Friday, May 1, 2015

Should I Worry?

I often see  questions in forums/groups by moms wondering if they should worry about their child's speech.  And I get SO frustrated at the responses.

He's fine!
He'll talk when he's ready.
Boys talk later than girls.
If he smiles, he doesn't have autism.
Some kids are thinkers, some are talkers.
He might not have anything to say.
Kids develop at their own speed.
Don't worry!
He's fine!

Once upon a time, I was that mom too.  And all those answers did nothing but delay treatment.  If you're not a SLP (Speech & Language Pathologist), you shouldn't be telling a mom her child is fine.  If you're not a pediatrician or psychologist, don't be telling her he doesn't have autism.  STOP making diagnosis for kids you've never met.  Stop brushing her concerns off.  He might be fine.  He might not be fine.

When my first, Hugh, was little, he wasn't saying much.  Well, quite often he did talk a lot, but it seemed disjointed, incomplete, chunky.  I heard all those same lines.  His daddy didn't talk till he was 4. My brother didn't talk well.  Boys talk later was a popular one (my neighbour said that about Hugh, then three years later said girls talk later than boys!).  When Hugh was 2  1/2, I was starting to worry.  But I was a first time mom.  Then I had a visit from a lactation consultant to help with Lucy who was a newborn.  I've written about this visit before (but of course, can't find it right now).  She mentioned that although speech wasn't her area of expertise, she felt Hugh had some issues and that perhaps an evaluation would be good.  It's done through our Public Health office.  It took a few months  to get in, and he finally started speech therapy at 3years, 3 months old.  He progress pretty rapidly, and finished in a year or so.

Lucy came along to all the appointments, of course.  She was a girl, so she should talk sooner, right?  She DID love to talk, however it was half babble, half words...she'd talk, and if she didn't know a word, she'd just babble until the next word in her sentence.  At 2 1/2, she could tell you all the letter names, but barely put together  sentences.  She started therapy at 2y10m, with the same SLP.  She had the most unusual "f" formation the therapist had ever seen in almost 20 years of work.  I had NO clue.  It took a LONG time to get rid of that issue, and she continued therapy until she was about 5-6 (she aged out of the Public Health program and started receiving SLT at school).

So, surely, by kid #3 (Megan), we'd get it right!  We started sign language.  Some people were against this,thinking the kid will sign instead of talk.  That's rarely the case.  I learned about the progression of sounds that infants make.  Ever wonder why ALL kids' first words are momma, dada or baba and not milk, dog, or brown?  Megan wasn't making any of the sounds she should have by six months.  At 8 months, she had her first assessment.  Kids who learn signs from birth, will usually start signing around 8-10 months.  She didnt' make her first sign till 13 months, and the context was odd.  One of the signs we always did was "more", but it was usually used with food ("more yoghurt?") or activity ("more swing?").  She used it when she went in a room of 8 dogs.   Pointed to the dogs (one was ours) and signed "more".  I knew that was significant!

Megan started speech therapy at 1y10m (22months).  Some people say you can't do SLT if the child won't repeat words/sounds back to you.  Not true at all.  Kids often work better with a stranger.  Some say there's no point in therapy if they're only saying a few words.  Not true.  Therapists will figure out WHY they're not saying much, and work to build on this.  Is it physical?  Is it language?  Megan had both language and physical speech issues (also with "F", but different than Hugh and Lucy).  Language took her a LONG time to understand.

Shortly before Megan started Junior Kindergarten, at 3y9.5m, we moved, and we were set up with SLT here, without having to go through the whole process.  Megan received Public Health SLT during JK and at the end of JK was referred to the school board's SLP.  It took nearly a year for that assessment.  A year without any therapy.  When they did that assessment, they said because she was missing her two front top teeth, they couldn't get a real idea of if she needed more therapy, so was denied.

Her speech eventually caught up, but her language has not.  My mother once said talking to Megan is like talking to an ESL student (English as a second language).  She's better now, but she often has a hard time with language, sentence structure, and using the right word.  This carries over to her reading and writing.

When ever I read that a mother is concerned about her kid's speech, I write something like this:
 Look up what sounds he should be making. Babies learn them in a certain order, and if he's skipped some, or his sounds aren't up to his age, that's a concern, more so than how many words. I didn't learn that until my THIRD kid was in SLT.
With my fi
rst, we were told "boys talk later/his father and uncle didn't talk till 3/he'll talk when ready" etc. No one except a SLP should be telling you he's fine. I wouldn't worry yet, but by 20 months, if you still are concerned call for an assessment. The process takes a while, and too many parents wait to long, and then their kid gets to be too old for the OHIP covered stuff, so then they go on the school board's wait list which also has a long wait. My first wasn't in SLT till 3y3m, the second kid was 2y10m and the third, 1y10m. That kid started having assessments at 8 months cause we knew by six months she wasn't making the right sounds. I'm not telling you to worry. I' not telling you to not worry. LOL. Just that speech and language learning is complicated, and the best thing to do is do some research (not just # of words) and have a professional assessment by a SLP, not strangers on a silent forum 

Phoning to arrange an assessment NEVER hurts.  What hurts, is listening to (well meaning) moms who say the things I wrote at the top.  It could take months for the assessment to happen.  In that time, the child might have suddenly found their voice.  Or not.  After the assessment, it can take months--even a year or more--to start therapy.  In that time, the child might have found their voice.  Or not.  Once the child turns 5, they are referred to the school board SLP.  That assessment can take a year to get.  In that time, the child might have found their voice.  Or not.  The wait, after the assessment, can take another year.  

Imagine now, if you delay that very first call.  Just delay it a month, and depending on your child's age, they might miss out on SLT through Public Health entirely. 

It is totally possible that you make that call, and when your assessment time comes, you're happily able to say "Not needed now".  But imagine if you wait because "he must be a thinker and will talk when ready".  Only....he doesn't.

An assessment NEVER hurts.  Waiting CAN hurt.  If in doubt, just phone.  You'll be glad, no matter the outcome.  Wait, and you might be very upset later on.