*This post is about OUR personal experience with the process of speech therapy. I am sure this will not mirror all speech therapy experiences. If you feel you have a child who could benefit from this type of help, contact your child’s pediatrician for an evaluation.
Communication Breakdown
My daughter speaks her own language.
Gibberish.
Her speech is very difficult to understand and, until recently, has been unintelligible to most people in her life. It is both frustrating and heartbreaking to not be able to talk with your child. When they are a baby, you quickly learn to understand their short list of needs and how to read them without words. They can tell you with their body language, sounds, and facial reactions if you are connecting with them. But as my daughter got older her needs became more complex and she would become hot-headed when she couldn’t articulate what she needed.
Push, Push, Push
I knew I had to push this issue at her third-year checkup. I had discussed her speech issues with her doctor in the past and was dismissed with a “she’ll outgrow it” response. This was no longer acceptable. My daughter was bright, funny, and fully aware that no one understood a darn thing that came out of her mouth. She relied heavily on her sign language and would often give up trying to speak, knowing that we couldn’t understand her.
It was clearly starting to affect her self-esteem. Its just wasn’t fair. It was time to start pushing for real help from a therapist.
Before our appointment with her doctor, I had captured a few videos of her. Some talking to me, some singing songs, and one candid video of her following an instruction I gave her. I wanted to give an accurate example of her current speech and capabilities. It is not always easy to get my kids talking in a doctors office. They tend to get nervous and a little anxious about being in a foreign place, so I knew I couldn’t rely on her chatting up the doctor to display her abilities.
At the Appointment
During our appointment, the doctor had her draw a few shapes and lines. He asked her to follow a couple simple instructions in a “Simon Says” manner. As expected, she didn’t have much to say. Even when asked to speak, she simply replied with a quiet, “no thank you” that (of course) only I could understand. I pulled out my phone and showed him the videos. That was what he needed to see.
Unfortunately, he couldn’t simply give me a referral to a Speech Therapist. There were several steps for us to take in order to prove that she didn’t have any physical reasons for not being able to speak clearly.
Jumping Through Hoops
Medical
Before finishing out our appointment, my daughter’s pediatrician examined her mouth and throat. He looked for physical red flags that would prevent her from forming words correctly. There weren’t any obvious signs of a physical deformity, so he signed off his portion of the examination and referred us to visit a pediatric dentist.
Dental
The next month we were seen by the pediatric dentist. The dentist examined her mouth, looking for a tongue tie, pallet issue, or misalignment of her teeth. She was cleared without any dental issues. The doctor then referred us to a Pediatric Audiologist for an in-depth hearing test the following month.
Hearing
This step was the most intimidating for my daughter. We were placed in a soundproof room (which sort of reminded me of a submarine) and prompted to respond to a series of sounds. This may have been easier for an older child, but at three, she was too distracted and bothered by the environment to even pay attention to the instructions for the test. Thankfully, the specialist we saw was in the pediatric field, so she was able to conduct the tests without my daughter really knowing she participating.
The first attempt included a set of headphones and raising the correct hand to show which ear the sound is being sent to. The audiologist was able to read her cues without my daughter raising her hands at all during the testing. The second half of the test included closing my daughter and me in the creepy submarine room together and being subjected to a series of sounds and visuals that come from all directions in the small room. This was definitely the more telling of the two tests. My daughter was able to recognize and point out all of the sounds without issue. She clearly did not have a hearing problem. Her doctor then referred us to a Speech Evaluator.
Speech Therapy Evaluation
Thank goodness, this was the last step in the approval process! We were set up for a speech evaluation after several more weeks of waiting.
This appointment was the easiest of the bunch. We sat in a room full of toys and puzzles with the evaluator. My daughter was prompted to repeat a series of words and sounds while working on a puzzle. The evaluator encouraged her to repeat the words several times, rewarding her with a new puzzle piece each time she complied. A series of notes were taken on the sounds she was able to produce. The appointment took about 45 minutes, with a short discussion at the end with me on how to interpret the results, diagnosis, and if speech therapy would be a good fit for my daughter.
There was also a brief explanation on how therapy sessions are handled and the options we may have regarding them. More on that later.
