different from the way we played with her already. By all means DO IT, but it's not the magic bullet.
She is doing great, now; she tests in the average range for speech and understanding, but if I'm honest with myself, she still sounds much more babyish than her peers. What has helped us most is a kind of Floortime approach -- basically playing and following her lead in play a lot. We've also done some things our own way. Everyone says not to correct them or make them say anything, but things really got better for her when we actually did say -- "say 'I want an apple' not just 'apple'." She was never annoyed by it. We also do a lot of music and 1:1 music therapy which I liked more than the speech therapy, to be honest.
I really like the book "The Child with Special Needs." I would have not wanted to read it when she was 2 because I would not have wanted to think she has special needs, but it's great (actually for all kids) at stimulating all kinds of development. And I would be more aggressive in more ways (more speech therapy, notwithstanding what I said above, and I would definitely have done baby sign) but also less aggressive (enjoyed her more, stopped making every single thing we did about her speech.) I would work hard at comparing her a lot less to other kids; comparison was really hard at 2.
Speech impairments are far more common than autism. People were constantly telling me to have her tested for autism, but then I would think -- what about her do I want to fix other than having her talk in sentences? There was nothing else -- great social skills, very warm, normal play, loves books more than anything -- she just struggles with speech. I think she will always need to be taught speech and vocabulary more directly than other kids, to be honest.
Her therapist thinks she will catch up fully, and everyone else close to her (nursery, family, music therapist, etc. agrees) but I still worry a lot about her.
Good luck!
posted by heavenknows at 7:37 AM on August 13, 2019 [5 favorites]
She is doing great, now; she tests in the average range for speech and understanding, but if I'm honest with myself, she still sounds much more babyish than her peers. What has helped us most is a kind of Floortime approach -- basically playing and following her lead in play a lot. We've also done some things our own way. Everyone says not to correct them or make them say anything, but things really got better for her when we actually did say -- "say 'I want an apple' not just 'apple'." She was never annoyed by it. We also do a lot of music and 1:1 music therapy which I liked more than the speech therapy, to be honest.
I really like the book "The Child with Special Needs." I would have not wanted to read it when she was 2 because I would not have wanted to think she has special needs, but it's great (actually for all kids) at stimulating all kinds of development. And I would be more aggressive in more ways (more speech therapy, notwithstanding what I said above, and I would definitely have done baby sign) but also less aggressive (enjoyed her more, stopped making every single thing we did about her speech.) I would work hard at comparing her a lot less to other kids; comparison was really hard at 2.
Speech impairments are far more common than autism. People were constantly telling me to have her tested for autism, but then I would think -- what about her do I want to fix other than having her talk in sentences? There was nothing else -- great social skills, very warm, normal play, loves books more than anything -- she just struggles with speech. I think she will always need to be taught speech and vocabulary more directly than other kids, to be honest.
Her therapist thinks she will catch up fully, and everyone else close to her (nursery, family, music therapist, etc. agrees) but I still worry a lot about her.
Good luck!
posted by heavenknows at 7:37 AM on August 13, 2019 [5 favorites]
What happens now is entirely going to be the result of his other strengths and weaknesses. Your son is capable of understanding speech. As with a deaf kid it is important to get him to learn as much speech as possible so that he can think in words. Yours may or may not have auditory processing difficulties, so rather than try to enrich his verbal environment with sounds you will likely do best if you figure out which different ways of enrich his verbal environment are attractive and non stressful for him.
If your son likes to be talked to listening is a skill he can master and is the most immediate pathway. He may be unmotivated to learn finger wriggle speech because he already can think in words clearly so adding a sign for dog is unnecessary and awkward and isn't helping him communicate. You can see the dog, he knows you can see the dog, so he doesn't need to tell you dog, so no willingness to to play that game.
There are three places where speech learning can go wrong - hearing, processing and output. In my family output is a problem. I had one child who could not control impulsive speech and lied fluently - the censor that stopped him from talking broke down allowed him to claim he saw a flying piano out the window during a snow storm and the things he wanted to be true came out as assertions that they were true. He had to work backwards to develop the censor, correcting himself after the words came out. His sister had the same issue with speech production but in the opposite direction. For her there were just so many words and ideas to choose from that nothing came out. If I understand correctly the problem is a lot like being unable to say the word blue because you are thinking of a precise shade and need a modifier or that's not what you want to say. If you say blue and mean robin's egg blue and the other person thinks navy blue it wouldn't work, so your brain ends up in a freeze pattern while you get lost looking for a nuance between cobalt and wedgewood.
