Speech Re-Evaluation: All Is Well!

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Categories Speech Therapy3 Comments

My twin daughters received speech therapy at age 4 and it made a world of difference in their ability to be understood. When they graduated therapy after a few months, the therapist told me watch out (listen out?) for the development of their /r/s. She didn’t anticipate any issues, but told us that /r/ would be the next thing to look out for. Since English-speaking kids don’t typically develop the /r/ sound for several years, we might notice delays down the road. They had all their other consonants down, although M was still working on a lisp-free /s/.

speechNow that M and J are 7.5 years old, they’re at the age where I anticipated they’d start to have more adult like articulation. When they told me that friends at school were commenting on their accent—they’ve lived here in Texas all their lives—I thought a speech evaluation might be in order. They do odd things like pronounce “shorts” and “shirts” as homonyms, which causes much confusion when we’re getting dressed in the morning.

I contacted the school speech therapist and told her the girls’ history. She is usually called into evaluate kids by teachers, not parents, but she agreed to take a listen. If further evaluations were in order, she could file that paperwork. She was very professional and I appreciated the time and effort she took to set my expectations and explain her process. In her very first email to me, she wrote,

According to our eligibility guidelines, an English /r/ is not typically mastered (i.e. produced correctly by 90% of population) until age 7.5 (based on the Massachusetts Speech and Hearing Association Entrance and Exit Criteria Guidelines), so it would not be considered “significantly delayed” (which is the criteria for school-based therapy) until the age of 8.5 or 9.  For Spanish /r/, the age of mastery is 5 for tap-r and 7 for /rr/.  However, with the girls not being native Spanish speakers, we would not work on Spanish /rr/ in school-based therapy.

After some back and forth to give her official permission to talk to my girls, I received the following email.

I just pulled your girls for a brief conversation in the hallway after their TAG [Talented and Gifted] class. What charming children! So verbal. J has no noticeable sound errors, and M has a slight, developmentally-appropriate distortion of /r/. She is stimulable for /r/, which means that if you show her and tell her how to do it, she is able to be taught. I say, “Pull your lips back like you’re smiling, then pull your tongue waaaay back to the back of your mouth and say RRRRed.” With this type of instruction, she is able to approximate the /r/ sound. This means that she will likely acquire the sound on her own without intervention. At this point I would definitely say that there is nothing to worry about and you should be very proud of your lovely daughters.

Do I feel a little silly about having worried? Yes, I admit that I do . Still, I’m so glad I asked.

I did make a mistake, though. I failed to tell my girls that I’d contacted the speech therapist. When I asked J and M whether they’d enjoyed their chat with her, M told me that she was a little embarrassed. She was worried that I wasn’t proud of her speech. I told her that wasn’t it at all, that I had felt terrible about delaying her evaluation the first time around and that I just wanted an expert to tell me that everything was okay, which is exactly what happened. M was satisfied.

I was reminded that my children are getting older and I need to be ever more transparent about how I advocate for them and talk to them about what I’m thinking and planning.

“She’s so nice,” J volunteered about the speech therapist. “And very beautiful.”

Speech delays are more common with multiples that singletons. A review of studies on the subject indicates that prematurity plays a role in this. A bigger contributor is likely the social realities of being a twin. Twins get less time one-on-one with mom than comparable singletons. Instead, they spend time talking to mom and their twin at the same time. I’ve certainly observed my pair encouraging each other’s speech quirks… like the period a couple of months ago where they were convinced that “velvet” was a colour, what I would call burgundy. I actually had to pull out the dictionary to get them to realize that no one else had any idea what they were talking about.

If you’re wondering about your own child or children’s speech development and how it compares to a typical kid’s, Katie over at Playing with Words 365 has written a clear and complete article describing the range of typical articulation development in English-speaking children.

Have you ever had your children evaluated for their speech development? Been concerned that something might be wrong only to find that everything is fine?

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 7-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun, when the girls entered elementary school and also blogs at Adoption.com and Multicultural Mothering.

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Twin Accent, but No Twin Language

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Categories Classroom Placement, Development, Language, Older Children, School-Age, Speech Therapy3 Comments

A surprising proportion of people ask me whether my twin daughters ever had their own language. They didn’t.

I find myself apologizing for the girls’ lack of twinspeak, more correctly known as cryptophasia. Perhaps it was because we used Baby Sign–J and M starting signing at 7 months of age–that they didn’t need a special language with Sissy, I find myself responding. Or perhaps it was because I also spoke to them in Bengali. After all, my entire academic background is in linguistics and I write for a mother of multiples blog. I should be a fountain of cool twin language trivia.

I confess that J and M sound very alike today. I used to have no trouble distinguishing their voices, but even I get their voices confused at least once a week. I have to remind them to open their phone conversations with Daddy with a comment about who is speaking. When she gets very earnest, M tends to click her tongue before every sentence, and J takes more pauses, but hardly anyone can tell their voices apart. In fact, a friend of theirs who happens to be blind describes them as having one voice rather than distinct voices.

