Another speech and language question!
January 12, 2019 10:22 AM Subscribe
I know you are not my kid's speech therapist, but I'm hoping for other clues to figure out why my 3 year old does not want to use sentences.
My daughter has just turned three, and has always been a late talker. She was diagnosed with a "moderate" delay when she was 2 because she was not putting 2 words together. At 2.5 she started doing this a little bit ("read it," "open it," "bye daddy" "mommy back now") but not all the time. At 3, she now has a huge vocabulary as far as I can tell, and knows and uses hundreds of words. Just not together (and also, not often articulated well.)
She seems so utterly behind every time I am around other 3 year olds because she is not really making sentences yet. My husband tests her sometimes by pretending not to know what she's asking for, and then she will pull out a long sentence ("give me milk now!") So I suppose she knows how? But really, that's only when they're alone and he provokes her.
Her understanding seems great, and none of the speech therapists we've consulted have had any doubt of her receptive language. Today, for example, we saw a cat, and I said, hello cat, she said hello cat, and I said, "well we have to speak to the cat in her own language." And she started saying "meow, meow" -- so obviously she understands complex thinking. Her half-day nursery teacher says she seems fine socially -- just is behind talking. She is very loving, has amazing eye contact, is potty-trained, knows her colours, absolutely loves being read to more than anything at the minute -- but, still, no sentences, mostly one word and sometimes two words, and few verbs.
Our most recent speech therapist has just sort of shrugged her shoulders when I ask why, and we just keep using the usual techniques she gives us to get her to talk. I wonder if it's because her older sibling is often there (and is a very dominant character), as she does seem to talk more one on one.
My husband seems to think she will just catch up on her own. I keep reading research studies that show terrible outcomes for late talkers in reading, school, future etc. (I know I should quit but it's become an addiction!) I also am a true worrier, and I blame myself for things I did when I was pregnant (nothing awful like drugs or alcohol, just decisions/medications I took that I now worry I shouldn't have -- I don't really want to go into it because thinking about it makes me go crazy. Apparently, it's not that bad as reasonable people have told me the worries are silly, and either way, I was doing the best I could at the time.)
Does this sound like anyone else's kid? I have to decide whether to pay for another block of speech therapy (I am in the UK, and speech therapy on the NHS is hard to come by for a problem like this that is now deemed "mild.") We are cash-strapped, so it is a lot of money when I'm not sure if the same techniques are going to help her.
TLDR: Three year old seems to understand everything, but does not like using sentences. Does this sound familiar?
My daughter has just turned three, and has always been a late talker. She was diagnosed with a "moderate" delay when she was 2 because she was not putting 2 words together. At 2.5 she started doing this a little bit ("read it," "open it," "bye daddy" "mommy back now") but not all the time. At 3, she now has a huge vocabulary as far as I can tell, and knows and uses hundreds of words. Just not together (and also, not often articulated well.)
She seems so utterly behind every time I am around other 3 year olds because she is not really making sentences yet. My husband tests her sometimes by pretending not to know what she's asking for, and then she will pull out a long sentence ("give me milk now!") So I suppose she knows how? But really, that's only when they're alone and he provokes her.
Her understanding seems great, and none of the speech therapists we've consulted have had any doubt of her receptive language. Today, for example, we saw a cat, and I said, hello cat, she said hello cat, and I said, "well we have to speak to the cat in her own language." And she started saying "meow, meow" -- so obviously she understands complex thinking. Her half-day nursery teacher says she seems fine socially -- just is behind talking. She is very loving, has amazing eye contact, is potty-trained, knows her colours, absolutely loves being read to more than anything at the minute -- but, still, no sentences, mostly one word and sometimes two words, and few verbs.
Our most recent speech therapist has just sort of shrugged her shoulders when I ask why, and we just keep using the usual techniques she gives us to get her to talk. I wonder if it's because her older sibling is often there (and is a very dominant character), as she does seem to talk more one on one.
