Speech Update

First of all, thank you for all the comments regarding her speech delays. I read every comment and shared them with the speech pathologists.

I filled out the Early Intervention form online and they emailed me back saying she may qualify for services, but not speech services. In fact, oddly enough, communication is where she scored the highest! The categories were communication, gross motor, fine motor, problem solving and personal/social. Where she may qualify is in problem solving. The funny thing about this is I don't think she has a problem with that; I think she just can't always communicate what she wants to say. Well, hopefully she will be picked up because I am sure she will only benefit from outside intervention, especially if given by a speech pathologist, even if it's for problem solving.

Meanwhile, I also took her to her appointment at the pricey private place for the free evaluation. The speech pathologist did an hour long, though still fairly informal, evaluation. In the end she determined that Almi does have a slight speech delay--basically she's right at the cusp of needing services--but she did think that she could have been right on target if she had been in country since birth. She went on to say that since she appears to grasp concepts quickly that she would probably respond well to speech therapy. I asked her how long she would recommend and she said an hour a week, in two half hour sessions, but thought it would be fine to wait to see what the District offers and how she progresses over the next few months before signing up for their private speech therapy. (I believe she said their therapy is about $67/hr and they don't accept insurance, though I could try submitting a claim.)

She noticed Almi getting frustrated when she couldn't express herself and recognized that she needs work on using more 3 word+ utterances. She said she could use work with more complex sentences (with adjectives and adverbs). She also said she is fronting her ds and gs, which she explained to mean that she is pronouncing words that begin with d and g at the front of her mouth instead of the back.

When I got home I looked online to see what else I could learn. From this chart it appears she has the following issues: word-final devoicing (she says 'buck' for 'bug'); velar fronting (she says 'titty' for 'kitty'); weak syllable deletion (she says 'teffone' for 'telephone'); and stopping (she says 'dump' for 'jump'). I wasn't sure which of those phonological processes was age-appropriate until I saw this chart. Assuming my ten minutes of research on the internet hit upon an accurate assessment, it appears they are all considered age-appropriate until at least age 3. Armed with this information and the comments by today's evaluator, I am going to hold off on private therapy for a few more months. Hopefully with the suggestions I was given today and the possible servicing from the district, she will get on track.

Meanwhile, here's what the speech path recommended:

1. Follow up with the early intervention people and see what they are offering. Hopefully she will qualify for one hour a week. If so she will get a plan similar to the IEP in public schools. Use this time to make requests that are speech-related if they are not already in the plan.

2. Put several items in front of Almi and ask, "What do you want?" or "Which one?" I know that Almi can point or say, "Dat one" but the goal is to get her to say, "The yellow shirt" or "I want applesauce, please."

3. When talking with Almi I should encourage her to use three (or more) word utterances. So, for example, if she wants milk she will say "Milk!" or "Milk pees." Eventually I would want her to be able to say, "Mommy, may I have some milk please?" so I should model a simple sentence for her first, like "Milk please, Mommy" and see if she will repeat. She suggested I do this during a non-threatening time, like during play. Then as time goes on add another word. Or when getting dressed and she says, "shoes" I should respond with more detail like adding the color or that they are pretty or have velcro. The idea is to give her access to more vocabulary and encourage her to use it. I have been doing this quite a bit but I will be doing it a lot more.

4. She then said to take it a step further shortly but this time don't give in if she doesn't repeat me. So, in the milk example if she didn't say, "Milk please, Mommy" then I shouldn't give it to her. Lately when she gets frustrated and starts grunting or making an unintelligible whine, I have been saying "Use your words" and she has expressed herself in words (though simply like, "Mommy help"). I am going to be better about requiring this each and every time as well as repeating my modeled sentence in order to get what she wants from me.

Before leaving I asked her if she felt my TV-free home was an issue and she said she didn't think children's television programming would hurt, but I shouldn't feel the need to rush home and plug it in. I also asked her about moving Almi to a non-English speaking country this summer and she said that sometimes things like that can't be avoided and though she won't lose what she has learned, it may interfere with her English language acquisition. Finally, she said she is glad she is in an academic day care where concepts and vocabulary are part of every day.

So, all in all I am really glad I went. I'm not as worried and look forward to working with Almi at home. I can't wait to see how things are by this summer!