To all the parents of toddlers with a speech delay:

Are you concerned your toddler has a speech delay, but you aren't sure what to do next? I went through the same thing, and I want to help you learn from our experiences and to improve your toddler's speech...

I’ve written this article for you to share my experiences with my daughter’s speech delay.  I’ll show you what I’ve learned from it, and hopefully what you can learn from me to help your child’s speech.

Having gone down this road ourselves and experiencing the stresses that comes with it, I want to help you move through the difficult times quickly and get to best parts: hearing your child talk to you!

Below I will show you these 3 important aspects to helping your child's speech.

  • Whether your child is meeting the DEVELOPMENT MILESTONES for toddlers
  • What strategies you can use for AT HOME SPEECH THERAPY
  • What your BEST next steps will be

I’ll also throw in as much other info as I can to help you learn from us.  If this sounds good, keeping reading as I have more details on those shortly.

I’ll start off with what we went through so you can understand our experiences and how we got to the speech delay.

Our daughter Rebecca was born in the fall of 2012 in Toronto, Canada.  She was our first child and we were anxious and excited for her arrival.  We really weren’t sure what to expect.  What would life be like with a tiny baby in our hands, our home, and our hearts.

The day she was born was an interesting one.  We had a planned c-section scheduled for mid-morning (so we were at the hospital by 8am).  But due to factors outside of the hospital’s control, we were bumped many times.  It was a long and painful day.

First, there was the woman with the triplets that decided to arrive early (the triplets decided, not the new mom!).  Then, we found out that one of the ORs had some sort of power failure that put it out of service.  Asa result, the delivery ward’s OR had to take overflow.

Finally, there were complications with some other patients.  I recall hearing the term “code omega” over the PA a few times in the early evening.  I found out that meant a life threatening blood loss was occurring.  Shortly after, I heard a man on the phone in the hall outside our room.  He was saying how his wife’s internal bleeding after delivery went unnoticed and she nearly died.  He was explaining how it was the best day (their first child was born) and worst day (nearly losing his wife) of his life.  I can understand why we weren’t a priority at that point.

With all of these things happening, we ended up having a delivery just after midnight, over 16 hours after we arrived.  While this is nowhere near a record-breaker for delivery time, it was certainly unexpected since it was supposed to be a “planned” c-section at a set time.

Thankfully the delivery went well and little Becca was (and still is) our cutie.

 The following months were exhausting and fantastic at the same time.  There were many late nights trying to get Becca to sleep and no shortage of stinky diapers to change.  But as all parents know, those are easily forgotten when compared to the heartwarming moments when your infant smiles back on you, when she laughs at something you do, and all the other “little” moments as they get older.

Becca the day she was born

The moment I was looking forward to the most was when Becca and I could have a conversation.  There’s nothing more I wanted at the time than when we could have a chat about how her day went and to learn more about who she was becoming.

I built up the idea in my mind and was excited for the first words.  And then finally around a year old, she starting to use her first word.  “Da”.

“This is it!  The breakthrough is coming” we thought.  She was starting to say “da”.  Soon I expected “ma”, and maybe a “milk” or “more”.  And an “up” when she wanted to have us pick her up.

We eagerly waited for those more words to come.  We naively thought they’d be popping into her vocabulary every few days.  But they weren’t.  We realized that was being overly optimistic.  So we relaxed and waited for them to come on their own time.

But the waiting seemed longer than we expected.

She went from 1 year old to 13 months to 14 months and the only progress we saw was a “ma”.  She used it when she wanted a more of something, but not consistently.

By now we were wondering if this was normal.  Was there supposed to be such a lag between the first few words to the next few?  We were getting worried.

Her 18-month appointment was still a few months away, so we opted to do some research on the subject before panicking too much.  Plus, we often heard the old saying “don’t worry, kids learn at different speeds”.

I did some research online and found several sites that had development milestones for children under 5 years old.  While the sites did not match exactly, they were always close.  And they were all reputable sites (including the American Academy of Pediatrics, Health Canada, and the Center for Disease and Control, to name a few).

Assess Your Toddler's Development Milestones

If you're like me and this is your first experience with speech delay, then you be wondering whether your child even has a speech delay.

It's a fair to have.  As new parents, we weren't up to speed on what the rate of progress should be.

We were very aware of all the early day milestones to watch out for (and very paranoid about whether Becca met them!), such as having enough pee diapers and poop diapers, how often she feed, and the amount of sleep she got.  We were so paranoid we even tracked this information (at least the pees and poos).

And in the first few months, we acted immediately whenever she was even slightly sick, rushing to the doctor.  But like all new parents, you start to learn when you need to go to the doctor and when you can wait.

So by the time we got to 12 months, we were in a good routine and didn't know the exact number of words she should say.

Speech Milestones

All of the speech milestones below are an average of the ones listed at various sites (CDC, AAP, Health Canada, etc).  I've found that there was some variation in the word count they had.

To use this, match up your child's age to one of the categories.  If it's a few months off, use the closest age.

If your child's age is in the middle of two milestones, the words they speak should be more than the lower number and up to (or above) the higher number.  But it may not be an average/in the middle (as children can learn in bursts and could meet their milestone just as they get close to it).

It is also important to note that being slightly off is not necessarily a sign of an issue.  These are the average number of words a toddler says at that age.  So you can be a bit below and that's fine.

If your toddler is very far below, that is a bigger warning sign and you need to take action.

If they are slightly below, perhaps you just learn some more techniques to help them, but there may not be any need to panic.

  • 12 Months: 0 to 2 words (may have a first word like "ma" or "da")
  • 18 Months: 10-15 words
  • 24 Months: 45-55 words
  • 30 Months: 300-400 words
  • 36 Months: 500 words

Now that you've done the quick check, you have a better idea if your child may have a delay or not.

If they are at the milestone (or above), then there is no likely delay and you probably don't need to keep reading.  But feel free to forward this page to any other parents if young kids (or even post on Facebook/Twitter/etc to help them).

If they are just below the milestone, still low risk that there is a speech issue.  But you may want to take some steps to improve how they learn, so keep reading.