Hearing similarly has nuances. Some people fail to process sounds because of auditory discrimination where dab and bab sound entirely alike. Others fail to process sounds because they can't figure out pitch and intonation. Others are so excited and interested in all the pretty colours and moving things at the mall that they fail to hear the parent shrieking "Wait! Stop!"
None of this is meant to say that your child has a problem condition. People who are perceived as typical have the same structures and processing as people who are perceive as a-typical. Everybody who has ever missed a friend who tried to say hi in a crowd is the same as the person who tunes out sounds when the visual stimulation is so high. Tuning out sounds is a critical skill to develop so you can understand someone talking when a fan is on as you have to tune out the sounds of the fan.
My point about how there are three places where your child needs to successfully master certain abilities to develop speech is to point out to you that your child may be mastering two out of three, one out of three three, or none out of three and a glitch in any one area can cause a delay. speech therapists try to figure out where the glitches are occurring, but generally focus help on just one area because they have only a few session hours to work in. As a parent you have multiple places where you can focus.
You know your child has a bunch of strengths - social, motivated, so you know that there are lots of things that you or therapists can do to isolate potential component problems and provide support to get your child verbal. But until you have a good grasp of where the problem or problems are occurring, let alone if there even is a long-term problem you won't have a prognosis.
A forty-five minute evaluation or three intensive days of evaluation may provide information but will not parse out the complexity that is your child's current capacity and potential capacity. It's just too complex a question. Not only that, your child is extremely plastic - we all are - so they may have a major deficit, but get fascinated in something, and spend so much time voluntarily doing an activity that builds that capacity that three years after an evaluation that suggested they had a problem area, retesting will indicate that they are gifted in that area.
There are two areas that are most important in child development. One of these is social skills and one of these is mastery. Social skills is NOT what you probably think, it's actually empathy and interest in people. It's definitely not things like cooperation, obedience, manners and imitation. You can have a child who is good at cooperation, obedience, manners and imitation but unless they can figure out that two girls in their class could be doing the same thing for different reasons they will struggle with social analysis and will fail to treat the two girls differently. Those social skills are what motivate us and enable us to work with other people. If your kid can't wonder why Mum is hurrying them one morning and not hurrying them the next they can't work around the concepts that this introduces, such as telling time, being late, caring about being late, making Mum mad, making Mum sad, getting in trouble, making Mum's life easier, making Mum's life harder... And you don't teach this to a kid by drilling them in being obedient. You don't want a kid who puts his shoes on when Mum says, "Put your shoes on!" and only does it then. You want a kid who notices the way you are moving and runs to put his shoes on without being prompted.
Mastery is the other critical skill your kid needs. Mastery is requires independence. If you had to teach your baby to roll over and lift his head, believe me, you'd never get him out of his crib. 99.99% of your kid's learning and development is independent. As parents we spend most of our kid's early life preventing that development. The kid goes in a crib to prevent mobility when he or she is very young. The kid is not allowed to methodically tear pages out of books. The kid has to follow directions. The kid has to be quiet. The kid has to not blow bubbles in his milk... I am not saying that you should be permissive or not keep your child safe, rather that your child will develop mastery - interest in doing what he is interested in doing, in spite of you, more than because of you. Happily thwarting your child's instinctive desire to roll off the changing table and give himself a concussion is not bad for him, because you ignore him and allow him autonomy so much that he gets to practice rolling over on his own, for hours over the few weeks where he develops those skills. He can do it in the crib. You only thwart him for forty seconds while he is on the table. He's got the groundwork to develop mastery inside him. It's pre-loaded like the instinct to focus on faces that laid the ground work for his social skills.
Mastery may require independence but coaching can either enhance it or inhibit it, depending on what type the coaching is. Bad coaching is primarily instructive and controlling. "Put your shoes on like this." Good coaching helps the child learn by building the kid's analysis skills and supporting the development of intrinsic motivation. "Did you want to go to the park?" You're already doing tons of this stuff.
