My two-year-old child appears delayed in speech-language development, but my pediatrician says he/she is probably just a late talker and will talk within the year. Should I do something now, or wait? »
WHEN SHOULD I BE CONCERNED ABOUT MY CHILD’S COMMUNICATION DEVELOPMENT?
ANSWER: This depends on what you are noticing in the home. A young child (9 months) who is not responding to sounds, alerting to his/her name, showing comprehension of simple words, or pointing to call attention to interesting objects, may be showing early signs of a hearing loss or language disorder. Other general guidelines:
- First Words by 12-15 months
- Frequent Two-Word Combinations Heard by 21-24 months
- Frequent Three-Word Combinations Heard by 36 months
- Intelligible speech in conversation 90% of the time by age 4 years
- Grammatically complete sentences most of the time by kindergarten age
MY TWO-YEAR-OLD CHILD APPEARS DELAYED IN SPEECH-LANGUAGE DEVELOPMENT, BUT MY PEDIATRICIAN SAYS HE/SHE IS PROBABLY JUST A LATE TALKER AND WILL TALK WITHIN THE YEAR. SHOULD I DO SOMETHING NOW, OR WAIT?
ANSWER: While it is true children show some variation in when they achieve early language milestones, it also is true that a skilled speech-language pathologist can usually identify children who are more at risk for persistent delays, or who are showing signs of more deviant speech language development (sometimes associated with other developmental disorders, such as autism). The earlier these children are identified, the sooner they can take advantage of intensive early intervention programs, often at no cost to families. Thus, it is better to rule out a more serious problem at a young age.
MY CHILD HAS A HISTORY OF FREQUENT EAR INFECTIONS. COULD THIS AFFECT HIS/HER SPEECH OR LANGUAGE DEVELOPMENT?
ANSWER: Possibly. While there is no direct causal link between chronic ear infections and speech/language delay, children are generally thought to be more at risk for developing communication impairments with this medical history, and should be closely monitored.
WHAT CAN I DO AT HOME TO HELP MY YOUNGER CHILD’S SPEECH-LANGUAGE DEVELOPMENT?
ANSWER: Generally speaking, understanding your child’s current communication level (preverbal, single word communicator, phrase or sentence level communicator, etc.) is very important in terms of what to model at home. Try not to overuse questions to get your young child to talk, but rather model comments about events as they are unfolding. Try to avoid rapid and lengthy speaking turns, and encourage turn-taking. Praise your child’s efforts to communicate using all possible means: gestures, pointing, gaze, and verbal attempts.
MY CHILD IS OLDER AND ALREADY HAS HAD SOME TESTING AND SPEECH THERAPY. DO I NEED TO START WITH ANOTHER FULL EVALUATION?
ANSWER: YES or NO. Children with recent testing (within the past 6 months) and with speech therapy objectives already in place can often proceed directly to scheduling treatment, provided a copy of recent reports is available. In any event, a consultation will be scheduled to meet with you, your child, and to review reports provided (usually lasting at least an hour). At that time, we will determine whether additional testing is needed, and what course of treatment is recommended, e.g. individual or group therapy.
MY SCHOOL DISTRICT DOESN’T HAVE A THERAPIST, BUT MY CHILD SHOULD BE RECEIVING SPEECH THERAPY UNDER HIS/HER INDIVIDUAL EDUCATION PLAN. CAN YOU HELP?
ANSWER: POSSIBLY: The Speech Pathology Group is an approved Non-Public Agency, and thus can provide contracted speech therapy services at our Walnut Creek and Berkeley clinics for a limited number of cases. This requires a signed contract between an approved school district administrator and SPG’s director, Susan Stark, to initiate an “ISA: Individual Student Agreement”. SPG therapists typically cannot attend IEP meetings in person, but will try to make themselves available via teleconferencing, provided adequate notice of meeting dates (2-4 weeks).
HOW LONG WILL SPEECH THERAPY TAKE BEFORE MY CHILD CATCHES UP TO HIS OR HER PEERS?
ANSWER: This depends on many factors such as: severity of the disorder, student cooperation, motivation, and readiness to learn. Family involvement in implementing home practice is another significant factor. In general, children with receptive language problems (difficulty understanding language) tend to require longer courses of treatment, as do children with underlying neurocognitive impairments such as autism.
HOW MANY TIMES PER WEEK SHOULD MY CHILD ATTEND SPEECH THERAPY?
ANSWER: Most children are seen in our clinic one to two times per week, whether or not he/she is receiving school-based therapy, depending on the severity of the disorder, or what type of intervention program is recommended. More intensive schedules are occasionally implemented as needed.
WHAT ARE YOUR HOURS OF OPERATION?
ANSWER: Our Walnut Creek clinic is open Monday-Saturday; Berkeley and Pittsburg clinic sites are open Monday-Friday. Therapy sessions are typically scheduled on the hour, between 9am and 5pm.
HOW LONG ARE THERAPY SESSIONS?
ANSWER: Sessions are usually scheduled for 45 minutes of direct contact (with 15 additional minutes spent preparing and documenting a session).
CAN I OBSERVE THERAPY SESSIONS?
ANSWER: Parents are encouraged to observe therapy sessions, either periodically by accompanying children into the therapy room at least briefly, or by observing through closed circuit video monitoring, if available. Many children perform best when working separately from parents. For those children, parents may be included in treatment sessions for the last 5-10 minutes in order to understand current objectives and home program ideas.
DO YOU PROVIDE WRITTEN REPORTS OF MY CHILD’S PROGRESS?
ANSWER: Written progress reports are generated upon parent request, and are charged for at our hourly rate. Progress can also be discussed verbally via face-to-face meetings or teleconferencing (also charged at our hourly rate.)
MY CHILD HAS TROUBLE COMMUNICATING WITH PEERS IN GROUP SETTINGS. SHOULD I ENROLL HIM/HER IN A SOCIAL LANGUAGE GROUP?
ANSWER: POSSIBLY. Some children are in need of individual therapy to establish readiness skills for group interaction, e.g. basic receptive/expressive language competence, turn-taking, and ability to process language efficiently in order to maintain conversational topics. Others may be placed in appropriate group therapy settings. In any event, SPG performs consultations before making a recommendation for or against group therapy.
WILL MY INSURANCE COVER THE COST OF THERAPY?
ANSWER: Unfortunately, very few insurance companies reimburse parents for speech therapy to treat “developmental articulation disorders” or “developmental language disorders,” limiting coverage to rehabilitative speech therapy (e.g. due to traumatic brain injury, or to treat congenitally related speech problems, such as cleft palate). Children with a diagnosis of autism are occasionally covered for limited services. Check with your insurance provider.
DO YOU HAVE A WAITING LIST? HOW LONG DOES IT TAKE TO GET AN APPOINTMENT?
ANSWER: We often experience a high demand for after-school appointments, thus many times have a waiting list for 4 or 5 pm appointments. For those needing consultations or evaluations, or who can schedule morning therapy sessions, it is usually possible to be scheduled sooner.