If they are well below the milestone, then you certainly need to take action.  Keep reading to learn what to do next.

Development Milestones

However they performed, you should also evaluate them for all the other development milestones besides speech.

There are several other development milestones to consider such as use of gestures, understanding when you say "no", and following multi-step instructions.

I've consolidated all of them age in a small eBook.

Noe that this guide also has all the speech milestones in additional to the development milestones.  I've also added an assessment chart so can you easily review where they are at anytime you want.  It's free for everyone.

Download Assessment Guide

We read these sites along with many other sites, and each one told us the same thing.

Becca was below her speech milestone.

We were somewhat stunned.  We didn’t know what to do or what our next steps should be.

Should we see her doctor right away?

Maybe it would correct itself over time?  Maybe we should wait?

The decision was a difficult one.  We have limited information, and a variety of advice from parents who didn’t go through this.  We decided to wait until Becca’s next doctor’s appointment at 18 months.  A decision that I often regret.

But over the next few months, we saw progress.  We were excited!  She was finally saying more words and communicating.  Albeit only a few more words, but there was certainly some progress!

But even with the progress, she started to get upset more often.  We figured she was frustrated at her lack of ability to communicate.  But she was developing her vocabulary, so we thought this would pass.

The day of her doctor’s appointment arrived and we both wanted to be there.  We knew she had improved recently, but we also knew she was still behind on her speech milestones.  We were anxious to hear what the doctor thought.

The appointment started with the routine stuff first.  Height and weight, is she sleeping well, eating enough, etc.  Yes, yes, that’s all good.

Is she sick often?

That one was a yes; she did seem to get sick a lot.  We did notice that she had more colds than we thought a baby should have, a constantly running nose, and a few ear infections over the past year.  He takes note of that.

Then we go through the development checklist with him for an 18-month old.  Becca should have been at 50 words by 18-months, but she was around 7 or so.  As to the rest of the development milestones, she was good on most, but a few she had not met yet.  In my mind, I was so worried that there were bigger issues going on.  I wasn’t sure if I could take that stress.  Would I crack?

When the doctor started to speak we were fixated on him.  Becca did have a delay. It could be caused by issues with her ears, so we were referred to a specialist.  The other areas she was behind on wasn’t too concerning as they're related to speech development.  And we should see a speech therapist as well.  But he didn’t think she had any major underlying problem.

Relief

While not a good news story by any means, I had built up a bigger problem in my mind waiting in that small, sterile doctor’s office.

The specialist was another part of this ordeal.  Where we live (Toronto, Canada), the heath care system is public.  Everyone has equal access and for the most part there are no private doctors.  It’s a system that I strongly support, as everyone should have equal access to the same health care.  But in this case, I wasn’t happy as I wanted to see the specialist as soon as possible, but the appointment wouldn’t be for a few more months.

During that time, we knew Becca would still be progressing very slowly.  The question we had was “what do we do”?  We looked up what the impact of speech delay on a child and became more concerned.

Some of the impacts we learned about is below.  When we read these articles, the feeling we had was fear, and worry.  Some of the issues that a child can have without intervention of their speech delay are very serious.  That’s why it became very clear to us.

Don’t wait to get your toddler help with their speech.  Any delay is bad.

EFFECTS OF SPEECH DELAY ON YOUR TODDLER

As we started learning more about speech delay in toddlers, we were wondering what the real effect can be on them in the short term and down the road.

I started reading any article that was about speech delay in children to get a good understanding of what could really happen.  My hope was the the impacts would be relatively minor.  But what I found out seems to show that isn't always the case.

The short term problems that most sources said we could experience were:

FREQUENT TANTRUMS

This is one we were starting to experience.  It's very common for a child to get more frustrated and breakdown when they are trying to communicate to you but they can't properly express themselves and you aren't understanding them.

This was certainly the case with Becca.  I vividly recall when were in the dining room (adjacent to our kitchen) and she was trying to say something but the words were not clear.  As she pointed to the kitchen, I tried to help her by labeling various things she may want.  "Does Becca want a cookie?", "does Becca want a grape?", etc.  But she quickly broke down crying her little eyes out.  In the end, she wanted a milk.  But the damage was already done.

LACK OF SELF-CONFIDENCE

Another concern that research had shown was that a child is more likely to be less social with other children, especially when the other kids can say more then they can.

And another checkmark (or should I say strike?) against Becca.  When I'd pickup Becca at daycare I noticed that all the other kids around her age were starting to be more talkative, playing with each other, and running around.  But Becca was intimidated by them and would shy away from their games.  It was sad to see how something as simple as delayed speech would have this effect on her.

ACTING OUT

Linked to the tantrums is when children act out when they can't express themselves.  This usually shows up as physical acts against other kids when they can't express themselves.

Sadly, Becca had some of this at daycare as well.  You never want to have to sign a report about your child hitting another child, but this happened a few times.  Usually biting in Becca's case, a few times she hit the other child.  And it was usually something as simple as needing to ask another child not to take a toy she was using.  Rather than saying that, she resorted to violence as she couldn't express her desire.

DELAYED TOILET TRAINING

No one wants to be in diapers longer than they need to.  But a critical step in toilet training is getting your child to be able to express their need to go to the potty.

With Becca, she wasn't as delayed in this (thankfully), but she wasn't super early at getting trained either.  By 28 months she was able to express her need to potty (even though she didn't have many other words).  If we weren't lucky, I'd hate to think how many more months we'd have to deal with diapers...

While most parents deal with a certain amount of these short term issues anyway, the larger concerns we learned about were the long term effects.

 

READING, WRITING, AND LANGUAGE

There are various articles on this topic with different research reports, but they often have the same themes.

First, 20-30% of children who do not get treatment for their speech delay will not catch up to their peers.  This implies that we do need to take action if we want to avoid our kids not catching up.  (Source: Ellis EM, Thal DJ, (2008) Early language delay and risk for language impairment).

