Speech therapy questions....

Michi · Apr 13, 2007

For those of you with kids in speech therapy....do your kids ever have 'regressions?'

My DD was doing SO well for awhile, and her therapist said that she was probably going to graduate from the program after this school year. Now all of a sudden, we are both (her teacher and I ) having a very hard time understanding her again, and now the teacher may recommend another year of the program! I want what's best for her, but we were SO happy that she was going to be done!

Also - her teacher said that she has noticed some other concerning things lately...She has been really clumsy..tripping/falling a lot, and her hands are very shaky when she works on small motor skills. (???)

I took her to the doctor yesterday, and physically she's fine. The doctor suggested getting her eyes checked, and that maybe that could account for the shaking and falling (if she can't see well) ...but it still doesn't account for the speech regression.

Do any of you with 'special needs' children have any advice. Is there someone else that I should take her to for an evaluation?

TIA,
Michi

smurf · Apr 13, 2007

I'm assuming the doctor she saw is a ped or a family physician. I think she should see a pediatric neurologist, if she hasn't already.

Suzibeck · Apr 13, 2007

I wouldn't say my dd regressed but she would get up to age level, or nearly so, and then platau (that doesn't look right?) until she fell behind again. She has been out of speech (this is my 7 yo) for just over a year now, and I still have to frequently remind her to use her slow, clear speech. She gets going to too fast and slurs her words, but when she is reminded to speak slowly, she is much easier to understand.

Which dd is this? While I think seeing an eye doctor is a good thing, in general for all kids, I don't think poor vision could explain the loss of speech skills or the shaky fine motor stuff. I have to agree with the op and I'd suggest requesting a referral to a neurologist. The other person I would consider seeing would be an occupational therapist. They can be very helpful with fine motor issues but with the regression you are seeing, I think a neuro is the best choice.

My dd had a dx of Speech and Language Impaired and Sensory Integration Dysfunction. She also had Dysphagia, a swallow disorder and I'm not sure of her vision dx, but she had some issues there as well. We worked with OT, PT (just a bit), Speech Therapist (for both speech and feeding therapy) and a behavioral optometrist. We still see the Optometrist yearly, but mostly just for a normal vision exam and she will give me suggestions if we are having any problems. All other therapies are over now!

Michi · Apr 13, 2007

Yes, we did see just out primary physician.
She thought that we should just 'monitor' her for a couple of weeks and see if her symptoms get better or worse.
I see neurologist myself (for migraines) and I have an appointment next week.
I think I will ask what her opinion is.

TheRealMacGyver · Apr 13, 2007

I'm certainly no expert, (but I did stay at a Holiday Inn Express last night

).

The main types of speech disorders are:

1. Articulation Disorder: Most frequent, Mostly in the form of substitutions, omissions, additions, and distortions. i.e. substituting: "d" for "th", "t" for "k", or "w" for "r". omissions: "boo" for "blue, "cool" for "school". distortions: sometimes called lisps, s, z, sh, and ch are mispronounced.

2. Apraxia of speech: this is a motor speech disorder. Characteristics include errors in production of vowels, inconsistent speech errors, more errors as words or sentences get longer, voicing errors ("b" for "p" or "g" for "k")

3. Voice disorder: Really subjective, but we all have a unique relationship of pitch, resonance, intensity, and quality. Problems here can be from breath support, vocal support, cold/congestion, hypernasality, etc.

4. Fluency disorder: (rate and rythm of speech) Mastery of fluency is indicated by smooth, free-flowing speech. We all have fluency problems from time to time (when you pause and say umm, umm)

ETA: Just reread this and realized I forgot to ask "do you know which of the above your daughter has", Anyhow, Brooke, below will be of more help than me anyhow, but just wanted to add that so I didn't look stupid!

Hope that isn't more than you wanted, I would echo the above on seeing another specialist.

BrookeSLP · Apr 13, 2007

If you will remind me what your DD is being seen for in speech and how long she has been going, I'll give you my 2 cents as a speech pathologist.

easterbun · Apr 13, 2007

My DS is in speech therapy for a disfluency and he has what we call "good days" and "bad days" - it's not so much that he regresses, as there are really SO many factors involved with his specific speech problem... but if you are noticing other symptoms as well, I'd push for a more thorough evaluation.. definately ask your neurologist if a neuro eval would make sense right now - they will know better than your pedi does.

Michi · Apr 13, 2007

I went over her IEP and this was what it says:
Katie speaks in 1-3 word utterances that are generally unintelligible. Katie received a Severe rating on the HCAPP with errored patterns being velars, stridents, glides, prevocalic liquids and consonant sequences/clusters. She also deletes final consonants in her words. Katie's expressive skills and social development are also delayed, apparently an effect of her unintelligible speech.

Does that help at all (???)

BrookeSLP · Apr 13, 2007

When is that IEP from? Also, does she have another diagnoses beside speech impairment? Feel free to PM me if you'd prefer.

