Talking when prompted

[Anonymous]

Some of you who have children recovering from speech delays have mentioned previously the element of only being able to get the child to talk when prompted. Would you be willing to share your diagnosis?

My DD is a young 5 and is doing very well in speech therapy. We first started seeing a delay around 2.5 when she would only use two-word sentences. She is eventually getting to her speech milestones, but it takes her much longer. Her speech therapist says she is making fast progress (now using four-word sentences in therapy), and she WILL use spontaneous speech, but I feel like we have to prompt her to say almost everything! Her spontaneous speech is much shorter.

When she had her intake eval for speech, her speech therapist said she only needed therapy one day a week and that her vocabulary is terrific and that her basic language is all there, it's just getting the longer sentences going. But I am worried how little she says without being prompted first.

FWIW, we have a developmental pediatrician already who diagnosed my middle child with ADHD-inattentive. He suspects she has it as well but we are doing a formal eval for her this fall when she is a bit older.

Does anyone with kids who had these kinds of speech delays have any advice or insight? I have been encouraged hearing from those who said a lot of speech came in for them between 5 and 6!

[Anonymous]

Sounds like you're doing a great job Mom, but of course there may be something else going on.

I'd make an appointment with a developmental pediatrician now just to touch base, and when your child is 6 consider having an evaluation done by a neuropsychologist given the family history. Could be ADHD inattentive, could be anxiety, something else or nothing at all.

[Anonymous]

The four word sentence thing is troubling. I think you should be doing speech several times a week. My son has been using eight word sentences since 4 and 11 since 5 and he is in low average range and goes to speech three times a week.

[Anonymous]

Anonymous wrote:Sounds like you're doing a great job Mom, but of course there may be something else going on.

I'd make an appointment with a developmental pediatrician now just to touch base, and when your child is 6 consider having an evaluation done by a neuropsychologist given the family history. Could be ADHD inattentive, could be anxiety, something else or nothing at all.

I agree with the above poster. Could be something more or nothing at all but getting an idea now will give you the summer to work on any additional therapies before the next school year.

[Anonymous]

OP here. She does have anxiety, in fact we were considering selective mutism for awhile. The ADHD-inattentive is all over the place in our family and my son was actually extremely similar at this age – apparently the speech delay was an executive functioning issue, plus he had anxiety, and still does. He is all caught up now speech-wise, but that's why we started watching for the ADHD in her so early.

We had an evaluation when she was 3 for spectrum disorders and it was ruled out at the time, although – as we know – it can always be ruled back in.

I will ask her therapist this week about possibly doing more days a week. We are at a highly recommended center in Bethesda, and just barely got our insurance to cover one day a week (which we were happy to get), but I will see if she thinks it's a good idea. So far, my DD is not a huge fan of going to speech, so that's another consideration.

[Anonymous]

Anonymous wrote:OP here. She does have anxiety, in fact we were considering selective mutism for awhile. The ADHD-inattentive is all over the place in our family and my son was actually extremely similar at this age – apparently the speech delay was an executive functioning issue, plus he had anxiety, and still does. He is all caught up now speech-wise, but that's why we started watching for the ADHD in her so early.

We had an evaluation when she was 3 for spectrum disorders and it was ruled out at the time, although – as we know – it can always be ruled back in.

I will ask her therapist this week about possibly doing more days a week. We are at a highly recommended center in Bethesda, and just barely got our insurance to cover one day a week (which we were happy to get), but I will see if she thinks it's a good idea. So far, my DD is not a huge fan of going to speech, so that's another consideration.

If you aren't already, I'd consider getting your child a psychologist to work on the anxiety, rather than more time with the SLP (especially if she doesn't care for it).

[Anonymous]

Op I'd definitely get a full eval. Have you ruled out ASD? It sounds like the resistance to speak isn't explained by a speech delay alone. I would go ahead and do the ados.