My husband seems to think she will just catch up on her own. I keep reading research studies that show terrible outcomes for late talkers in reading, school, future etc. (I know I should quit but it's become an addiction!) I also am a true worrier, and I blame myself for things I did when I was pregnant (nothing awful like drugs or alcohol, just decisions/medications I took that I now worry I shouldn't have -- I don't really want to go into it because thinking about it makes me go crazy. Apparently, it's not that bad as reasonable people have told me the worries are silly, and either way, I was doing the best I could at the time.)
Does this sound like anyone else's kid? I have to decide whether to pay for another block of speech therapy (I am in the UK, and speech therapy on the NHS is hard to come by for a problem like this that is now deemed "mild.") We are cash-strapped, so it is a lot of money when I'm not sure if the same techniques are going to help her.
TLDR: Three year old seems to understand everything, but does not like using sentences. Does this sound familiar?
Response by poster: Amy93 I think that's a good point -- she communicates really well as is. My husband just tried that to see if she COULD speak in a sentence. She just seems to prefer single words or two words, and yeah, we can basically understand what she wants. Temperamentally she's quite mild -- no huge tantrums, sleeps pretty well, gentle nature. Maybe it's just her personality, hmmmm ...
And yes, we've had a hearing test, just in case anyone asks. Thanks!
posted by heavenknows at 10:35 AM on January 12, 2019
And yes, we've had a hearing test, just in case anyone asks. Thanks!
posted by heavenknows at 10:35 AM on January 12, 2019
She may just need encouragement forming a habit. If shes used to not speaking in sentences she's probably not going to start on her own at this point without any help.
Sounds like she really will be fine, though. Good luck!
posted by Amy93 at 10:36 AM on January 12, 2019
Sounds like she really will be fine, though. Good luck!
posted by Amy93 at 10:36 AM on January 12, 2019
There might be an English as a foreign language program for little kids that has a reward system clever enough she suddenly starts speaking the language. Maybe if language use is separated out from the everyday and especially hunger or discomfort, then it becomes a more abstract learning and playing experience.
posted by Oyéah at 11:18 AM on January 12, 2019
posted by Oyéah at 11:18 AM on January 12, 2019
If you know she CAN form sentences, per your husband, then it really does sound like it's more of a shorthand habit for her not to. In which case, even just exposure to people gently reminding her that she needs to say more than "milk!" to get milk will eventually do the trick.
I had two late talkers who eventually exploded from few words to complete grammatical sentences with complex and correct use of multiple tenses, so I'm not sure I'd worry just yet, especially if her speech therapist is not concerned.
posted by lydhre at 11:27 AM on January 12, 2019
I had two late talkers who eventually exploded from few words to complete grammatical sentences with complex and correct use of multiple tenses, so I'm not sure I'd worry just yet, especially if her speech therapist is not concerned.
posted by lydhre at 11:27 AM on January 12, 2019
Anecdata time!
When I was around five, there was a boy of the same age who lived next door, and he talked like that. Both at school (Kindergarten) and at home, he used two words at most, often even less than that; a part of a word. And it worked, because he got what he wanted; when he told his mother 'poon' she'd go and fetch him a spoon.
He was regarded as being behind in his speech. But he wasn't, not really. Because when we were playing, he'd say things like 'I'm the pirate, and we're at sea and this is our boat'.
He overcame his habit when people started requiring that he spoke in whole sentences. At school, when he said 'see' instead of 'naar de WC' (to the toilet), the teacher simply said 'What was that, (name)?' Then he tried again: 'Nadesee'. She said, in a calm and friendly voice: 'To the sea? That's a pretty long way to go.' His next try came out 'Nade WC'. She considered it close enough and let him to go the toilet.
This may sound a bit mean now. He did, however, turn out fine.
posted by Too-Ticky at 11:28 AM on January 12, 2019 [1 favorite]
When I was around five, there was a boy of the same age who lived next door, and he talked like that. Both at school (Kindergarten) and at home, he used two words at most, often even less than that; a part of a word. And it worked, because he got what he wanted; when he told his mother 'poon' she'd go and fetch him a spoon.
