M has successfully completed two programs with a speech therapist, and we’re considering having her evaluated again. Twin sister J joined her for the second of those programs, and also benefitted greatly. Watching both my daughters work their way through speech therapy has taught me a few new things, and convinced me all the more of others.
- There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.
- Follow your gut.
- It never hurts to get a second opinion.
- Some lessons are more likely to stick if they come from someone other than a child’s parent.
- Things are often more complicated than they appear.
- There is such a thing as knowing too much about something.
The first time we visited a speech therapist was at the recommendation of the family pediatrician. When M was nearly 3 years old, I became concerned about how slowly she ate. I once timed her spending 17 minutes chewing a single piece of meat, and finally had her spit it out. The pediatrician suggested that she had dysphagia, or trouble swallowing. I had imagined that a couple of degrees in linguistics gave me a basic understanding of what speech therapists do, but I was wrong. Speech therapists deal with all sorts of oral motor issues, including problems with chewing or swallowing.
It turned out that M had never quite figured out how to use her tongue to effectively move food around in her mouth as she chewed. Because of that, foods that required chewing would cause her to choke. After six sessions of feeding therapy with an amazing speech therapist and a lot of reinforcement at home and daycare, she could eat successfully. Meals became enjoyable again. It’s been over 2 years, and we haven’t seen any backsliding. In fact, M enjoys food so much now that she plans to open a restaurant when she grows up. Bonus: military medical insurance covered 100% of speech therapy session costs.
It was during feeding therapy that the therapist raised a concern that M might have articulation delays. It had never occurred to me that there was anything off in her speech, since the child talked incessantly and no one who knew her—I, her teachers, or our neighbours—had any trouble understanding her. I thought her pronunciation of yellow as “lellow” was darling, rather than worrisome. The linguist in me had always ignored the nagging doubts, knowing full well that there was variation in the timing of pronunciation mastery, but there should be no cause for alarm as long as the order of acquisition were being followed.
When my husband returned from Iraq and needed me or J to translate for him so that he could understand M, it was clearly time to revisit the speech therapist. My MA in theoretical linguistics hadn’t taught me as much about the practicalities of language development as I’d thought. The practice we’d been to for feeding therapy no longer took our insurance, so we had to find a new therapist. We had both girls, now 3 months shy of turning 4, evaluated at the new practice. They ended up being evaluated by different therapists, and we learned how incredibly subjective these evaluations can be.
J was determined to be 2 standard deviations above the norm for her age when it came to grammar, vocabulary and comprehension, but 2 standard deviations below the norm for articulation, the production of mature speech sounds. She sounded more like a child just turned 3 than one soon to be 4. M, on the other hand, was evaluated only for articulation, and declared to be just dandy. These results didn’t ring true for us. M was, to our ears, far less clear in her speech than J. My husband insisted that M be reevaluated, this time by the therapist who had seen J. When the office staff let us know that they were concerned that insurance might not pay for a second evaluation, we offered to pay out of pocket. Insurance did end up covering it, though. The second set of results was more in line with our expectations. Although J’s need for speech therapy was a judgment call, M definitely needed it. Where the first evaluation had her placed her in the 43rd percentile, the reevaluation placed her in the 2nd percentile for articulation.
Since their delays were along the same continuum, the therapist offered to work both twins together in weekly sessions. The sessions were great fun for the girls. The therapist pulled out board games, and let them each take a turn after they completed a pronunciation exercise. She focused on making them aware of how the sounds coming out of their mouths were different than hers. Soon enough, they could say ‘sh’ and ‘v’ easily. It was extraordinary to see how those two sounds alone helped with others’ comprehension of their endless chatter.
After 3 months, both the girls graduated from speech therapy. All J had left to master were ‘l’ and ‘r’, and the speech therapist didn’t think those needed to be rushed. M had a lisp to work on too, but we were comfortable with the exercises she needed to do at home to help with that. We should keep an eye on the girls, she told us, and consider revisiting a speech therapist if they didn’t appear to be making any headway after a while.
My husband and I think that we’ve given it long enough, and both girls’ ‘r’s are still very baby-like. At this point, speech evaluations are often conducted through the school district, so we need to ask both their classroom teachers what they think of their speech before we go hunting for yet another speech therapist.
Sadia and her 5-year-old girls, M and J, do their talking, lisps and all, in El Paso, TX, much to the exhaustion of her soldier husband. They try not to talk while eating, but it’s tough when there’s so much to say. They are happy to report that chewing challenges are no longer to blame for the length of conversations around the dinner table.