This leads to the second data point I found.  When children do not catch up with their peers, they have persistent language difficulties, and difficultly with reading and writing when they get to school. (Sharma M., Purdy, S.C. & Kelly, A.S, (2009) Comorbidity of auditory processing, language, and reading disorders).

 

In our case, we were trying to get Becca help.

But I do have an issue with governments who know this, yet have systems in place that can take months and months to get the treatment they need.  Or let a large cost fall to the parents.  That's unacceptable.

But I'll get off my soapbox for now...

 

BRAIN DEVELOPMENT

During my researching, I came across another study that I found interesting.  In it, the researchers wanted to evaluate what was happening in the brains of toddlers during speech.  They looked at toddlers in three groups:

1) Those who were speaking at an early age,

2) those who were speaking on-time, and

3) those who were late talkers.

They specifically wanted to compare the brain activity of each group through the use of MRIs during various listening and reading tests.  The results are not encouraging.

While early and on-time talkers were fine, late takers showed reduced brain activity during various tests for writing, reading, speech, and behaviour.  (Preson J L, Frost S J, Menci W E, Fulbright R K, Landi N, Grigorenko E, Jacobsen L, Pugh K R , (2010) Early and later talkers: school-age language, literacy and neurolinguistic differences).

While the study didn't assess longer term impacts as the kids get older, this was a risk we really didn't want to take.

 

SOCIAL DEVELOPMENT

The last set of studies that you should know about are related to social development and behaviour.

The first one noted that when kids can’t communicate clearly, they may struggle to make friends and be part of a social group. They may prefer to be alone and become shy or distant.  (Spiliotopoulou, B, (2009) Expressive language disorder and how it connects with mood and behavior disorders).

As I mentioned, we started seeing this with Becca.

The final study noted that toddlers with speech delays could be at increased risk of being TARGETS OF BULLIES, or develop tendencies to ACT AGGRESSIVELY because they can't resolve problems verbally. (Whitehouse, A, Watt, H, Line, E, Bishop, D, (2009) Adult psychosocial outcomes of children with specific language impairment, pragmatic language impairment and autism).

While Becca was not being bullied, we certainly don't want that in her future.

BUT DON'T PANIC...

Please take these as cautionary warnings.  I think they serve best as reasons why we need to try our best to help our children with a speech delay.

The reality is the fact you are reading this means you want to improve their speech.  I'll cover what we did and the general strategies further below so none of these will be an issue.

After learning about the impacts, we got into action to look for a speech therapist.

There are two paths you can take for this in Toronto.  You can get a public therapist, who is available to anyone and everyone.

The drawback of a public therapist where we live is the wait list. To get on the list you require a doctor’s referral, and the wait was 10 MONTHS LONG at the time!

That blew us away.  Especially after learning what happens when you let a speech delay continue without treatment.

The other option was private therapy.  This we could get into very quickly.  But then we found the other hurdle.  Private therapy costs $150/hour.

How many people can really afford that?

I’ve outlined the difference between each below, and what you can expect from speech therapy (it may not be what you think).

WHAT IS SPEECH THERAPY AND WHAT TO EXPECT

The first thing to know about speech therapy is who you go to.

Many people think that you go to a speech therapist.  However, that is actually wrong.

The field you and your child may get help from is called speech language pathology, and the Speech Language Pathologist is the clinician who specializes in the diagnosis, evaluation, and treatment of communication disorders, cognition, voice disorders,  and swallowing disorders.

In many areas, Speech Language Pathologists may operate in a private practice or in a public practice.  My examples of each below are back on my experiences in Toronto.  While both private and public will likely exist in your area, the specifics may vary.

 

Private Therapy

 

Just like it sounds, a Speech Language Pathologist that runs a private practice is not covered by any government health plan, but will have to be paid by you directly (although you may be able to reclaim some of the cost through any private insurance you have).

The cost will vary, but I've seen it run from $120 to $160 and hour.  When they assess your child you will pay a bit more (as they do a report for you), and then all other sessions are the same price.

The sessions will be dedicated to you and your toddler, with one Speech Language Therapist coaching you.

 

Public Therapy

 

A public session with a Speech Language Therapy is covered by your government's public health plan (if your area/country has one).

While you don't have to pay anything, you will almost certainly have a long wait.  When we signed Becca up for public therapy, the wait list was 10 months long.  I've also seen articles for similar wait or longer in different countries, so this is a common occurrence.

The session will also be different.  With public therapy, you will often get a group session.  You and your toddler will be in sessions with 4-8 kids, each having a parent with them.  However, there may be 2 Speech Language Pathologists, and perhaps 1-2 Speech Language Pathology students helping.

 

Cost vs. Time

 

While this is obvious, I believe it is important to note that you will need to make a hard tradeoff in many cases.

Do you want to spend a lot of money (as you will likely need 6-8 sessions minimum costing you $720.00 to $1,280.00)?

Or are you willing to be on a long wait list while your child needs help?  That wait could be a few months, or as long as a year or more.

 

Even worse is that for those families who live in more rural areas and smaller communities, you may have only one of these options locally, if not none of them.  Then your option would be a long drive for each session regardless of the option available to you.

But there is a way to avoid the high cost and long wait.

I will show you how to further below.

 

A Speech Therapy Session

 

I want to tell you what actually happens in a speech therapy session so you aren't surprised like I was.

I went to the first one thinking that maybe it was like a psychiatrist.  I would bring Becca for a session and I'd wait around in another room.  Or perhaps like a doctor's office, where I'm there for support but the main interaction is between Becca and the Speech Language Pathologist.

I was very wrong here.

The speech therapy if FOR YOU, the parent!

Well, sort of.

In both cases, the initial session is an assessment of your child.  It will start with some information you'll provide them ahead of time (age, words spoken, how they are with the development milestones, etc).

Then you will have a private session with you, your child, and the Speech Language Pathologist (it's a private session for assessment whether you take a public or private route).  They will spend an hour or so interacting with your child and watching you interacting with your child.  At the end of the session, they will give a high level view of where your child is at and when should happen next, and then you will get a more detailed report after.

