It's confirmed by a speech pathologist... our twins have an expressive language delay

Today we had a consulation with an independant speech pathologist for our now 19 month old boys. She observed them play, etc. Suspicions confirmed. She said they have an expressive language delay and it is good we called EI and we should persue it.

Saw her because we are hoping if we devolop a past history w/her we can get her if they qualify for EI because she might be able to do weekends.

In some ways I'm relieved because she said they do not appear to have a receptive delay. In other ways I'm concerned because our boys need help. She watched them play and she said they were really quiet, they should be babbling most of the time they're playing and they weren't - and they don't at home (though they go through brief periods of doing so). Come to think of it, I haven't heard mutisylabic babbling from them for a little while.

I'm also freaking out- don't knwo how we're going to make it work. My spouse and I have to work and work long hours far away from home. I have to leave at 7 am, he can't get back until 5:30-6:30 p.m. How on earth are we going to manage weekly visits that we HAVE to be there if we get someone who isn't the nice pathologist we saw? One or both will lose our jobs. Also, how are we supposed to utilize any tools learn as at MOST I get 15 minutes w/them in the morning after they are woken up, dressed before I have to drop them off at daycare, and their dad has only about an hour with them before they go to bed? How do we make it work with our schedules- both for doing therapy and utilizing what we're supposed to do at home?

So, they did pass the 'minimum words' at 18 month doctor visit, but they say those 6 words not very often, twin A hasn't gained any new words and is now using 'da' for almost everything. not saying much. So I went ahead. Developmental pediatrician said 'not to worry' unless not saying 2 word combinations at 2, but didn't want to wait until then because i could see their words were not progressing.

For those of you with similiar problems... expressive language delays w lack of much babblking, work conflicts, scheduling conflicts, what did you do? How did it work out? Did the speech therapy help?

 

I don't really have a lot of experience in this area, but my BF had to have EI for her son while he was still in daycare (he needed speech and occupational therapy) and they came to the daycare to work with him. She and her husband did what they could during the week and weekends to help augment the work of the speech and occupational therapist.
It was the daycare that brought it to her and her husband's attention that her son was not doing the age appropriate things. So, you might want to get the ball rolling with boys daycare and keep them in the loop of what's going on.

I hope others will also reply with their experiences :hug:

 

Would it be possible for you to get some breaks from work so you can go to the weekly appts? That is what I would do. Or have family take them or a nanny?? Or what Nancy said and get daycare to work w/ speech? Good luck!

Good luck with whatever you decide. I'm sure it will work out just fine

 

I would definitely talk to the daycare; Nancy's BF was able to have EI go there to do the appointments, so I'm sure this is not a terribly uncommon thing. I would also investigate FMLA and see if there is any way you could take some time off as "protected leave", both for appointments and to work with your sons. Maybe you could speak with your HR department or EAP about any accommodations that they could make.

I'm sure this is so hard; I hope you find a way to make this work! :hug:

 

First off let me just say that my ds (the one in speech therapy and that has been since 18 months) never babbled after a year. He was very quiet and our speech therapist said that that can delay the speech but it isn't something to worry about.

As for the scheduling they will make it work. You do not have to be there and they will go to where ever the boys are. My friend runs a pre-school and she knows all of the therapists because they come in and work with different children. They leave notes for the parents of what they worked on and how the child did or they talk to them over the phone after.

I had thought I would have to be there as well and I worried because I have 2 other kids that need my constent attention, turns out it's sooo much better if I'm not in the same room!

What percentage of delay do they have? My ds at 18 months had 50% and was speaking and understanding at a 9 month level. Did you get hearing tests done? They require them for our EI group.
Good luck!

 

Check into FMLA, Family Medical Leave Act.

 

thanks everyone for your feedback!

Thanks for the parents with experience that yiou don't have to be there... I really hope it turns out we don't have to be there... the supervisor at EI said they can go to the daycares but a parent has to be there (we're in California?) . I hope the individual case worker we get is more flexible Thanks for the feedback from the parent who said you didn't have to be there! I don't know what percentage they boys are delayed. The therapist we consulted said she thought they would qualify if they are seen before they turn 2 because it requires at least a 33% delay in one area. She said they would NOT qualify if they aren't seen until they are 2, because California now requires an OVERALL 50% delay. She said she's fairly confident their receptive language is fine... but their expressive isn't (so I'd guess at least a 33% delay expressive based on what she said?)