So the two questions you need to ask are Is my child developing social skills? and Is my child developing mastery skills? If your child doesn't develop those it won't matter what his verbal skills are. His prognosis for employment, academics, health, friendship and happiness will be poor and his verbal skills will be inadequate. If your child develops strong social skills and strong mastery skills it won't matter what his verbal skills are, he will learn to communicate and compensate and function well. He might end up in a group home but he will be able to get what he wants and do what he needs to thrive. He might end up in a position of responsibility and power, owning and running a large company with many employees. In either case having those social skills and mastery skills will make him good at what he is. But if he fails to develop social skills and mastery skills he will be that person in the group home who is so hard to work with, or that boss that is resented, who commits borderline criminal acts, whose family members don't like him, and who gets his only fleeting moments of relief from his internal frustration from consumer toys and is frankly bad at what he does and has a family that dislikes him.
Of course you would rather he be the boss of his own company than in a group home simply because the boss of his own company would be less vulnerable to staffing switches and cut backs. but the same skills that will make him happy and functional in a group home are the same skills that will make him happy and functional as an entrepreneur - AND they will also enable him to become the happy functional entrepreneur if that is in his potential.
If you want to know what his potential is, then working on helping him develop social skills, social analysis, empathy, mastery skills, performance analysis, intrinsic motivation, willingness to fail and those skills will both enable you to evaluate how he deals with difficulties and how much he can do to work with those difficulties if he gets additional support. It's not so much Does he need hearing aides? as Is he a person who will be willing to wear them? It's not so much Can my son learn to speak? as Can my son learn to communicate?
When you have a relationship with someone else the big question to always as is Can't versus Won't. A police could drive you home but won't. A taxi driver can and will. A junior employee may need to remember something. But are they trying to remember it? Or are they just not motivated to bother? If they are not motivated no system you set up will work. This is won't. If they keep forgetting despite trying then the situation is Can't and the solution is not to force them by getting angry at them but provide them with tools such as a reminder system, so that you turn the can't to a can. A can't is always better than a won't because the solution is simpler. You can help someone who can't but you have to motivate before you can help some one who won't.
So you can evaluate his speech delays from the can't/won't perspective and look into motivating him to speak if there's any won't going on, or look into ways to help him develop speaking skills if it is a can't. If he can't speak you can expose him to all the various different therapies that could assist - teach him to sing, or teach him to read, or play sound production games with him.
Right now you don't have enough information to tell us what to expect, so we can't tell you either. We can only say it could go in a variety of directions and progress a variety of distances. Do not, for God's sake, catastrophize. The only thing that will do will devastate you. Your son is more likely to become a functional adult than not, even with the speech delays you describe. Your son could still turn out to be verbally gifted. Your son could turn out to have multiple disabilities. If your son turns out to have multiple disabilities it could destroy your life and his life. For it to destroy his life and yours would require you and the people around you to keep repeatedly doing dumb and destructive things. But you are not so bloody minded and stupid that you will keep doing things like that. When you do them they will cause problems and you will back up and stop doing them. You might get upset with your spouse, but you will probably not encourage yourself to hate them and try to ruin their life in revenge for not going you a "perfect" child. You'll be gloomy at them, or irritable and then because you need to work with them you'll apologize for being irritable. You might put your kid into a therapy that makes him miserable. If you do you have the option of taking him out. You can only allow a child who is slow to develop speech and has multiple disabilities to ruin your life if you bloody minded insist on doing the things that ruin your life in response to the situation -and you could do that with a child that didn't have multiple disabilities!
Right now you can see that parenting this child is going to present some challenges you never expected and you can't picture how you can deal with those challenges and you are confronting the fact that your ideal future is not as probable as you had initially assumed. This is both terrifying and disappointing. Worse, you probably are adding guilt to the terrified and disappointed because some part of you believes you should love the child you got, and yet you are feeling things that are not happy parental love and bliss, like resentment, annoyance, disgust - you are probably close to feeling disappointed in your child for something that is not his fault. "Why can't you be normal...? *grumble * " Well, that's a necessary part of any evolving relationship. There's not a parent in the world who hasn't got to the end of the child's youth without feelings of frustration and annoyance or disappointment and sadness. You can't go through eighteen years with someone who is evolving without them doing or being things that hurt you. It's as part of being a parent as your child head butting you in the teeth with the back of their skull, or keeping you awake with colic, or caroming accidentally into your china cabinet. But in this case the intensity of your emotions is linked to how tightly you are bonded to your child. Your negative feelings about your child would be a vague sense of pity if you were talking about the child of someone you had superficially met through work.