He was regarded as being behind in his speech. But he wasn't, not really. Because when we were playing, he'd say things like 'I'm the pirate, and we're at sea and this is our boat'.
He overcame his habit when people started requiring that he spoke in whole sentences. At school, when he said 'see' instead of 'naar de WC' (to the toilet), the teacher simply said 'What was that, (name)?' Then he tried again: 'Nadesee'. She said, in a calm and friendly voice: 'To the sea? That's a pretty long way to go.' His next try came out 'Nade WC'. She considered it close enough and let him to go the toilet.
This may sound a bit mean now. He did, however, turn out fine.
posted by Too-Ticky at 11:28 AM on January 12, 2019 [1 favorite]
My cousin's daughter was like your daughter--really bright, receptive language was great, preferred to speak in phrases rather than sentences. Her parents' work situation changed about a month after she turned 3, necessitating enrolment in daycare. My cousin said the change in her speaking was unbelievably fast--as in, within two weeks she was talking in complete sentences all the time. I witnessed it myself--I had seen her in person in December and then when I next talked to her on FaceTime a few weeks later, the difference was incredible. We think it's because at daycare, unlike being with family, she had to use full sentences with the adults to be understood, plus she was mimicking all her peers in the daycare, as kids do.
Is your daughter in preschool or daycare, or even weekly children's programs (eg at the public library) with age peers? This might speed up the transition to sentences if you are able to arrange it.
posted by hurdy gurdy girl at 11:32 AM on January 12, 2019
Is your daughter in preschool or daycare, or even weekly children's programs (eg at the public library) with age peers? This might speed up the transition to sentences if you are able to arrange it.
posted by hurdy gurdy girl at 11:32 AM on January 12, 2019
I’m a pediatric SLP who works with slightly younger kids and here are my thoughts. Typically when I see kids who have large vocabularies but aren’t putting words together I wonder how diverse their vocabulary is. I would make a list of the words you hear over the course of two days and see how it breaks down—is she using names for things, action words, “commenting” words like “look” or “uh oh,” descriptive words, location/spatial words (up, down, under)? If she’s missing one of these categories, or one of them isn’t as robust, or can be hard to put together longer sentences.
The examples you give are interesting to me, too, because two of them involve the word “it.” It is age appropriate to use pronouns but I see a lot of kids using them as a crutch (it, that, this) instead of using more specific names, which could be impacting her. I could model and encourage more specific words (“read it”; “Let’s read them book,” or even “Do you want to read the baby next or the horse book?” to get really specific ).
posted by Ideal Impulse at 11:36 AM on January 12, 2019 [6 favorites]
The examples you give are interesting to me, too, because two of them involve the word “it.” It is age appropriate to use pronouns but I see a lot of kids using them as a crutch (it, that, this) instead of using more specific names, which could be impacting her. I could model and encourage more specific words (“read it”; “Let’s read them book,” or even “Do you want to read the baby next or the horse book?” to get really specific ).
posted by Ideal Impulse at 11:36 AM on January 12, 2019 [6 favorites]
Response by poster: That's really interesting Ideal Impulse -- she does use "it" as a crutch, definitely. We do model using the whole word ("read the book"? "eat the cake?") Or sometimes I play dumb ("read the carrot?") and she will correct me most times, but she still seems to want to just use "it." I'm not sure what else to do and her last speech therapist didn't seem to have any additional suggestions. Perhaps we'll find someone else who might have more ideas. I'll start keeping a list.
Thanks, everyone, always open to more thoughts!
posted by heavenknows at 11:42 AM on January 12, 2019
Thanks, everyone, always open to more thoughts!
posted by heavenknows at 11:42 AM on January 12, 2019
Response by poster: Oh sorry, last threadsit -- she is in daycare, some half days, some days it's school-hours. Part of the problem is that in general she's just not very demanding -- I imagine she goes with the flow at nursery and doesn't really need to tell them much. And when she does one word probably will do ok. (Wee wee! Bunny! More carrots!) Not sure if this is something to worry about; am meeting with the head of the nursery soon to see what she thinks.
posted by heavenknows at 11:51 AM on January 12, 2019
posted by heavenknows at 11:51 AM on January 12, 2019
You’re being her interpreter, ie, she points at something and says ‘it’ or ‘get’, you fill in the blanks and do it so she’s never required to say a whole sentence because you figure it out anyway and do the work for her. I think turning it into a silly game where you play dumb as you’ve suggested and keep bringing her the basket or the fork until she asks for it properly will work.
