Recommendations - Next step for speech delay

[Anonymous]

My 16 month old has an expressive speech delay. She doesn't really babble. We were referred to early intervention (Arlington county) and they evaluated her as having the expressive language of an 8 month old.

We are beginning speech therapy though early intervention but I've read on DCUM that there are other things we should be pursuing, and I'm really confused by what's out there.

Here are my questions:

1. Can someone clarify for me what the next steps are, if I'm interested and willing to do more?

2. Are private speech therapists typically better than those one sees through early intervention, or no? If so, any recommendations?

3. I keep seeing developmental pediatricians mentioned around here. Is that something I should pursue? Any recommendations?

Thanks a million. I'm overwhelmed and really appreciate any guidance.

[Anonymous]

The good news is your child is really young, and you're getting assistance early. That's terrific.

Dev Pediatrician.

When a child is young and has 1 or more areas of developmental delay (e.g. speech) it can be helpful to see a developmental pediatrician. They will look for other more global signs (often there are none) of delay, and usually make referrals to other specialists if concerned.

Quality of speech therapists.

Impossible for us to say OP. Some people who work for the county programs are excellent, and some are not. Same for private therapists. The main difference is that, in the case of a private therapist, you are the client, not the county. So you can pick a provider you like, set the frequency and so forth.

Whether to supplement the EI therapy would depend, to me, on how frequently the county SLP will come, and how well your child bonds with her.

My child is older, so don't have current developmental pediatricians to recommend.

If you go to Children's Hospital in DC, just stay away from Dr. Penny Glass, who isn't an MD anyway.

[Anonymous]

I would wait till 2-2.5 to start private therapies. A lot of kids can catch up by that age and 16 months is still really young. would hold off till 2.5-3 on a developmental ped if you believe it is only a language issue and its expressive. I would be more concerned if it was also receptive.

[Anonymous]

In DC, felt my son had some great speech therapists through early intervention.

Only lasted till age 4, with an extension. Then we started doing private. And couldn't tell difference!! Just in the pocketbook since most don't take insurance.

[Anonymous]

Anonymous wrote:I would wait till 2-2.5 to start private therapies. A lot of kids can catch up by that age and 16 months is still really young. would hold off till 2.5-3 on a developmental ped if you believe it is only a language issue and its expressive. I would be more concerned if it was also receptive.

I'd make the developmental pediatrician appointments now. It takes about 6-7 months to get in any way, at which point the child will be older. If by that time the concerns are resolved, then cancel the appointment and make someone else on the wait list really happy.

[Anonymous]

Make an appointment at children's and KKI and take the first appointment and canceling the other.

I would also take your child to an ent for a hearing test. The audiologists have your kid sit on your lap in the booth.

I would get the Hanen book it takes two to talk. Also ask EI if they re doing the class.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would wait till 2-2.5 to start private therapies. A lot of kids can catch up by that age and 16 months is still really young. would hold off till 2.5-3 on a developmental ped if you believe it is only a language issue and its expressive. I would be more concerned if it was also receptive.

I'd make the developmental pediatrician appointments now. It takes about 6-7 months to get in any way, at which point the child will be older. If by that time the concerns are resolved, then cancel the appointment and make someone else on the wait list really happy.

This is a good point. Do it this way. It only took us 1-2 months to get into ours but they worked for our insurance company so its a bit difference.

[Anonymous]

Wow 16 months seems so young to get a speech delay diagnosis!!

[Anonymous]

I would not hold off on a developmental pediatric appointment. I found ours so helpful of things to do in the near future as well as things to look out for down the road.

Expressive speech delays often go with low tone. The DP may recommend PT or OT.

[Anonymous]

Anonymous wrote:Wow 16 months seems so young to get a speech delay diagnosis!!

We got one at that age too. And it was a real issue, not outgrown quickly.

[Anonymous]

Anonymous wrote:Wow 16 months seems so young to get a speech delay diagnosis!!

My child started speech therapy at age 1. If there is no babbling that is definitely a sign of delay and it's very wise to start early if you can.

[Anonymous]

OP, as the other PP said it's great that you are starting early.

There's no guarantee that a private speech therapist is better than one through the county. If you get a reasonable # of hours through the county (at least once/week, maybe 2#/week) and you don't like the person, you could try asking for a different person--we were able to do that in DC without a problem.

One other thing you might think about is introducing some sign language. Having some basic signs can help reduce frustration in a child with a language delay. Look into the "Signing Time" series (there are different ones for babies and older kids).

[Anonymous]

Anonymous wrote:OP, as the other PP said it's great that you are starting early.

There's no guarantee that a private speech therapist is better than one through the county. If you get a reasonable # of hours through the county (at least once/week, maybe 2#/week) and you don't like the person, you could try asking for a different person--we were able to do that in DC without a problem.

One other thing you might think about is introducing some sign language. Having some basic signs can help reduce frustration in a child with a language delay. Look into the "Signing Time" series (there are different ones for babies and older kids).

I agree with some basic signs--like "more, please, milk."

Also as when or if to start private services is completely child dependent.

When they're young, EI tends to give a lot of services/support. If your kid is making progress, there's no rush for private. Progress can be slow sometimes too. I'd give it a few months and then decide if you need to supplement.

[Anonymous]

Our first SLP through EI was amazing - by far the best we've had in either county/schools or private. (He was also the only guy, and was goofy and fun with my son in a way that just clicked)

Which is to say, don't write off the public option just as a matter of course.

Presumably the county did a more general evaluation also. Were there any other areas of concern (even if they didn't meet the cut off for services) or was he average/above average in everything except expressive language? If it was just the one area, I'd probably hold off on the dev ped evaluation and see how speech works for several months. But *absolutely* do the audiologist eval right away. (The county will probably pay for it and require it anyway)

Good luck!

[Anonymous]

Not OP, but I have a similar situation here. I am in Montgomery county. My 23 months old has expressive & receptive speech delay diagnosed 2 months ago, and he just starts receiving county early intervention speech therapy last week.

He has already seen a developmental pediatrician in DC, and it was about 2 hours appointment. I don't know if it is worth it or not, because it is just to confirm that my LO has speech delay, and no other obvious problem. It is a release of mind. I hear that I may have to pay $300 to $1,500 cash for that appointment if the insurance does not pay for it. Finger crossed, and I will see because I have not seen the bill yet.

I am not pursing private therapy as of now because I also hear that to wait till my LO being 2.5 year old or 3 year old would be more beneficial & cost-benefit. I also am not sure if my insurance would pay for speech therapy for my LO even though I have an official speech delay report from developmental pediatrician. Anyone knows?

I don't know what my next step too. If money is not an issue, I would go for private therapy. But I am not sure are there private speech therapy for this young? Any recommendations for Montgomery county?