So right now you are scared for, and worried for and sad for and perhaps angry for your child. But however miserable it may be to be feeling those things they are a sign that your bond is good and your commitment to your kid is lining up the way it is supposed to. That hurt is there to help motivate you to ask for advice, to observe your child, to be vigilant, to be a good parent. And it's working.
posted by Jane the Brown at 8:09 AM on August 13, 2019 [2 favorites]
If your son likes to be talked to listening is a skill he can master and is the most immediate pathway. He may be unmotivated to learn finger wriggle speech because he already can think in words clearly so adding a sign for dog is unnecessary and awkward and isn't helping him communicate. You can see the dog, he knows you can see the dog, so he doesn't need to tell you dog, so no willingness to to play that game.
There are three places where speech learning can go wrong - hearing, processing and output. In my family output is a problem. I had one child who could not control impulsive speech and lied fluently - the censor that stopped him from talking broke down allowed him to claim he saw a flying piano out the window during a snow storm and the things he wanted to be true came out as assertions that they were true. He had to work backwards to develop the censor, correcting himself after the words came out. His sister had the same issue with speech production but in the opposite direction. For her there were just so many words and ideas to choose from that nothing came out. If I understand correctly the problem is a lot like being unable to say the word blue because you are thinking of a precise shade and need a modifier or that's not what you want to say. If you say blue and mean robin's egg blue and the other person thinks navy blue it wouldn't work, so your brain ends up in a freeze pattern while you get lost looking for a nuance between cobalt and wedgewood.
Hearing similarly has nuances. Some people fail to process sounds because of auditory discrimination where dab and bab sound entirely alike. Others fail to process sounds because they can't figure out pitch and intonation. Others are so excited and interested in all the pretty colours and moving things at the mall that they fail to hear the parent shrieking "Wait! Stop!"
None of this is meant to say that your child has a problem condition. People who are perceived as typical have the same structures and processing as people who are perceive as a-typical. Everybody who has ever missed a friend who tried to say hi in a crowd is the same as the person who tunes out sounds when the visual stimulation is so high. Tuning out sounds is a critical skill to develop so you can understand someone talking when a fan is on as you have to tune out the sounds of the fan.
My point about how there are three places where your child needs to successfully master certain abilities to develop speech is to point out to you that your child may be mastering two out of three, one out of three three, or none out of three and a glitch in any one area can cause a delay. speech therapists try to figure out where the glitches are occurring, but generally focus help on just one area because they have only a few session hours to work in. As a parent you have multiple places where you can focus.
You know your child has a bunch of strengths - social, motivated, so you know that there are lots of things that you or therapists can do to isolate potential component problems and provide support to get your child verbal. But until you have a good grasp of where the problem or problems are occurring, let alone if there even is a long-term problem you won't have a prognosis.
A forty-five minute evaluation or three intensive days of evaluation may provide information but will not parse out the complexity that is your child's current capacity and potential capacity. It's just too complex a question. Not only that, your child is extremely plastic - we all are - so they may have a major deficit, but get fascinated in something, and spend so much time voluntarily doing an activity that builds that capacity that three years after an evaluation that suggested they had a problem area, retesting will indicate that they are gifted in that area.
There are two areas that are most important in child development. One of these is social skills and one of these is mastery. Social skills is NOT what you probably think, it's actually empathy and interest in people. It's definitely not things like cooperation, obedience, manners and imitation. You can have a child who is good at cooperation, obedience, manners and imitation but unless they can figure out that two girls in their class could be doing the same thing for different reasons they will struggle with social analysis and will fail to treat the two girls differently. Those social skills are what motivate us and enable us to work with other people. If your kid can't wonder why Mum is hurrying them one morning and not hurrying them the next they can't work around the concepts that this introduces, such as telling time, being late, caring about being late, making Mum mad, making Mum sad, getting in trouble, making Mum's life easier, making Mum's life harder... And you don't teach this to a kid by drilling them in being obedient. You don't want a kid who puts his shoes on when Mum says, "Put your shoes on!" and only does it then. You want a kid who notices the way you are moving and runs to put his shoes on without being prompted.