If you are using private therapy, you will then do periodic (we were weekly) sessions for 1 hour.  You will go there and they will play with your child a bit, showing you a core technique to use to help develop their speech, and then you will play with your child using that technique and they will coach you on how you use it.  There could be some back and forth on who is interacting with your child.

In a public group therapy session, my experience was this.  It was an 8 week program (excluding the assessment which happened before).

The first and fourth weeks consisted of course work.  We (all the parents) were in a classroom without our kids, for 1.5 hours long.  The Speech Language Pathologists spend the time instructing us on several techniques to use with our children, through videos, power point presentations, and discussion.

The all the other weeks we all came to a large room (with our child) with various play areas.  We would then play with our kids while using the techniques, and the Speech Language Pathologists came around to help coach us.

And that is what you will get from speech therapy for your toddler (based on my experience with Becca, who was a mild case with a basic underlying issue).

Speech therapy is designed for the PARENT to use the the techniques at home.

Your child will not get better from a handful of sessions.

 

Your child WILL GET BETTER by consistently using the speech language techniques at HOME over time.

 

Further down I have an outline of the general strategies you can use at home.

Then I'll show you how to get all the lessons you will need to start helping your child at home.

So we did what we thought was best.  We got on the wait list for public therapy, and we also started asking about referrals for a good private therapist.

Private speech therapy is faster to access.  While the system here is public, some professions like speech language pathologists (SLP) can practice privately as well.

We ended up being referred to one by Becca’s daycare.  The therapist did in-home visits, which was convenient as some only operate from their home office.

As with any new visit to a SLP, the first appointment was just an evaluation so a proper assessment can be done.  The SLP meet with us and either the SLP or myself would interact with Becca to create situations for her to say something.

And while this makes sense, there is one thing that you need to consider.  How shy/timid is your child around strangers?

At the time, Becca was somewhat timid.  That resulted with her taking more time to warm up to the SLP for a good assessment.  I recommend that before you meet with an SLP, let them know how shy or outgoing your child is to new people.  They should be able to set their expectations for the first session.  It's possible that more time will be needed for them to warm up to the SLP for a good assessment.

After that, we did weekly appointments with the SLP for a period of time (until the insurance coverage on speech therapy reached its max).  In the sessions, I learned several core strategies that would improve the rate Becca would pick up works (see below).  We put them into practice and each week I’d update the SLP with what we did, followed by a new a new technique to use (she would normally only teach a few techniques each time).

STRATEGIES YOU CAN START USING NOW

After going through many weeks of SLP sessions with Becca (and over $1,000.00 spent), there are clear themes that we realized we needed to follow.  And while all of these will seem somewhat obvious, we didn't actively think of them while interacting with Becca.

Understand Their Perspective (Literally)

From the day Becca was born, we we strived to be good parents.  We did what seemed like common sense and spoke around her often, sang and talked to her, read stories, and interacted with her more and more as she was growing.

I believe most parents do this.

And all of these thing are what we should be doing.  But we missed one obvious aspect to it that made us feel a bit dumb.

We didn't consider her perspective.

Or put another way, we didn't consider her viewing angle.

Maybe your experiences will be different, but I remember several moments that sum it up.

  • Talking to her and making funny sounds while she was in her crib
  • Singing to her while she sat facing forward in my lap
  • Describing what she saw as I pushed her stroller and she was looking ahead
  • Reading to her when she was beside me

While all of these are great activities to do, notice the way that I described them.  I was either above or behind Becca, or both.  What I learned this means is Becca

cannot see HOW I FORM the words with my mouth...

Seems obvious, doesn't it.  But I'll admin that I had never explicitly thought of that.

Before Becca was born, I was used to talking to family, friends, and coworkers, all whom were adults.

And when Becca was born, I did change what I did.  But that was simply looking down to her from whatever position I was used to being in.   I had never thought that there was a better way to help speech development.

When you think about it, it makes complete sense that your position will help your child's speech.  They are trying to form their sounds that they have never formed before.  And while many toddlers use trial and error until they form the correct sound, seeing how you form the sound will give them some help in doing it as well.

So your task is simple here.

Ensure your toddler has the BEST viewing position of your face when your speak.

But before you even get that far, you have to ensure that they are LOOKING AT YOUR FACE.

Adapt To Your Child's Attention

After I learned about making sure Becca was positioned to see my face, I spent way more time on the floor interacting with her.

I'd read books that way, label lots of her toys so she'd learn the words, sing songs, and just play with her in general.

These are all important things we need to do with our toddlers when they are developing.  But I was taught that I needed to be more aware of Becca's attention.

For example, I'd try to teach her the word "doll", but she was focused on a car.  And as much as I'd try to get her to say doll, or get her attention by saying things like "Becca, look at the doll", she either didn't react to me or would just glance over at go back to her car.

When I look back, this happened regularly.  I'd be trying to teach her a word, but I wouldn't get here focus on what I was doing.  And if I don't have her focus, how would she see how I was pronouncing the word?

Which brings me to the next lesson I learned from the speech therapy sessions.

Without Becca's focus, she won't learn new words from me...

When I look back, this happened regularly.  I'd be trying to teach her a word, but I wouldn't get here focus on what I was doing.  And if I don't have her focus, how would she see how I was pronouncing the word?

Which brings me to the next lesson I learned from the speech therapy sessions.

Follow your toddler's attention.

This is so important, and thankfully easy to do!

As Becca was learning more about her environment, her attention would continually jump from one activity, toy, or object to another.  She could play with something for a several minutes, but then suddenly lose interest and move to a new toy.

Even within a play set her focus could change.  We have one of those Fischer Price farms, and she may want to use the horse for a few moments in the barn, then jump to the pig in the silo, and then open and close the loft doors.

So when she starts with the horse and then jumps to the pig, I sop talking about the horse and focus on the pig with her.

Being fluid is critical.  Stick with the changing focus.

 

For a comprehensive at home speech therapy guide, keep reading.

While all the techniques made sense to use, I didn’t see the progress I’d hope for given the price I paid.