Re: can we take breaks at work for the therapy? No. Both my husband and I have a 2 hour commute each way to work. that would mean a minimum 5 hour break in the day- which would mean at most a 3 hour work day 2 days a week. If they do both kids in the same day at best a 2 hour work day. At best if it was `1st thing in the morning or last thing in the day, we would each lose 3-4 hours of work if the therapy was on different days for each twin. (if therapy was at 9, I wouldn't get into work until noon.... if therapy was at 4 (the latest) spouse would have to leave work at 2:00 p.m.

Re: FMLA- I doubt it would qualify, I don't think needing speech therapy is a "serious health condition". According to FMLA: coverage is:

• to care for an immediate family member (spouse, child, or parent) with a serious health condition; or
• to take medical leave when the employee is unable to work because of a serious health condition.

I don't think that speech therapy done by a non-MD qualifies- I checked and it all requires hospital stays or medical certification.

Thanks so much for the support, and feedback!

 

I would still contact your or your DH's HR dept. and/or EAP. There may be no accommodations they would be willing to make, but you never know until you ask! Sometimes they will allow you to flex time, or work from home one day a week. Most companies are bone-heads about this kind of thing, but there's no harm in asking!

Best of luck to you!

 

I'm in Ca and that's where my friend owns the daycare/pre-school. I'm more North then you but we go through a group called Pride and Joy and they are wonderful. Good luck!

 

I hope you get this worked out soon. We also have EI therapy for gross motor and feeding. It is a lot to juggle with all of the appointments and meetings, I have often thought I am skating on thin ice at work, especially in this economy. I have been told that they will go to daycares – our feeding therapist is going this week since Gavin is behaving differently in different environments. Hopefully you can sort out if you have to be there or not. If you don’t – maybe you can try and arrange to be there once a month just to check on progress. Since both my boys are in motor therapy they send 2 therapists to the house at the same time on the same day so that we don’t have to manage 2 separate appointments.

 

My boys are also receiving ST. In ny a parent does not need to be present. Hopefully yo can find a provider who will work weekends. Mine offered to do Saturdays. It will work out. As far as helping I have already noticed a slight increase in babbling and gesturing (signing). Good luck!!

 

I am presently taking this course called "it takes two to talk" -- www.hanen.org I think you can order the books /DVD from places like Amazon.com. Even for those 15 mins morning and evening and again on the weekends you could make some real progress. My one daughter was behind due to hearing and then it took sometime to catch up. At 2.5 yrs old she is nearly up to 200 words but still working on combining words. It other ways she has really caught up. Read to them whenever you can, get down on the floor so you are eye to eye and play with them. When you ask questions dont' ask a TON of questions one after the next and not WAIT WAIT WAIT to hear the answers. As parents we can sometimes "talk AT" our kids.

This program has helped more than any speech class I've taken her too.

Heather

 

Both of my twins also have an expressive language delay. They were diagnosed at about 18 months old and have been in speech therapy ever since (first through ECI now through the school district). Here also ECI will go to where your kids are and no parent has to be present (surely they have other families with single working parents or two working parents and have faced this dilemma before!)

Just as encouragement, they have made great progress. Though they are still not "normal" they are now very expressive. They started out with basically no words and now say long sentences and are working on transitions, tenses, pronunciation, etc. I didn't have their hearing tested until about 6 months into therapy because they seemed normal, but turned out to both fail the hearing test, even though they have no history of ear infections. With ear tubes, their hearing and speech have both improved (although the hearing issue was clearly not the whole problem) I'd definitely recommend getting their hearing tested...you might be surprised.

One mistake I made early on was using a lot of yes or no questions, simply because they would shake their heads. It was the only way I could figure out what they wanted so some of it was unavoidable, but it does stifle communication.

My other suggestion is to look into baby signs. That was the first thing ECI had us do. They picked it up quite quickly and it was so great to have a way to communicate. Their oral communication didn't really pick up for a long time, so it was nice to have an alternate method of communication. It encourages them to communicate with you, even if they are not able to currently do it orally.

Good luck! Although mine still have a ways to go, I am hopeful that by the time they start school, they will need minimal to no intervention.

Suzanne

 

My 6yr old son had a speech delay - and now at 6yrs has an excellent vocabulary and has speech pronunciation of about a 5yr old (we never had access for public speech assistance due to where we lived nor did we have the funds to pay ourselves so I did it all on my own with him).