Mastery is the other critical skill your kid needs. Mastery is requires independence. If you had to teach your baby to roll over and lift his head, believe me, you'd never get him out of his crib. 99.99% of your kid's learning and development is independent. As parents we spend most of our kid's early life preventing that development. The kid goes in a crib to prevent mobility when he or she is very young. The kid is not allowed to methodically tear pages out of books. The kid has to follow directions. The kid has to be quiet. The kid has to not blow bubbles in his milk... I am not saying that you should be permissive or not keep your child safe, rather that your child will develop mastery - interest in doing what he is interested in doing, in spite of you, more than because of you. Happily thwarting your child's instinctive desire to roll off the changing table and give himself a concussion is not bad for him, because you ignore him and allow him autonomy so much that he gets to practice rolling over on his own, for hours over the few weeks where he develops those skills. He can do it in the crib. You only thwart him for forty seconds while he is on the table. He's got the groundwork to develop mastery inside him. It's pre-loaded like the instinct to focus on faces that laid the ground work for his social skills.
Mastery may require independence but coaching can either enhance it or inhibit it, depending on what type the coaching is. Bad coaching is primarily instructive and controlling. "Put your shoes on like this." Good coaching helps the child learn by building the kid's analysis skills and supporting the development of intrinsic motivation. "Did you want to go to the park?" You're already doing tons of this stuff.
So the two questions you need to ask are Is my child developing social skills? and Is my child developing mastery skills? If your child doesn't develop those it won't matter what his verbal skills are. His prognosis for employment, academics, health, friendship and happiness will be poor and his verbal skills will be inadequate. If your child develops strong social skills and strong mastery skills it won't matter what his verbal skills are, he will learn to communicate and compensate and function well. He might end up in a group home but he will be able to get what he wants and do what he needs to thrive. He might end up in a position of responsibility and power, owning and running a large company with many employees. In either case having those social skills and mastery skills will make him good at what he is. But if he fails to develop social skills and mastery skills he will be that person in the group home who is so hard to work with, or that boss that is resented, who commits borderline criminal acts, whose family members don't like him, and who gets his only fleeting moments of relief from his internal frustration from consumer toys and is frankly bad at what he does and has a family that dislikes him.
Of course you would rather he be the boss of his own company than in a group home simply because the boss of his own company would be less vulnerable to staffing switches and cut backs. but the same skills that will make him happy and functional in a group home are the same skills that will make him happy and functional as an entrepreneur - AND they will also enable him to become the happy functional entrepreneur if that is in his potential.
If you want to know what his potential is, then working on helping him develop social skills, social analysis, empathy, mastery skills, performance analysis, intrinsic motivation, willingness to fail and those skills will both enable you to evaluate how he deals with difficulties and how much he can do to work with those difficulties if he gets additional support. It's not so much Does he need hearing aides? as Is he a person who will be willing to wear them? It's not so much Can my son learn to speak? as Can my son learn to communicate?
When you have a relationship with someone else the big question to always as is Can't versus Won't. A police could drive you home but won't. A taxi driver can and will. A junior employee may need to remember something. But are they trying to remember it? Or are they just not motivated to bother? If they are not motivated no system you set up will work. This is won't. If they keep forgetting despite trying then the situation is Can't and the solution is not to force them by getting angry at them but provide them with tools such as a reminder system, so that you turn the can't to a can. A can't is always better than a won't because the solution is simpler. You can help someone who can't but you have to motivate before you can help some one who won't.
So you can evaluate his speech delays from the can't/won't perspective and look into motivating him to speak if there's any won't going on, or look into ways to help him develop speaking skills if it is a can't. If he can't speak you can expose him to all the various different therapies that could assist - teach him to sing, or teach him to read, or play sound production games with him.