I felt something was missing.  More on that later…

By now the private lessons were wrapping up, and our appointment with the specialist came up.  In case you need to have one of these, the tests in the appointment are outlined below for you.

The result was clear though.  Becca’s inner ears still had fluid in them, and that was causing issues with her hearing (it was reduced significantly).  However, all other aspects of her ears were fine.

My initial reaction was uncertainty.  How do I take this?  Is this an issue?  Where do we go from here?

But before my head could spin too much from this, the doctor gave us some great information!

WHAT HAPPENED AT OUR ENT APPOINTMENT

The day of Becca's ENT appointment arrived.  We were hoping to find out more of what may be happening with her.

For clarity, and ENT stands for Ears, Nose, and Throat.  ENT doctors specialize in those three areas as they are interconnected.

But the ENT was the final part of the appointment.  The first part was actually running some tests with an Audiologist.  Audiologists are health-care professionals who evaluate, diagnose, treat, and manage hearing loss, tinnitus, and balance disorders in newborn, children, and adults.

In our case, the Audiologist ran two standard tests on Becca.

"Echo" Test

The first test that Becca had to do was what I call an "echo" test (not the actual name).

This test measured her hearing by essentially bouncing sonar in her ear and measuring the "echo".  This is a definitive way to test if her hearing is impaired in anyway.  As we suspected, it was.

If your child has to go through this, the good news is the procedure is very quick.  A small headphone/mic is placed in the ear and it takes just a few moments for the test to complete.

Of course Becca was scared given the environment so she sat on my lap for this.

"Positioing" Hearing Test

The "positioning" hearing test, as I like to call it, was to test how well Becca could hear sounds and place where they coming from.  They audiologist needed my help with this one given Becca's age.

The test involves going into a tiny room/box.  In this room is a seat in the middle, a one-way ,mirror in front of you, and small toys all around the room.

Becca had to put on headphones for this.  The audiologist would then play sounds that come from different directions, using different tones and volumes.  Whenever Becca would look in the correct direction, the toy in that area would become animated and make fun sounds.  If she didn't look, then none of the toys made any sounds.

The reason I went in with her is so she can sit on my lap and I can help keep her calm (as it can be scary for small child).  Also, after each sound she had to look forward again for the next test.

The test took about 20-30 minutes.

The end result was that Becca passed only some of the tests and failed quite a few others.  This is consistent with what we were learning about her hearing issues.

ENT Appointment

The final component of the specialist appointment was meeting with the ENT doctor.

The visit included answering several questions about Becca's speech, vocalization, sleep patterns, and an array of other similar questions.  After the questions he examined her ears, nose, and throat and looked for any abnormalities.  He also reviewed the results of the hearing tests Becca just took.

Thankfully he was able to get to a quick diagnosis.  Her inner ears were enlarged due to fluid buildup, and she would have to get tubes per in her ears.

 

Inner ear issues are a common issue with toddlers, and simple to fix.

The solution is a minor procedure to place a tiny tube in their ear, which allows any fluid they get from infections to drain out immediately.  In fact, this is the most common surgery that toddlers get.  And it’s very low risk and quick.

We were ecstatic!

A simple procedure and her hearing will be 100%, and her speech can get back on track.

But with every step forward, there was always one step back.  As part of the public health care system, we’d have to schedule the surgery.  And that was going to be another four month wait!

At this point, I feel that we just can’t catch a break.  Each time we have a step forward, we also move a step back.

As much of a downer it was, we don't give up.  We push forward.

Not long after this we get a small break.

The public speech therapy had a cancellation and we get to go in a few months sooner.  I’m actually enthused about this.  I’m hoping some more speech therapy while we wait for the surgery will help keep her progress going.

The first appointment was similar to the one with the private SLP.  It was a session for them to evaluate Becca’s speech and assess where she was at.  With no surprise, they confirm she is behind in her speech.  And while she is marginally better than she was several months go, she’s not anywhere close where she should be.

I had high hopes for these therapy sessions.  In my mind, I visualized more techniques that I had yet to learn, and they would come together with the lessons we had from the private SLP.

However, I was a bit dismayed that the techniques consisted of mainly the same material, with very little in terms of new content.  I realized that the scope of techniques to help us was very limited.

I was disheartened.

Becca and I had gone through over 16 hours of speech therapy together over many months.  I incorporated the techniques in our daily lives when I could.  And we kept waiting for the tidal wave of words to come.  But they didn’t (at least not quickly).   I felt that the progress should have been a lot more.

As we got closer to Becca’s surgery, a new thought dawned on me.

While we used the speech therapy techniques, perhaps the bigger issue was that her hearing issue was preventing her from progressing quicker.  Which makes a lot of sense.  If she is only hearing a small percentage of what we are saying, of course she’s struggling!

It started to make more sense.  This surgery was what she needed to quickly catch up to where she needs to be at.

ADDRESSING THE ROOT CAUSE

The experience we had with Becca brought to light an important lesson for anyone who has a speech delayed child.

That is their speech delay may not see much improvement without addressing the root cause.

In the case of Becca, her hearing was impacted by an enlarged inner ear which was caused by fluid buildup.  By getting a small operation to put in tubes, the fluid would drain and not buildup.  Thus eliminating her hearing issue.

Causes of Speech Delay

There are various reasons why a child could have a speech delay.  Some have root causes that can be resolved, and some don't.  I believe it's beneficial to understand whether your child does have a root cause for the delay.

Some potential root causes are:

  • Hearing loss
  • Learning disability
  • Intellectual disability
  • Prematurity
  • Autism
  • Auditor processing disorder
  • Selective mutism
  • Apraxia of speech

For us, we found the Becca's root cause was a hearing issue.  I recommend that you try to find out what your child's root cause is, if you don't already know what it is.

If it is something like a hearing issue, it may be easily correctable.

If there is no real root cause or if the root cause isn't easily addressable, then continue using the speech techniques you can find below to help them develop as best as they can.

