Should we get a speech eval and if so, where?

[Anonymous]

DS is 4.5 years old and in private Pre-K/daycare. He has an amazing vocabulary and can be easily understood by everyone (family and strangers). However, he has several articulation issues:

"Th" is an "f" or "d" sound, depending on the word -- I want dat; This finger is my fumb.

"L" and sometimes "Y" are a "w" sound. This is the color Wehwoh.

"R" is hit or miss.

He does not lisp, at all.

Recently, I've been working with him, asking him to repeat words and talking about tongue placement, with some success. If he takes his time and is repeating me, he can say words with these letters reasonably well, but not perfectly.

He has always had issues with his mouth -- could not latch to BF, even after we had his frenulum clipped, he didn't learn to use a straw until he was 3, he cannot blow a whistle -- I think there's something in his brain that is just not connecting with how to use his mouth.

So, since he is improving working with me, should we wait until K for an eval, or get one now? We live in Alexandria, so should we go through the school system, or go private? Since he had his frenulum clipped, is there any chance this is a medical issue that insurance will pay for? If so, how do we make that happen?

Thanks!

[Anonymous]

Some of these articulation errors are normal for his age:

http://www.talkingchild.com/speechchart.html

The frenulum being snipped probably had no effect. Not being able to suck through a straw/latch/blowing might be a sign of low tone, which can affect speech. I would contact your home elementary school and ask to have him evaluated. Usually services are offered through the school during school hours, so you could always go for private ST if this doesn't work for your schedule.

Since he's understandable by most other people, is very good. (I'd hold back on trying to fix his tongue placement at this point and see where the evaluation/his own development takes you.)

[Anonymous]

Meant to add that low tone is technically "hypotonia:"
http://www.ninds.nih.gov/disorders/hypotonia/hypotonia.htm

If needed, speech therapist can address it with oral motor exercises but so can OTs. Since you mentioned the straw/whistle thing, I would ask for an OT evaluation with the speech. These often go together.

This is also something that he may grow out of. For example, some babies are incredibly drooly b/c of low tone, but as they grow and muscles strengthen, this isn't an issue.

[Anonymous]

Thank you, especially for the links -- these are very helpful and, according to the chart, he is within typical. I will think about doing the school eval and see what it says, but not knock ourselves out for private evals/therapy yet.

[Anonymous]

Some hypotonia kids also have slow digestive systems. Not sure if your kid has that problem but ours does. It is all connected to the muscle issues.
Just an FYI.

[Anonymous]

Anonymous wrote:Thank you, especially for the links -- these are very helpful and, according to the chart, he is within typical. I will think about doing the school eval and see what it says, but not knock ourselves out for private evals/therapy yet.

Sounds like a plan. You can always revisit when he starts K.