Right now you don't have enough information to tell us what to expect, so we can't tell you either. We can only say it could go in a variety of directions and progress a variety of distances. Do not, for God's sake, catastrophize. The only thing that will do will devastate you. Your son is more likely to become a functional adult than not, even with the speech delays you describe. Your son could still turn out to be verbally gifted. Your son could turn out to have multiple disabilities. If your son turns out to have multiple disabilities it could destroy your life and his life. For it to destroy his life and yours would require you and the people around you to keep repeatedly doing dumb and destructive things. But you are not so bloody minded and stupid that you will keep doing things like that. When you do them they will cause problems and you will back up and stop doing them. You might get upset with your spouse, but you will probably not encourage yourself to hate them and try to ruin their life in revenge for not going you a "perfect" child. You'll be gloomy at them, or irritable and then because you need to work with them you'll apologize for being irritable. You might put your kid into a therapy that makes him miserable. If you do you have the option of taking him out. You can only allow a child who is slow to develop speech and has multiple disabilities to ruin your life if you bloody minded insist on doing the things that ruin your life in response to the situation -and you could do that with a child that didn't have multiple disabilities!
Right now you can see that parenting this child is going to present some challenges you never expected and you can't picture how you can deal with those challenges and you are confronting the fact that your ideal future is not as probable as you had initially assumed. This is both terrifying and disappointing. Worse, you probably are adding guilt to the terrified and disappointed because some part of you believes you should love the child you got, and yet you are feeling things that are not happy parental love and bliss, like resentment, annoyance, disgust - you are probably close to feeling disappointed in your child for something that is not his fault. "Why can't you be normal...? *grumble * " Well, that's a necessary part of any evolving relationship. There's not a parent in the world who hasn't got to the end of the child's youth without feelings of frustration and annoyance or disappointment and sadness. You can't go through eighteen years with someone who is evolving without them doing or being things that hurt you. It's as part of being a parent as your child head butting you in the teeth with the back of their skull, or keeping you awake with colic, or caroming accidentally into your china cabinet. But in this case the intensity of your emotions is linked to how tightly you are bonded to your child. Your negative feelings about your child would be a vague sense of pity if you were talking about the child of someone you had superficially met through work.
So right now you are scared for, and worried for and sad for and perhaps angry for your child. But however miserable it may be to be feeling those things they are a sign that your bond is good and your commitment to your kid is lining up the way it is supposed to. That hurt is there to help motivate you to ask for advice, to observe your child, to be vigilant, to be a good parent. And it's working.
posted by Jane the Brown at 8:09 AM on August 13, 2019 [2 favorites]
Three of my four kids have had speech delays at that age. My eight year old's issues turned out to be caused by ear infections/fluid, so he made very fast progress after having ear tubes put in and quit speech therapy soon after he started. He was caught up probably by age 2.5 or so and has had no impacts since.
My twins were preemies and have had no language skills delays (meaning the number of words they know and their ability to string them together) but profound delays in articulation. They turned five yesterday and they've caught up some with years of therapy, but they are both still behind, one of them significantly so. The one with the severe delays also has some vocal cord nodules that are apparently a result of being intubated for so long as an infant, so that makes her voice scratchy and makes it even harder for her.
The biggest problem we face with this is social stuff. She can't communicate well with strangers, so she doesn't like for her twin to leave her at playgrounds or on play dates or whatever and play with another kid, because she has trouble going off and finding a kid on her own. She loves playing with much older girls who sort of play doll with her, but it's very uncommon for her to seek out a child her own age whom she doesn't know and start playing with them. They've been in preschool for the last year at a dedicated speech therapy site run by our school district, so this coming year will be their first time going to a mainstream classroom. I'm a little nervous to see how it will go for her. And I also think that we see a little bit more tantrum type behavior from her just because it's harder for her to communicate her needs.
So that's the bad part. Good part: I don't believe it's affected her ability to learn, her love for books and singing and other verbal stuff, her relationships with her family or close friends, or her general happiness at home and school. She's totally engaged socially, she just needs some help to get there. In her case, her twin and her older brothers provide a lot of that help.
I should also note that my kids were born at 27 weeks gestation and the one with the severe speech delays was VERY very ill both in the NICU and her whole first year of life, and had a major brain bleed. So she is emphatically NOT the average case of a 2 year old with speech delays -- in my totally-non-expert opinion, average is much more like the anecdotal positive stories you're getting.
Oh and one more thing! Sorry, I'm writing a novel. We did sign language for a while and then stopped it because various factions in our army of therapists disagreed about whether it was a good idea. Three years later, I really wish I had continued with it. The most likely outcome here is that your son suddenly decides to get chatty and nine months from now he's talking your ear off, but if you have the time to invest in sign language I would recommend it just in case.