[Anonymous]

OP, what does her SLP say? Can you supplement at U of MD, especially over the summer when they are in session. My child was pretty quiet at 5 until the language came more. Starting around 6 and only around some people, did he talk much more. He had multiple teachers and some complained he was too quiet and others complained he talked too much. It can be normal but if there is anxiety, it could be anxiety related.

[Anonymous]

OP, also, if a child is that delayed in speech they generally do not "recover." They can progress well and do fine but many will still have some sort of something that they can learn to compensate for.

[Anonymous]

OP here. Not our first rodeo, so yes, I know there can be other things down the road. For my son, who was very similar at this age, it was ADHD-inattentive and LDs (recently diagnosed at 10). Talks fine now though, so in that sense, I would say he recovered from that component of things. Now we can't get him to be quiet.

Already answered the spectrum question, and developmental pediatrician is aware of what is going on and we are doing a more thorough eval in the fall. Will be discussing this in more detail with her SLP, but as I said, she feels like she is doing well. She will be going to speech camp over the summer, so we are looking forward to that as well.

Would still like to hear from any parents who specifically dealt with speech and language delays and having to prompt their kids to talk – for what it's worth, she will talk more to her siblings when we are not in the room.

[Anonymous]

Anonymous wrote:OP here. Not our first rodeo, so yes, I know there can be other things down the road. For my son, who was very similar at this age, it was ADHD-inattentive and LDs (recently diagnosed at 10). Talks fine now though, so in that sense, I would say he recovered from that component of things. Now we can't get him to be quiet.

Already answered the spectrum question, and developmental pediatrician is aware of what is going on and we are doing a more thorough eval in the fall. Will be discussing this in more detail with her SLP, but as I said, she feels like she is doing well. She will be going to speech camp over the summer, so we are looking forward to that as well.

Would still like to hear from any parents who specifically dealt with speech and language delays and having to prompt their kids to talk – for what it's worth, she will talk more to her siblings when we are not in the room.

If she will talk to siblings when you are not in the room, I wouldn't worry or force it too much. My son only liked to talk at that age when he was sure of what he was saying. Or, he'd get stuck and stop mid-sentence (we'd just repeat what he said and encourage him to continue). A few years later its much much better. Give it another 2-3 years. Even within a year, turning 6 made a huge difference. Its more time. Encourage the siblings to get her to talk. I never forced it, just encouraged. It may be more of a comfort and she may also need more time for answer as she has to formulate it before speaking so instead of getting an immediate response it may be a minute later, which is ok. So, ask a question and give a very long pause. Also, make sure the questions are simple, not multi-step nor very long sentences.

[Anonymous]

ADHD and LD's are separate issues. My child doesn't have either (at least what we know of an no signs, especially academically). Many people intermix them but they are separate. Its important to watch for LD, especially if reading and math are a struggle early on.

At age 5, its a combination of speech therapy and just time. It will come on its own when its ready (and as you've seen from your son). You cannot force it as you know.

[Anonymous]

Talking to siblings more when parents aren't there... Sounds like anxiety. Social anxiety. Can you look into the Little turtles shyness study at univ. Of Maryland? That might help you to work on the anxiety which stops her from speaking more freely

[Anonymous]

OP here. Thanks to 13.35 – I appreciate your kind words!

Actually, we were on the waiting list to get into the shyness study, and she aged out of it while we were waiting. Both sides were disappointed as they felt she was a great candidate. But they couldn't bend the rules, and we understood that.

[Anonymous]

I absolutely think you should be doing speech several times a week. At that level, you should also qualify for speech services from the school. Can you give us an example of her normal language use? Is it something like 'Can I have milk?' or more complex? My kid is pretty behind and speaks in 10-11 word sentences at this age, i.e., 'I want to go home now and play with my trains, not to the store.' If she is at 4 word sentences, I wouldn't say she is conversational. I would get a second opinion from another SLP ASAP.