I was feeling optimistic the day of the surgery.  She was in a good mood and was having fun playing the waiting room.  When it was her turn to go with the nurse, she was scared and didn’t want to leave mommy and daddy.  The nurse eased her concerns a bit, but she was still in tears as she wheeled away down the hall into what seemed like the unknown to her...

The wait was quick and before we knew it we were allowed into the recovery room with her.  She was groggy as she awoke from the anesthetic, but was in a relatively good mood compared to some of the other kids in the room.  The smile she gave us brightened our mood, and we were able to take her home soon after.

Over the next few weeks, my expectations were that her words will take off.  Between the tubes in her ears and the speech therapy techniques, how could they not?

And we did see progress.  She did start speaking a few more words.  We were very happy.

But at the same time, it wasn’t the progress I thought she’d have.  The progress that she needed.

I really started to dwell on this a lot.  I couldn’t let things continue at this absurdly slow pace anymore.

I had previously thought something was missing when we went through the therapy before, and I was realizing that I may have been on to something.

This gave me a surge of new motivation.

I was determined to throw myself into this 110% in an effort to help Becca get to her correct speech milestone!

I started with education.

I decided rather than relying on a handful speech therapy sessions, I would read as many books as possible from multiple speech language pathologists.  (Amazon was likely happy with me that week).  There is a wide variety of speech therapy books available, ranging from a dollar to hundreds of dollars!

I selected a wide assortment of books and when they arrived I spent the next few weeks reading all of them all, taking notes, and reviewing what I learned.  It reminded me of exam time at school.  I was determined to master what I needed to know for the sake of my daughter.

As I was conquering the topic, I put a lot of thought into what else is needed to make speech therapy at home more effective.  I critically evaluated our routine with Becca over the past few months, and ran through various scenarios of how I could have done things differently.

I also pulled from my professional experience in a large financial institution and applied best-in-class methods we use to ensure success in our projects.  The reason I did this is I realized that while SLPs are exceptionally well trained with speech therapy knowledge, they often lacked the ability to structure the program to optimize results.  That’s how my corporate world experience came in useful.

In the end, I created a much more effective program for delivering speech therapy at home to Becca.

Now was the time to put it into practice.

AREAS OF IMPROVEMENT

I reengineered the program to help us with Becca.  There ended up being a lot of changes that I felt were needed to make this work.  While I focused on our specific needs, these changes will work for most parents and their children.

 

Matching Technique with Becca's Stage of Speech

 

One of the lessons I learned though all of this is the importance of when to use the correct techniques.  But this is not something that any speech language pathologist teaches.   This is something I had to learn on my own from using the techniques I was taught, and putting a lot of thought into how each one could help Becca.

For example, there are some techniques that are great for helping add more words to Becca's sentences.  But when she only had a few words in her vocabulary, it made more sense to focus on techniques that were geared to adding single words, not growing sentences.

That's why I took all the techniques and reorganized them to match the stages that Becca needed.  From just adding single words at the beginning to increasing her sentence sizes later on.

Ordering the techniques this way ensured that I wasn't using ones that were more advanced than would help Becca, which made the time spent with her more effective.

 

Progress Tracking

 

Another gap I found was that the SLPs never formalized progress tracking for Becca.  When we discussed how she was doing, I couldn't quantify the successes.  I believe that was because we were never given any specific method, forms, charts, etc to track her success.

When I revamped the program for Becca, I use an old saying in the business world "you can't manage what you don't measure".  And with that in mind, I created a tracking system to measure her progress.

Tracking her progress gave me two benefits that I really appreciated.

First, if I noticed a streak of no progress I could reassess if I was using the right techniques or if I needed to change something up.

Second, it's motivational to see progress.  When I saw weeks with Becca's word count jump up, it really helped me get more enthusiastic.

 

Strategy & Tactics

 

Another gap with the training we received was there was system to keeping me on track with helping Becca.

While part of what I learned should be integrated into everyday life, the SLPs did recommend dedicated play time using the techniques.

However, like most families our days are hectic.  Between picking up Becca, getting dinner ready, and bath time, I often had difficulty carving out time for dedicated speech play.  I had the intention to do it often, but only got to it sometime.

When I built the new program, I created a planning tool to help overcome the issues I had.

The tool allows me to plan out each week, day by day and what technique I want to use.  This helps me keep on track and stay focused.  Since I added this in, I was able to have a lot more play sessions with Becca to help her speech.

 

Self Motivation & Skill Mastery

 

I believe that this section is especially important.  It's not something you will learn from an SLP, nor from almost any other profession.  But it's critical when you have a long journey ahead, with many ups and downs.  It's easy to get stuck in the downs and lose steam.  And when you lose steam, you're not helping your child.

When I reengineered the program, I added everything I learned from all the books, courses, and experience I accumulated about how to keep yourself motivated and on track.

I drew concepts from NLP (neurolinguistic programming), self hypnosis, and general affirmations to create a way to keep myself motivated each day.

But these techniques did more than keep me motivated.

They were extremely effective at accelerating my development with the speech language techniques, in terms of remembering to use them throughout the day, and how effective I was at using them.

While there has always been questions on how NLP, affirmations, and the like actually work, I see it simple as this: it forces you to think about it every day at the same time.  That creates a routine that becomes habit.  And as that habits gets strong, each day you are exposed to what you are learning more.  And from increased exposure, you will absolutely get better.

And that translates to you helping your child more and more effectively as each week passes.

 

If you are interested in some of all of my reengineered program, I have details below how you can download it now.

With the new structure I created I was much more prepared for what lay ahead of me.

I had planned what my activities were going to be with Becca for the rest of the week.  I was uncertain how it was going to go.  In the first few days I had to force myself into the new routine of scheduled speech activities, which I was not used to.  But with the schedule to keep me on track and the motivation techniques I started using, I was able to push through a difficult start.

Once we got past the first several days, the routine started to feel more natural.  It quickly became second nature to shift into focused speech lessons with Becca, seamlessly integrating it with her play.  This was a great win as I previously found it difficult to consistently sit down with her for dedicated time to help her speech.