Anyway, good luck to your kiddo, and of course feel free to memail anytime.
posted by gerstle at 8:13 AM on August 13, 2019
My twins were preemies and have had no language skills delays (meaning the number of words they know and their ability to string them together) but profound delays in articulation. They turned five yesterday and they've caught up some with years of therapy, but they are both still behind, one of them significantly so. The one with the severe delays also has some vocal cord nodules that are apparently a result of being intubated for so long as an infant, so that makes her voice scratchy and makes it even harder for her.
The biggest problem we face with this is social stuff. She can't communicate well with strangers, so she doesn't like for her twin to leave her at playgrounds or on play dates or whatever and play with another kid, because she has trouble going off and finding a kid on her own. She loves playing with much older girls who sort of play doll with her, but it's very uncommon for her to seek out a child her own age whom she doesn't know and start playing with them. They've been in preschool for the last year at a dedicated speech therapy site run by our school district, so this coming year will be their first time going to a mainstream classroom. I'm a little nervous to see how it will go for her. And I also think that we see a little bit more tantrum type behavior from her just because it's harder for her to communicate her needs.
So that's the bad part. Good part: I don't believe it's affected her ability to learn, her love for books and singing and other verbal stuff, her relationships with her family or close friends, or her general happiness at home and school. She's totally engaged socially, she just needs some help to get there. In her case, her twin and her older brothers provide a lot of that help.
I should also note that my kids were born at 27 weeks gestation and the one with the severe speech delays was VERY very ill both in the NICU and her whole first year of life, and had a major brain bleed. So she is emphatically NOT the average case of a 2 year old with speech delays -- in my totally-non-expert opinion, average is much more like the anecdotal positive stories you're getting.
Oh and one more thing! Sorry, I'm writing a novel. We did sign language for a while and then stopped it because various factions in our army of therapists disagreed about whether it was a good idea. Three years later, I really wish I had continued with it. The most likely outcome here is that your son suddenly decides to get chatty and nine months from now he's talking your ear off, but if you have the time to invest in sign language I would recommend it just in case.
Anyway, good luck to your kiddo, and of course feel free to memail anytime.
posted by gerstle at 8:13 AM on August 13, 2019
I'm not a parent, but I am a preschool teacher to a child with a speech delay. This child came over to the preschool at 3 barely talking. We do the Ages and Stages Questionnaire roughly every 6 months. He was very behind in lots of things on the 36 month one. We're planning on doing the 42 month one soon (for certain values of soon, we're understaffed at the moment).
The director finally convinced mom to have him evaluated (she was in a bit of denial). He entered EI. Fast forward about 10 months and he's communicating much better. His speech in not totally clear, but is improving. He started saying my name about 2 months ago. He occasionally cries and if I ask him what's wrong, he now can tell me he wants his mommy. He counts from 1-10 and can sing his ABCs. He was able to tell a peer "Mine! I want it!" when he didn't want to share.
He also is outgoing and energetic (what 3 year old isn't?). He's very loving and has no issues with eye contact. He's starting to play more with others now that he can communicate better.
He went to EI at a school in his district and will start back when school reopens. There was about a week of tough transition when he started and then when EI closed for the summer.
The change has been dramatic. I'm really curious to see how he'll score on his next ASQ. Do I even need to say how proud of him I am. :-)
posted by kathrynm at 9:20 AM on August 13, 2019 [1 favorite]
The director finally convinced mom to have him evaluated (she was in a bit of denial). He entered EI. Fast forward about 10 months and he's communicating much better. His speech in not totally clear, but is improving. He started saying my name about 2 months ago. He occasionally cries and if I ask him what's wrong, he now can tell me he wants his mommy. He counts from 1-10 and can sing his ABCs. He was able to tell a peer "Mine! I want it!" when he didn't want to share.
He also is outgoing and energetic (what 3 year old isn't?). He's very loving and has no issues with eye contact. He's starting to play more with others now that he can communicate better.
He went to EI at a school in his district and will start back when school reopens. There was about a week of tough transition when he started and then when EI closed for the summer.