Morganthe · Apr 13, 2007

Has her hearing been checked recently? A slight hearing loss or shift could cause speech changes too.

UlrikeDG · Apr 13, 2007

TheRealMacGyver said:
I'm certainly no expert, (but I did stay at a Holiday Inn Express last night ).

Well, you're way ahead of me there. Do you recognize this one? My friend's 5 year old son is really hard to understand. He went through the 4 seasons the other day, and they came out: "Twing, tummer, pall and winter." He says T for K as well; "tate" is "cake". She had his hearing checked, and the doctor said it was fine.

BrookeSLP · Apr 13, 2007

UlrikeDG said:
Well, you're way ahead of me there. Do you recognize this one? My friend's 5 year old son is really hard to understand. He went through the 4 seasons the other day, and they came out: "Twing, tummer, pall and winter." He says T for K as well; "tate" is "cake". She had his hearing checked, and the doctor said it was fine.

From that very small speech sample, he has the phonological processes of stopping, fronting and gliding. If he is not in speech therapy, he needs to be.

BrookeSLP · Apr 13, 2007

UlrikeDG said:
Well, you're way ahead of me there. Do you recognize this one? My friend's 5 year old son is really hard to understand. He went through the 4 seasons the other day, and they came out: "Twing, tummer, pall and winter." He says T for K as well; "tate" is "cake". She had his hearing checked, and the doctor said it was fine.

From that very small speech sample, he has the phonological processes of stopping, fronting and gliding. If he is not in speech therapy, he needs to be.

UlrikeDG · Apr 13, 2007

I also remembered that he does "d" for "th".

I have absolutely no idea how to go about finding/getting ST around here. He just turned 5 in Feb, and he's from a homeschooling family.

BrookeSLP · Apr 13, 2007

d for th is normal for his age

The homeschooling thing can be tricky if they do not have the means to pursue private therapy. They are entitled to at least a free evaluation through the school district, so have them start there. His speech is VERY VERY delayed for a 5 yo and it must be addressed.

flipper68 · Apr 13, 2007

Don't mean to hijack a thread here, but homeschooling (or private school) does not prevent a child from receiving special eduation services (PT, OT, speech, resource).

An evaluation, Multidisiplinary Team Meeting, and an IEP are all entitlements of PL 94-176. The school district can be a PIA and make it difficult (only available in certain locations in the district, parents must transport, etc.) but they MUST be offered (transportation is also a requirement in all IEP's - need for it must be discussed).

Read up on rights as a parent of a child with special needs. Look into special education advocacy. Exceptional Parent Magazine http://www.eparent.com is a good place to start - as well as a call to the special education office of the district to ask about services and an evaluation.

I'd encourage you to really hurry. Some districts cut off "signing up" for evaluations so the testing can be completed before the end of the year.

UlrikeDG · Apr 13, 2007

It does, however, complicate matters. In Iowa, when a child is diagnosed as having special needs, parents must jump through extra hoops in order to homeschool. For that reason, it's better to remain "unofficially" special needs unless absolutely necessary.

Is S.T. ever covered by medical insurance?

BrookeSLP · Apr 14, 2007

Also, some states have interpreted the new IDEA differently. Starting 6 years ago, my state stopped offering therapy services to private/homeschooled children. They can be evaluated, but if the parents choose not to put them in public schools, there is no therapy.

UlrikeDG · Apr 14, 2007

I think the absolute worst case scenario here would simply involve dual enrollment in order to get therapy services. Dual enrollment is fairly common here.

arly1983 · Apr 14, 2007

BrookeSLP said:
Also, some states have interpreted the new IDEA differently. Starting 6 years ago, my state stopped offering therapy services to private/homeschooled children. They can be evaluated, but if the parents choose not to put them in public schools, there is no therapy.

We are having that problem with Jackson right now...Babies Can't Wait will take care of him until he is three and then we have to take him to the Early Intervention Preschool or Headstart in order for him to recieve therpy untill he is five and then the Public School System is the only place he can recieve it after that. We have applied for SSI with the Social Security Office and we hope we can recieve it and pay for his therpy ourselves and send him to Private School...My DH and I both attended private school and I also homeschooled. When I did my student-teaching in college as I persued my Early Childhood Eduaction Degree, I knew I never wanted my child in public school (at least in this school district). Now that he is speacial needs, I am twice as worried, I have seen inclusion and I do not want that for my child...The next district over is alot better for the elementry grades, though I am not impressed with the middle and high school, so we might pay our fee, enroll him in that district, and drive 50 mins to get him there.....At this point we are at a loss. I always had very defined ideas about what I wanted for my children's education and now I am at a loss. I only studied speacial education for one semester, I think I am going to contact a couple of my old professors (they have doctorates in Ed and one is Sp. Ed.) and see if they have any ideas. I know they will at least be able to give me information..It has been a week and half since our diagnosis and I look at everything diffrently....

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