During this time I also used the same set of motivational techniques to help me become more self-aware and open for opportunities.  By doing this I improved the amount of times I was using the speech therapy techniques in most of our everyday activities.  Now I was able to utilize more time that would help her speech develop.

Of course, I was more anxious about the results, and whether my improved speech therapy structure and revised set of techniques would work.

In the first few weeks of the new system, I was partially disappointed that I didn’t notice any new words.  But at least I did notice that Becca was more engaged with our time playing and when I spoke to her.   I felt that was a good sign so I kept going.

In the next few weeks, she did start picking up some more words.  I was keeping myself in check (although I wanted to be ecstatic) as I knew that wasn’t a lot and could be random chance.  But it was a giant motivational boost for me.

As we moved into the next few months, we saw Becca’s progress flourish.  She was picking up more words each week.  Some came from our dedicated practice.  But some she just picked up randomly from us when we weren’t trying.  She’d hear us say something and just start repeating it!

That is the definition of joy!

By the time Becca was 3 years old, she knew MORE WORDS THAN A TYPICAL 3 YEAR OLD!!!!

I couldn’t believe what a difference it made for Becca.  We were thrilled with her process, and she was so much happier.

 

And I finally got to have my little chats with her.

 

 (Photo of Becca, almost age 5, getting ready for her first day of senior kindergarten) 

 

Since then, Becca’s speech has been fantastic.  She is always above her milestone targets, is very chatty, and is a much happier little girl.

I believe her improved speech has been a key reason she did so well in the junior kindergarten this past year.  She has become good at reading her books (and likes doing it), she can spell a large assortment of words (as well as write them), and her teachers say she is very creative and outgoing.

I hope this helps you adjust your strategies with your child to speed up how fast they learn words.

This can be applied to toddlers with speech delay as well as on young children without any known delay (just to help keep them on track).  I’ve summarized what I’ve said here below.

Do you want a copy of all revised program that I created and used to help Becca’s speech?  I have a digital download available below, which is a much more extensive than what I've covered on this webpage.

SUMMARY

For those who like a summary of what they just read (or those who skip to the bottom of pages), here is a quick summary of the key points I reviewed above.

Speech Milestones

You learned about speech milestones and development milestones.  The key speech milestones are below.  For a copy you can take away, go back to the top and download the free PDF I created.

Remember the general guidelines I get out.

If they are at the milestone (or above), then there is no likely delay.

If they are just below the milestone, still low risk that there is a speech issue.  But you may want to take some steps to improve how they learn.

If they are well below the milestone, then you certainly need to take action ASAP.

  • 12 Months: 0 to 2 words (may have a first word like "ma" or "da")
  • 18 Months: 10-15 words
  • 24 Months: 45-55 words
  • 30 Months: 300-400 words
  • 36 Months: 500 words

Strategies You Can Use

Start using the following key strategies to help your at home speech therapy skills.  Following these guidelines will improve your ability to help your child's speech catch up.

 

Understand Their Perspective (Literally)

Remember that as an adult, our kids are literally looking up at us.  This makes it much harder for them to see how we are forming the words with our mouths.

Ensure they get see your face.

Get down to their level (sit on the floor with them), and face them directly (don't talk with them to the side or from behind them).

 

Adapt to Your Toddler's Attention

Kids have short attention spans as they are looking for stimuli everywhere (which is good as their brains need to be stimulated).

When teaching them words, don't focus on what you want to teach them.  Teach them what they are focused on.

Be agile and jump around as fast as their attention moves.  Holding on to your "lesson" for them after they've lost interest will not help them at all.

Address the Root Cause

While not all speech delays have a root cause (or don't have one that can be resolved easily), it's important to take every step to remove all the barriers to your child's speech development.

At the very least I recommend:

  • Assess their developmental milestones
  • Review the results with a doctor
  • Be proactive and ask for referrals for specialists for any case where you feel they may be too far behind
  • Start using the at home speech techniques right away (get a head start - professional help can often take a long time)

Outside of now having my nice chats with Becca, there were a lot of other benefits that I didn't quite realize we'd see (although some of the research suggested at them, it was still a treat when it happens).

The main one was the benefit to Becca's emotional health.  As her speech improved, she was able to communicate her needs to us more effectives, and her frustration decreased and she seemed proud to be able to let us know what she wanted and become more independent.

The communication improvement also decreased the number of tantrums we had to deal with.  Becca had some fairly epic meltdowns over relatively trivial things, mainly because of her communication.  As her communications improved, the frequency and severity of meltdowns decreased.  (Not to zero of course.  She's still a little girl after all!)

Another side benefit as her speech improved was the ability to quickly potty train her.  This was a struggle for us when she wasn't able to tell us she needed to pee, but once she could tell us this, the potty training really took hold.

And once her speech was caught up to her peers, she was able to develop a lot more relationship with her classmates at daycare.  Being the only child with delayed speech really isolated her for a while, which was gut wrenching to see.  We were so happy when we'd pick her up and she would be actively playing and talking with the children.

I Created Talk Now To Help Becca's Speech, But Now I Want to Help Your Child's Speech

We had a roller coasting of a ride with Becca's speech development.  There were many stressful points, it was difficult to afford (the private SLPs), and the public system was too slow.

That's why I did what I did.  I reengineered the lessons I learned from public and private SLPs, many books written by SLPs, and combined the revised lessons with leading business-world processes to create something that was significantly more effectives for us.

Once Becca's speech was on track, I thought I was done and I'd toss the work I did on a shelf (or computer folder as it may be).

But something happened to make me rethink that.

My coworker Nat asked me how Becca was doing.   From that chat I found out that her son was experiencing a speech delay.  So I did what any good person did and gave her all the material I created and wished her good luck.

No longe after that, another coworker of mine, Warren, heard about the system I created and gave to Nat.  He was interested in finding out more as his cousin was having the same issue with their child.  So I did the same and gave him a copy.

The interest in what I did made me think a bit about what I had created.  I knew in our area it was a long wait to get into public therapy, and a private SLP was expensive.  At the same time, Warren's cousin was overseas yet seemed to have an interested as well.  I thought this may be something more people want access to.