I’d suggest that getting her nursery educators to require more words from her will help. They’re also good people to ask about strategies to deal with this, chancesare they’ve seen this before.
posted by Jubey at 11:55 AM on January 12, 2019
I’d suggest that getting her nursery educators to require more words from her will help. They’re also good people to ask about strategies to deal with this, chancesare they’ve seen this before.
posted by Jubey at 11:55 AM on January 12, 2019
If it's possible, I suggest getting a new, formal speech evaluation that focuses specifically on her expressive language and includes both formal evaluation instruments (tests with the SLP 1-on-1) and observations in different settings (at daycare and at home).
This will tell you if she is just content letting sister talk for her or if she has a specific deficit of the kind Ideal Impulse describes. It should also tell you how to intervene.
The current SLP may have been unhelpful because they don't know the cause of the problem (so need more testing) or don't see the problem in session (so need to ask SLP what to do at home to encourage full sentences).
posted by Snarl Furillo at 1:29 PM on January 12, 2019
This will tell you if she is just content letting sister talk for her or if she has a specific deficit of the kind Ideal Impulse describes. It should also tell you how to intervene.
The current SLP may have been unhelpful because they don't know the cause of the problem (so need more testing) or don't see the problem in session (so need to ask SLP what to do at home to encourage full sentences).
posted by Snarl Furillo at 1:29 PM on January 12, 2019
It's time for stories. Do you read to her? Anyway, for a week or two I would immerse her in lots of lots of stories, not videos. They can be illustrated with still pictures, like reading her picture books, or with no pictures at all, like with un-illustrated books, be told verbally without props, and they can be told verbally with props, such as holding a stuffed animal and making it paw upward because it can't reach the top of the counter.
After two weeks or two days or whatever time you have before it looks promising, get her to start beginning or ending your stories. And then get her to start telling you stories. Ideally a routine like you tell her a story on the way home from daycare while your spouse drives, and then she tells you a story, alternating so she gets daily practice is good. Stories do not have to be original. It's fine if you tell her Little Red Riding Hood and then she tells you Little Red Riding Hood. Stories require more of the linking words than merely communicating her own needs.
Start coaxing her to repeat phrases such as "Once upon a time..." "I don't want to pee in my bed." "I can't take you anywhere. "Our boots go on the boot tray" etc. If she is dumping her boots where she takes them off, drilling her in the phrase as part of reinforcing where the boots go will get her to practice using all the words that turn a phrase into a complete sentence. Include probing questions like, "Whose boots go on the boot tray. Does your book bag go on the boot tray? Then what goes on the boot tray? Do your boots go beside the boot tray? Ideally this should be very simple for her so that she is teaching Mum and Dad where the boots go. It's not the concept here that you are teaching but how to say it. So your response is not, "Good girl, you parroted the right rule, you are compliant," but "Oh! So that's where our boots go!" You want a collaborative, or empowering dynamic, not a didactic-compliant dynamic.
"Tell me what to do?" "Where does the bear go next?" If linking words like on are missing, then play a game to make her giggle where the poor bear is trying to sleep on top of her cave and keeps rolling off.
Play a game of round robin. Everyone at the dinner table gets to say what they did today, taking turns in predictable rotation. "What did you like most about today?" If she says "Bus" make conversation about the bus and ask questions. "Did you like watching the buses? What did you do? Omgosh! Did you ride on the roof of the bus like your bear rides on the top of your toy car?"