At 26mths when he had his one and only speech assessment he had what they considered 5 words - and 3 of them were signs. They counted them as they were part of the receptive aspect. He understood and could respond by sign but not by speech. He did not babble until about 2.5yrs of age.

Now at 6 he has not a stutter but a stumble. He repeats the first word of his sentence over and over again and once he gets to the 2nd word he speaks clearly and fluently. The more agitated or excited he is the worse it is.

So, just to give you a positive outlook that its awesome you are starting the process of getting help and getting your foot in the door! If I could get my guy where he is on my own then you have all the doors open to you! HUGS! and good luck with the rest of your questions.

 

Wow, thank you everyone who posted a response and extra thanks from posts from the parents who wrote what they've experienced, I am encouraged by what you've written!

SuzanneTX, sounds like your twins have made great progress- do you mind me asking how often/how long they go to therapy?

ChaoticMum - my hat goes off to you. How did you do the therapy yourself? Do you have books you recommend? Are there any tools/things that you do that you think help make a difference? How did you get started?

(I'll take all the help we can get, but I will do anything we can do at home to help them, too)

 

At first, my girls received in-home therapy twice a month. At that time, it was from a case manager who had experience with multiple aspects of childhood development, rather than a SLP. I felt they weren't making great progress after about 6 or 8 months or so and we changed it so their therapy came only from a SLP (speech-language pathologist). After transitioning to the school district at age 3, they (very surprisingly!) offered twice weekly therapy in our home. Although the SLP has missed more days than I would like and we get no therapy in the summer months, I am very happy now with their progress. I am starting them in a twice weekly mother's day out program during the summer to help improve their developing communication skills.

I'll have to change my tickers at some point, but they are now 3 years 5 months old.

Good luck with everything. I have experienced a lot of emotions during this time, hoping that someday they would be able to communicate normally - I know it's scary. Since they have been so delayed, I think I am much more aware and delighted at all the funny things they say. It's interesting to have oral communication only begin once their cognitive skills are so advanced. They come up with very funny ways to express things (the latest one is Anna commenting that boys pee-pee with their "little tails"!)

 

This is just a comment... not to say you shouldn't start therapy, but ours at 18 months barely had the 6 words plus mama and dada. but they did have at least 11 signs, most of those different than the 6 words. I remember 3 mo. later counting words one day, and my ds had 21 words, and my dd 7! Then again around 2 yrs I counted words during a morning and my ds was well over 100 and my dd a little less than that. At the well visit they were super quiet, but all the pedi asked was if they had the 2 word phrases... They didn't really have any, they were starting to say "thank you", but I wouldn't really consider that a 2 word phrase, b/c you don't say the words separately.

anyway, I only say this b/c I really feel like they are progressing great, even though many kids are able to communicate more.

I also like the suggestion of the home therapy with videos and educating yourself. A friend of mine has her daughter in therapy and they suggested for her to teach her signs too. (I like Signing Times and Baby Signing Time).

I also think some people here have recommended "Baby Babble" dvds...

I would also say that in reflecting on our household... we have tended to not talk and communicate with the babies, it was especially noticable when I'd be listening to the baby monitor and knew my dh was in changing diapers and he didn't talk to them at all... hearing that really made me think that WE'RE the ones not assisting our kids... I know that's not everyone's issue, but I noticed it in our house. As for the 2 word phrases, we also noted that we were still telling the kids to say one word instead of a phrase... like "down" to get down out of the high chair... well, duh, if you're not helping them to say a full sentence they aren't going to just say it one day.

anyway, good luck. I hope you are able to get the therapy you need with something that works for your schedules!

 

I got a lot of advice from a private SLP who volunteered her time via phone to me, plus I did get to talk to the SLP who evaluated K.

1)Don't say 'Can you say DOG? try to say DOG". Just point to the animal and say "DOG" and leave it at that. This was a hard one for us to break but it really lessened EVERYONE'S frustration when we did.

2)Baby signs. I taught him his manners and the basics to lessen his frustration. When he was able to use the signs he was able to communicate and it allowed him to concentrate on saying the word knowing I would understand anyway because of the signs.

3)Reading - lots and lots and lots of reading one word paged books, colors, numbers. Flash cards where he would just turn one over and we'd say the word of the item and put it back - no matching at first, nothing specific - just him flipping cards. Then we'd have a race to flip a card and say the word - who ever said it faster 'won'.

4)Writing down the words he DID have - as a PP said its amazing how they did start to add up and how there were more than I realized once we started getting going.