I wasn't sure.

But the tipping point was when a few other coworkers who heard about this encouraged me.  While they had older kids and didn't need the system I created, they saw the value that it created for people.  They knew that a product that combined the thousands of dollars of speech therapy, the myriad of books, and the business and self-improvement methodologies to make it more effective would be valuable to most people with speech delayed toddlers.

And that's how they convinced me to offer it to everyone.

The Talk Now System

Once I decided to offer what I created to the public, I went to work to make the product even better.

I'm picky that way.  I didn't want one of my first forays into entrepreneurship to be hawking something that wasn't good.  I mean really, really good.

So I revamped the systems a few times now.  I've improved the look and feel, and made it easier to read so parents can use the techniques quickly.

I broke out the material into the eBooks so it's easier for you to focus on what you need.

TALK NOW CORE PROGRAM

The Core Program is my optimization of the SLP techniques that you will learn from most sources, whether it's a private or public SLP or the booked they write.  All the techniques I've come across are included.  But I've organized them to align with the stage of speech develop you are trying to fix.

The first stage is what I called the foundational level.  These represent the bare minimum techniques that needs to be used to help your toddler when they are barely using any words or just a few words, but no multi-word sentences.  This is the stage most parent will focus on for some time.

The second stage builds on the first.  Once your toddler has a decent base of words (based on their speech milestones), then these techniques will help progress them to  2-word sentences.

The last stage will help bring your toddler's speech into multi-word sentences and more complex words.

TALK NOW STRATEGY GUIDE

The TALK NOW STRATEGY GUIDE is the powerhouse that makes the Talk Now system so effective.  I recommend that you read this first.

Using the leading techniques in mental preparation from neurolinguistic programming, the best practices from process development, and a proven roadmap to keep you on track, this guide is what will make the difference between acceptable results and fantastic results.

I encourage you to refer to this manual often, print out the recommend charts and tables, and use this get double your toddler's words in the next 6 weeks.

TALK NOW SUCCESS TRACKER

The TALK NOW SUCCESS TRACKER is your feedback mechanism that will help you ensure you are on the right track and allow you to course correct when you're not making any progress.

One of the main reasons I find this so critical is based on one of my learnings in the corporate world.  And that is you: you can't manage what you don't measure.  And it makes sense.  How can you expect to help your child's speech if you aren't really sure of their progress?

You will use the forms in the success tracker to keep track of all words they say, various stats on the # of words they have & word combos, as well as several graphs to track short to mid term word count progress.

The tracking will also be a motivational point for you when you start seeing success build up.

To help Becca by reengineering the existing materials, I went through a lot.

Over $1,000 paid for private speech therapy

Dozens of speech therapy books read

Waiting more than  10 MONTHS for public speech therapy

Hundreds of hours spent evolving the system

If I were sell this to only one parent and wanted to recoup my money and time, I would sell this for $2,850.00.  That would fairly compensate me for all my costs and efforts to get to a system that works so well for Becca.

But that's NOT my goal.

I'm not doing this for financial reasons.  I'm doing this to help other parents so they don't go through the same painful journey we did.

I know that many health care systems around the world are like the one we have.  They can be slow.  And they can be expensive.  And when it comes to speech delay, we know that waiting is not an option.  Delayed treatment can lead to serious issues.

I also know that most folks cannot afford expensive private speech therapy.  We were lucky.

So forget the $2,850.00 price.

I will give you the manuals for MUCH LESS.

Less than weeks of speech therapy;

less than one session of speech therapy;

and even less than 15 minutres of speech therapy.

$27

Download Now

The download is instant and you will get all three manuals in PDF format.  You can read them on any device (your smartphone, tablet, computer, Kindle, or even print them out and read them).

Payments are processed by ClickBank, one of the Top 100 Internet Retailers in the US and Canada (with over 200,000,000 customers).

Satisfaction Guarantee

I also want to offer you a satisfaction guarantee.

If at any time during the first 6o days of using the TALK NOW system you’re not satisfied in any way, you can get 100% of your money back – no questions asked.

The reason I offer this is simple.  I want to help other parents like you with your speech delayed toddler.  While I really do believe that this system will help many people, I know that there are some cases where it may not make sense.

So if you give it your all and after several weeks you aren’t happy, then I will gladly refund your purchase.

Feel the stress disappear - one of the most stress-releasing moments in Becca's development was when she got past the point of basic words are was really communicating with us.  If this is your first child, you will understand when you get there.  If you already have an older one, then you know the feeling.  Imagine when their speech takes that leaps and they say "how are you mommy" or "give me a hug".  You will feel so good.

Look out for their future - as you sit there reading this, you're thinking about how this will help them with school.  How this will prepare them for asking the teacher questions, thinking about their lesson, and playing with their friends at recess.  Speech is vital to these, and you now you know helping them now will make a difference.

Peace and quiet - by now, you really want this.  And you want it today.  The chaos that comes from a speech delayed toddler gets worse the older they get.  As Becca got older and still couldn't express herself, she would go into tantrum mode more often when we didn't understand her.  But when her speech developed, the tantrums decreased (don't expect zero though), and we were granted more peace and quiet at home.

$27

Download Now

I truly look forward to hearing about your toddler's success using my TALK NOW program.  Join the ranks and add your own raving reviews!

Please send your comments, testimonials, success stories and questions to my personal email:

contact@toddlerspeechboost.com

Elise Lewis

The Talk Now program did not start out as a project for me.  Nor a hobby, interest, or past time.  It started out of passion.  Passion to help Becca and the difficult times she had with her speech.

My goal throughout most of this process was solely to help Becca.  And at this, I finally succeeded.  It took a lot of time, effort, and person cost to get there, but in the end it was worth it.

After that success, I finally repackaged what I had created so that I could share it with you.

Since this is my first real foray as an entrepreneur, I hope you forgive any errors, omissions, and typos.   If you do find any, of have any other feedback or questions, feel free to contact me directly at:

elise@toddlerspeechboost.com

Elise Lewis, Cofounder, Talk Now

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