She will be talking in complete sentences before she starts college. A few more weeks or another year won't make a difference by then. Keep in mind too, that she is developing enormously just like all her more obviously verbal peers, but she is developing somewhere else that you can't see. So where her verbal skills are not leaping ahead she may be developing colour perception acuity or fine motor skills, or proprioceptive skills, or an eye for fashion, or her sense of direction, but there is SOMETHING going on. Growth and development goes in fits and starts and spurts and plateaus and even regresses at times, and this is good. But the verbal skills are critical for the cognitive skills, so it is worth playing with her enough to recognize where her verbal skills are developing the strongest and working with that to develop her weaker skills.
Let's say she likes to crayon quietly. That's your opening to build her vocabulary around that experience with concepts such as light, dark, pastel, crimson, scarlet, blended colours, border, outline etc. You don't teach her those concepts as a drill. You teach her those words by discussing her colouring with her like at adult. Get yourself an adult colouring book and join her at the kindergarten table and ask her to explain her work and her thought processes. "Is it hard to colour within the lines? If I go outside of a line I colour over it with a darker colour. What colour are you going use for the background? I think I'll use purple here. Do you think this purple is too dark? If I press harder it will come out darker."
Then when you've shared the vocabulary of nouns and verbs and concepts, work on having conversations where you both say things in slightly different ways. "If I press harder it comes out darker. When I press harder it comes out darker. I will press harder so it will come out darker. I pressed harder so it came out darker." It takes grammar to express those nuances. Your job is to provide her with comfortable incentive to talk and this is the kind of situation that provides her with the incentive. This is also where you can notice where you might possibly be missing opportunities to develop verbal skills with her. It may be that you could make your speech to her more complex if you have gotten into the habit of speaking simply to ensure she can understand you. Or it could be that your own verbal habits are hard for her to keep up with. (Many years ago I was on the bus with my eldest, wondering why she was a slightly late talker when she started getting wriggly and rowdy and I turned around to her and said, "Curb your fractious tendencies!" At which point I had the abrupt realisation of just how I had been contributing to her speech delay.) It's not that you shouldn't simplify what you say, or that you shouldn't make it complex but she needs experience with multiple levels of communication. It can happen that kids who are in daycare are not getting to have conversations because their peers' conversation skills do not have give and take and they are talking over her, while the adults are only giving instructions, or providing feedback to the kids and they do not have the time and people resources to draw the kids out. If all she hears is, "Jack an' I went the store an' Jack was mad! I said I gots the seat. It was my seat I gots it first!" and "Lunch time everyone! Go and get your lunchbox from your cubbie! Does everyone have a plate? Good girl, Jasmine! You're in the drink line already!" she is and can coast through life serenely dreaming internal dialogue that would take your breath away if only she were to verbalize it.
posted by Jane the Brown at 2:28 PM on January 12, 2019 [4 favorites]
After two weeks or two days or whatever time you have before it looks promising, get her to start beginning or ending your stories. And then get her to start telling you stories. Ideally a routine like you tell her a story on the way home from daycare while your spouse drives, and then she tells you a story, alternating so she gets daily practice is good. Stories do not have to be original. It's fine if you tell her Little Red Riding Hood and then she tells you Little Red Riding Hood. Stories require more of the linking words than merely communicating her own needs.
Start coaxing her to repeat phrases such as "Once upon a time..." "I don't want to pee in my bed." "I can't take you anywhere. "Our boots go on the boot tray" etc. If she is dumping her boots where she takes them off, drilling her in the phrase as part of reinforcing where the boots go will get her to practice using all the words that turn a phrase into a complete sentence. Include probing questions like, "Whose boots go on the boot tray. Does your book bag go on the boot tray? Then what goes on the boot tray? Do your boots go beside the boot tray? Ideally this should be very simple for her so that she is teaching Mum and Dad where the boots go. It's not the concept here that you are teaching but how to say it. So your response is not, "Good girl, you parroted the right rule, you are compliant," but "Oh! So that's where our boots go!" You want a collaborative, or empowering dynamic, not a didactic-compliant dynamic.