In recent months, I’ve been getting questions about the source of the girls’ accent.  They get comments on their accent at school too. According to M, the older girls in their afterschool program consider it “completely adorable.” We were talking about homonyms the other day, and J offered up “short” and “shirt” as an example. M nodded in agreement. I told them that those words were only homonyms the way that they pronounce them. “Board” and “bird,” too. They have no trouble spelling the “hospital,” but pronounce it “hoss-ta-pole.” They both say “posichun” and “ackchun” for “position” and “action.”

Both M and J went through speech therapy at age 3 to tackle articulation delays. To my ear, they still sound significantly younger than their classmates, but I’m not in any hurry to push them back into speech therapy, since comprehension by others is no longer a problem.

All that I know from linguistics about the acquisition of language and accents would lead me to expect my children to sound more like their peers than their parents. They should be saying things like “y’all” instead of “you guys” like me, although you might be surprised by how twang-less today’s central Texas accent is. They’re in separate classrooms, but it doesn’t seem that that’s quite enough time apart for them to mimic their other classmates’ pronunciation more than each others’. It appears that, despite their lack of a twin language, my daughters’ twin accent indicates that their sisterly relationship has more of an influence on how they speak than any other.

Despite having grown up in Scotland, England and Bangladesh, after 15 years living in the USA, Sadia has come to sound resoundingly Valley Girl. Her 6-year-old twin daughters, J and M, attend an English-Spanish dual language first grade program in the Austin, Texas area. Their Spanish has a way to go before they can duplicate their Olympian feats of  conversation in that language. Unfortunately, Sadia doesn’t speak Spanish and cannot report on whether her daughters’ twin accent extends to that language too.

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Where My Twins’ IQ Test Results Throw Me Into a Tizzy

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Categories Ask the Readers, Classroom Placement, Difference, Education, Identical, Relationships, School-Age, Speech TherapyTags , , , , , , , 13 Comments

Our identical (we think?) twin boys are in 1st grade now. While their speech issues hinder their spelling, they’re still performing above grade level in language arts. But math is where they really excel. This fall, G’s standardized test scores for math were the highest in the class, well above the 99th percentile threshold. Right now a parent volunteer is running a pull-out group for some of the kids who can do more challenging work, but next year that might not be an option. We wondered if the boys might be able to jump a grade for math. This isn’t something our district does readily, so we knew we’d have to push. We requested that our boys be tested for the district’s gifted program — if they qualified, we’d have the leverage we need to push for differentiation.

We were surprised by our results. G did not qualify for the gifted program, missing the cut-off by 4 IQ points. P did qualify.

Initially, I was upset with myself for even requesting the test. I hadn’t thought about the possibility of one qualifying and the other not.  Now we had this bona fide test result, on paper, saying G was less capable than his brother. And G has always struggled with self-confidence.

We had a conundrum, too. While we agreed it would be devastating to G for us to place P in the gifted program, we didn’t feel good about withholding enrichment opportunities from P just because his brother didn’t qualify. This is similar to the situation HDYDI blogger Sadia faced this year, except she was faced with moving one of her twins to first grade while the other remained in kindergarten. In researching what to do for our boys, I found this study of different twin types and their reactions to having one twin placed in a gifted program, while the co-twin was not. It definitely affirmed our gut feeling that our boys wouldn’t do well in that situation.

The more I’ve thought about it, the less I trust the IQ test results. I consulted with the director of the university speech clinic the boys attend, and she felt his speech issues could have thrown off the results. G is very aware of his articulation errors, and speaks very slowly to strangers so they can understand him. P does not make any effort to slow his speech for the benefit of others. The speech clinic director said G is likely to choose his words based on what will be easy for him to pronounce and for others to understand, rather than choosing the words that best convey his meaning. G is a kid who asks for math work on his days off of school, because he says he feels anxious on days when he doesn’t get to do math. He picked up his sister’s 4th grade math workbook and started completing the pages for fun. My other two kids who do qualify for the gifted program don’t do anything like this.

We will probably have him retested at some point, so we know what all of our options are. Our oldest child attends a charter school for academically gifted students, and our public schools have various levels of differentiation available. For now we won’t retest — G said he didn’t like the test and it was boring, so I hate to put him through the same thing with the same test administrator this school year. In the meantime we’ve decided to home school next year — we can let them work at their own pace, and provide as much enrichment as either of them needs.

What would you do? Have you run into a similar situation? How would your multiples handle one being placed in a gifted program, while the other remained in the regular classroom?

Jen is a work-from-home mom of 7-year-old twin boys, and two girls ages 5 and 9. She also blogs at Minivan MacGyver. Once in a while.

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Our Speech Therapy Journey(s)

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Categories Development, Feeding, Medical, Preschoolers, Solid Foods, Speech Therapy, ToddlersTags , , , , , 4 Comments

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.

If you’re curious about what precisely goes on in a speech therapist’s office, feel free to peruse the detailed tales of feeding therapy and speech therapy sessions on my personal blog.

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.

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