The change has been dramatic. I'm really curious to see how he'll score on his next ASQ. Do I even need to say how proud of him I am. :-)
posted by kathrynm at 9:20 AM on August 13, 2019 [1 favorite]
My daughter has either apraxia or aphasia seems to be the consensus. Her articulation is massively lacking at 4, but her ability to understand what others is saying is just fine. She is in a EI classroom this year, will mainstream next year. She's a bit of a bull in a china shop for personality, but she's also capable of quiet moments and both solo and pair play, so it seems to be a case of unknown origin articulation issues. We're having a CT scan done of her brain soon to rule out any issues as she is also off the growth charts, so her doctor wants to check to make sure there's no tumors or anything. With her understanding fine, it's passed the point of checking for horses and are off to find the zebra.
posted by skittlekicks at 12:41 PM on August 13, 2019
posted by skittlekicks at 12:41 PM on August 13, 2019
My son didn't do much babbling as a baby, and only had 3 words at age of 18 mos. His doctor and I agreed he should have a speech evaluation if he still wasn't talking by age 2. When his 2 yr wellness check happened, he was still only saying 3 words, so we went ahead and scheduled the evaluation. I wish I had scheduled it earlier just in case, because there ended up being a 3 month waitlist for the evaluation and another 3-4 mos wait to get a once weekly speech therapy session scheduled. At that age speech therapy is mostly about training the parents on how to interact with the child to help prompt speech. He started talking more around age 2.75 yrs, mostly he just seemed ready to try out saying words. Our SLP taught me a lot of ways to help him build his vocabulary and helped me understand the development milestones along the way (eg., 3 word sentences, different types of questions, other things that you might not think about). He ended up with an autism diagnosis later that year, so the speech delay is likely a part of that.
Now, at age seven, he is very verbal and his understanding is great. He still goes to speech at school, once a week 1:1 for articulation practice, and once a week with a small group for pragmatic speech development. He's had speech therapy essentially since age 2.5. I think it helped but also he has 15 hours a week of ABA and they work on a lot of speech things with him, like identifying and describing his emotions, advocating for himself, initiating play, greetings, contingent commenting, etc. I think those things really helped develop his verbal skills a lot.
posted by JenMarie at 1:21 PM on August 13, 2019
Now, at age seven, he is very verbal and his understanding is great. He still goes to speech at school, once a week 1:1 for articulation practice, and once a week with a small group for pragmatic speech development. He's had speech therapy essentially since age 2.5. I think it helped but also he has 15 hours a week of ABA and they work on a lot of speech things with him, like identifying and describing his emotions, advocating for himself, initiating play, greetings, contingent commenting, etc. I think those things really helped develop his verbal skills a lot.
posted by JenMarie at 1:21 PM on August 13, 2019
One of my close friends has a kid with a speech delay. Like your kid, he’s very interactive and I wouldn’t describe him as particularly calm (he has pretty typical energy levels for a kid his age). He started speech therapy around age two; he’s now 3.5 and has made huge improvements. He’s still not quite caught up to his peers, but he’s made a lot of progress and is much closer to the developmentally typical range. He hasn’t been diagnosed anything that could cause a speech delay - just the delay itself.
posted by insectosaurus at 6:02 PM on August 13, 2019
posted by insectosaurus at 6:02 PM on August 13, 2019
This thread is closed to new comments.
Anyway, my wife (DrMsEld, a licensed clinical psychologist focusing on children) was hesitant to say anything to them for fear of overstepping but they finally asked/mentioned their current situation during a visit and she was able to relay her advice as a pro but as someone who had not and would not be doing a formal eval on said kiddo but who had seen the kiddo a good bit:
1) Get a full formal eval from MD types and Psychologist PhD types, it can't hurt and early interventions are best.
2) Get the speech eval, sounds like you've already done this.
3) Don't beat yourself up in a parental role, you need sleep and self care just as much as anyone does.
4) Control what you can, like sleep habits and routines. Daycare is good because it emphasizes these routines both on the school side and the parental side.
So, I realize I'm not answering your question as to "what happens next" on the anecdotal side of things but I am emphasizing her very experienced, very research driven but also with years of real world experience doing evals/treatment/supervision(taking and now giving) advice is, and I repeat myself from point 1 above, "early interventions are best".
Memail me if you have specific questions that I can try to relay to DrMsEld that might be relevant to your current situation or future plans, I'll see if there's advice/info to be had.
posted by RolandOfEld at 9:16 PM on August 12, 2019 [1 favorite]