"Tell me what to do?" "Where does the bear go next?" If linking words like on are missing, then play a game to make her giggle where the poor bear is trying to sleep on top of her cave and keeps rolling off.
Play a game of round robin. Everyone at the dinner table gets to say what they did today, taking turns in predictable rotation. "What did you like most about today?" If she says "Bus" make conversation about the bus and ask questions. "Did you like watching the buses? What did you do? Omgosh! Did you ride on the roof of the bus like your bear rides on the top of your toy car?"
She will be talking in complete sentences before she starts college. A few more weeks or another year won't make a difference by then. Keep in mind too, that she is developing enormously just like all her more obviously verbal peers, but she is developing somewhere else that you can't see. So where her verbal skills are not leaping ahead she may be developing colour perception acuity or fine motor skills, or proprioceptive skills, or an eye for fashion, or her sense of direction, but there is SOMETHING going on. Growth and development goes in fits and starts and spurts and plateaus and even regresses at times, and this is good. But the verbal skills are critical for the cognitive skills, so it is worth playing with her enough to recognize where her verbal skills are developing the strongest and working with that to develop her weaker skills.
Let's say she likes to crayon quietly. That's your opening to build her vocabulary around that experience with concepts such as light, dark, pastel, crimson, scarlet, blended colours, border, outline etc. You don't teach her those concepts as a drill. You teach her those words by discussing her colouring with her like at adult. Get yourself an adult colouring book and join her at the kindergarten table and ask her to explain her work and her thought processes. "Is it hard to colour within the lines? If I go outside of a line I colour over it with a darker colour. What colour are you going use for the background? I think I'll use purple here. Do you think this purple is too dark? If I press harder it will come out darker."
Then when you've shared the vocabulary of nouns and verbs and concepts, work on having conversations where you both say things in slightly different ways. "If I press harder it comes out darker. When I press harder it comes out darker. I will press harder so it will come out darker. I pressed harder so it came out darker." It takes grammar to express those nuances. Your job is to provide her with comfortable incentive to talk and this is the kind of situation that provides her with the incentive. This is also where you can notice where you might possibly be missing opportunities to develop verbal skills with her. It may be that you could make your speech to her more complex if you have gotten into the habit of speaking simply to ensure she can understand you. Or it could be that your own verbal habits are hard for her to keep up with. (Many years ago I was on the bus with my eldest, wondering why she was a slightly late talker when she started getting wriggly and rowdy and I turned around to her and said, "Curb your fractious tendencies!" At which point I had the abrupt realisation of just how I had been contributing to her speech delay.) It's not that you shouldn't simplify what you say, or that you shouldn't make it complex but she needs experience with multiple levels of communication. It can happen that kids who are in daycare are not getting to have conversations because their peers' conversation skills do not have give and take and they are talking over her, while the adults are only giving instructions, or providing feedback to the kids and they do not have the time and people resources to draw the kids out. If all she hears is, "Jack an' I went the store an' Jack was mad! I said I gots the seat. It was my seat I gots it first!" and "Lunch time everyone! Go and get your lunchbox from your cubbie! Does everyone have a plate? Good girl, Jasmine! You're in the drink line already!" she is and can coast through life serenely dreaming internal dialogue that would take your breath away if only she were to verbalize it.
posted by Jane the Brown at 2:28 PM on January 12, 2019 [4 favorites]
The Hanen series offers helpful strategies. Sorry, I'm on my phone and can't link. Anyways the ideas in those books helped us with our son when he had speech delays from around 2-4 years old.
posted by bluebelle at 7:34 PM on January 12, 2019
posted by bluebelle at 7:34 PM on January 12, 2019
This thread is closed to new comments.
That's not to say this is your fault--she has a speech delay, and you seem like loving parents who are doing what they can to help her. It is to say that kids are smarter than we think and if speaking in fragments has worked for her so far in life, why change it?
Try requiring her to speak in full sentences whenever she asks for something and see if she improves.
posted by Amy93 at 10:28 AM on January 12, 2019 [2 favorites]