Isla’s delayed speech was the first inkling of our quirky Isla having something else going on. She met the sitting, crawling and walking milestones. She was very busy but what toddler isn’t.
- did a lot of squealing to communicate
- said dadadada for a while but typical babbling didn’t come
- had no interest in books apart from using small ones to take to bed like a cuddly teddy bear
- didn’t imitate facial expressions
- was always easy to make laugh and had a cheerful demeanour
- didn’t always respond to her name
- wasn’t interested in sharing her discoveries or interacting in a usual way
- could understand what we were telling her but there was no signs of expressive language
“She is the youngest of 3 – her sisters probably talk for her” I would hear by well meaning people constantly. I didn’t agree with this though.
SEARCHING FOR ANSWERS
2-3 years old
Everything I read at the time stressed that early intervention was key. This was the start of me being a pushy (or lets say proactive ) advocate for Isla. By the time Isla was 2 she had :-
- had a hearing test
- seen an ENT who performed an adenoidectomy and had grommets inserted
- had her tongue tie released further
- Saw a Paediatrician at 2 years old. Was reassured everything was well apart from a speech delay and she would catch up.
- Were referred to Ministry of Education (MOE) Early Intervention Team. The referral never went through however so I self referred. I contacted them regularly about where we were on the wait list (squeaky wheel!).
3 – 3.5 years old
Speech Therapy – Ministry of Education
Nearly a year later when Isla was just about 3 years old she started speech therapy with Amy, a SLT from MOE. She would visit once per week and would come armed with a bag of new materials and toys and Isla looked forward to her visits. During these visits we would get homework to do until the next visit. Below are some examples of the sort of thing we would work on.
- Amy recognised Isla loved jigsaw puzzles and tactile activities. Her learning materials were laminated picture/word cutouts velcroed to a sheet. Isla enjoying pulling these off but had to wait and attempt the word before doing so.
- We would concentrate on one or two sounds per week. For example bah or gah and would also incorporate this sound into daily acitivity such as “gah gah go” while pushing her on the swing. There was lots and lots and lots of repetition. One sound all day and for the course of a week to cement it.
- We eventually moved onto a scrapbook and started working on prepositions (on, in, after, before etc) and why and because.
During this time I discovered:-
- Isla was a sensory seeker. She finds it easiest to talk while moving as this calms her body which allows her to focus.
- Isla couldn’t meet eye contact when trying to talk.
- It required a great deal of effort for her to initiate sounds. When concentrating for extended periods she would salivate excessively, burp and grind her teeth.
- Isla found some oral motor movements difficult especially lateral movements with her tongue.
- I felt it was more to it than just a speech delay. She had no expressive language and no interest in talking unless it was through “rote learned” therapy. It wasn’t just that she had trouble forming the word but she also didn’t know how to formulate a response. I was getting very frustrated with a lack of a diagnosis. We saw another paediatrician. Again was told was just a speech delay and no signs of autism.
The word Apraxia was mentioned but no-one wanted to commit to a diagnosis. I researched and also started Isla on the a course of fish oils. A specific blend of EPA/EFA. It was hard to know if this was helping. You can read more on this treatment here. http://cherabfoundation.org/2014/therapeutic-use-of-fish-oil/
3.5 – 4 years old
At this time I could not imagine Isla having a normal conversation. In these early days speech was my main concern. I had no idea of the bigger journey yet to come.
Time went on and slowly Isla began saying a few words and then two words together, then small sentences. Occasionally she would say a random word but then would not be able to repeat the word on request or the words were very difficult to understand. We often had to translate what she said to others!
Speech Therapy- Moira Nelson
www.justtalking.co.nz now based at the Parenting Place, Greenlane
As Isla started to make progress the MOE SLT’s visits became less frequent so we supplemented with private sessions with Moira. These sessions further cemented what we had been learning with Amy and introduced Isla to colours and numbers.
The harder part of speech therapy for Isla was keeping her focussed. Although Isla’s therapy moved rapidly and was fun, initially Isla didn’t understand what was required of her. She was always wanting to play with the next game before she had finished the one she was currently on. Moira was great at keeping Isla engaged by:-
- introducing a written check list of what they were going to do each session as you can see them marking off at the end of the video below). This made a huge difference and really made me understand how the use of visuals (even in written format) helps with transitioning. Visuals still help Isla order herself and know the expectation which reduces anxiety for her.
- moving on quickly when she could see something wasn’t of interest of her.
- keeping each session new and working with her interests.
Realising speech was such a struggle we thought it would be a good idea for Isla to have another way to communicate. Makaton is like sign language based on a core vocabulary where you say the word while signing. www.makaton.co.nz
Although Isla couldn’t do the actions herself ,as her fine motor skills didn’t allow, it was useful for a short time to help:-
- Isla grasp some words. Having an action assigned to a word made it easier for her to recall and learn a word. Our focus words were go, stop, eat, drink, sit, help and dirty.
- slowed down our speech while making the action for the word which was helpful for learning and processing.
For other children with limited speech Makaton signing gives them the freedom to communicate which helps reduce frustration. Makaton is used frequently in her satellite class now and Isla knows many signs such as thank you, good morning, happy, excited, sad and hungry. She will always sign thank you when she says it.
Hanen More Than Words
When we came to the end of our private visits with Amy from MOE we were referred to a course called Hanen More Than Words. This was a 3 month course that was really useful at giving us the tools to work on Isla’s speech on an every day basis. The key things I took away from this course were:-
- instead of asking questions, as you tend to do to help encourage child to speak, you should just comment so they can learn how to do so. For example instead of saying what colour is the sky? You would say the sky is blue. It really is a lot harder to do than you would think. We were taught how to use this commenting through play.
- pausing to wait for an answer or a statement. Sometimes it takes a while for children to process and respond and we can easily interrupt that process by talking again before its our turn.
- speech is easier to learn and words easier to string together when singing for a lot of children. Listening to repetitive songs are good. Isla had an app called Busy Beaver which focussed on this and she still likes to watch and sing along now.
Having Fun While Learning
All speech therapy Isla had in her younger years was based around play. At home she also played constantly with her sister Carys. Every day was like play therapy with Carys. Songs, interviews, Video Star. Carys was a natural therapist who enjoyed it as much as Isla. Below are examples of them having fun and Isla learning without even knowing it.
Isla is now 9 and talks a lot! She doesn’t make conversation “normally” but I never get sick of hearing her voice. She still asks a lot of questions and still likes to ask why a lot. This is partly her trying to make sense of the world but also a lot of her speech is repetitive behaviour. She currently will tell us that she loves us at least 10 times a day currently and will back it up “why do we love each other?”. This has become a little obsessive in its nature but there are worse things to hear daily I am sure!!!
SUMMING UP :-
- Seek speech therapy as soon as possible. Be proactive and trust your gut and seek answers.
- Have patience – you cannot rush development and sometimes you feel like you are making no progress at all.
- For younger children speech therapy should be fun and based around play.
- Avoid questions, make statements and model back any speech in the correct way.
- Music can be helpful – repetitive songs, games and recasting back any sounds with words.
- Pause and wait for a response.
- Makaton can help ease frustration by being able to communicate and can help as a visual to a word.
- Visuals can help give a plan of what is expected to help stay on task.
Have you got any tips for speech development? If so please comment below.