Pulling the results together
Once we completed the series of appointments we met with her doctor again. He went over the test results and overall diagnosis. Articulation Disorder. Which basically meant that she didn’t have any physical roadblocks preventing her from speaking, she simply does not understand how to form words on her own. A quick Google search yielded this description: A difficulty in articulating specific sounds. Can also involve substituting of one sound for another, slurring of speech, or indistinct speech. Yep, that described my daughter’s speech exactly.
With this knowledge in our pockets (and several months worth of time lost…), we FINALLY received a referral for speech therapy. (Hooray!)
Meeting our Speech Therapist
I made a point to bring my daughter alone for her first visit. We didn’t need the distraction of her other sisters to keep her from focusing on our goal. The speech evaluator explained that there would be a good chance that I would need to be present during the sessions so I could learn along and help to reinforce the correct sounds and mouth movements. This, of course, would cause a problem if I were to bring her two sisters to the appointments. They would need to be quietly distracted or (somehow) out of the room entirely.
As it turned out, our therapist was very perceptive. She sat with us before the session and talked about the big overall picture while letting my daughter play with a few toys she had set out for her. We went over the number of letters and sounds we need to work on and then blending sounds to get her on track for her age. During our conversation, she observed my daughter and how attached to me that she is. My middle child is my shadow, and thankfully, she caught that right away. The therapist asked if I would be okay with leaving the room during their sessions. It was clear to her that my daughter would respond better without me to rely on for cues and responses. She would meet with me after the session to go over the words and sounds for the week.
I agreed and happily enjoyed my 40 minutes of quiet time in the lobby. ☺️
How Our Sessions Work
The therapist took the information from my daughter’s speech evaluation and created a kind of roadmap for her to follow. She has a list of sounds that need to be conquered, placement of these sounds (whether it be at the beginning, middle, or end of the word), and blending of the sounds into words. My daughter started with the ‘P’ sound at the end of words. Up, Pup, Top. Basically, she and my daughter play together and she prompts her to say the correct sounds or words through their play.
At the end of the session, I join them and we go over the percentage of accuracy that she was able to say the sounds. Sometimes they work on one sound, sometimes they turn a sound into a word, sometimes they incorporate multiples of each. Frankly, it just depends on how well she does and how focused she is during her session.
Pacing
Sometimes I get a little impatient and feel like she should be moving along quicker, other times I get frustrated because we need to take several potty breaks during a session. When these things happen I try to remind myself that the value in doing this is worth doing right. If she needs to spend several weeks on a few sounds to master them, then so be it. It is impossible to expect her to understand that this out of pocket cost needs to be rushed. She just needs to move along as she is comfortable. And to get comfortable, we need to practice. This brings me to my next point, which is how I help reinforce the lessons she is learning.
Helping Out at Home
We do a lot of practicing at home. Not drilling, but practice in everyday conversation. I will occasionally ask her questions that I know her answer will prompt the right word. I try to motivate her to give me the sounds she is working on as often as possible without making it feel like work. Sometimes we play games together like, how many words can you think of that have the “PUH” sound? Or I will whisper the weekly sounds, words, or gibberish in her ear super quietly and she yells them back to me. It sounds silly, but it’s super fun for her age.
My daughter isn’t motivated by food or random toys, so we don’t go that route. I can definitely see how incentivizing could be a powerful tool, but we just keep it to conversation and games.
At Home Resources We Like
We like the iOS apps Articulation Station and Endless Reader. Articulation Station is a Speech Therapy app. It has three mini-games that all encourage connecting visuals with sounds and sounds to words. Endless Reader is a fantastic pre-reading app! Players spell words, each letter in the word makes the letters sound as you move it across the screen. So you are effectively sounding out the word.
Neither of these apps are cheap, but they are fun games that keep her moving in the right direction. I have noticed that she plays longer with each of them now that the information is starting to click in her mind. She is very proud of her progress on both those games.
Our Journey Isn’t Over Yet…
We still have a long way to go before we can put this experience behind us. There are still many sounds that need to be correctly introduced and then blended into words. It will take several months to get this done right, and that is okay. Her practiced sounds are starting to become second nature to her. It’s becoming easier and easier every week to understand and converse with my daughter. It is literally music to my ears! Her confidence is growing and her personality is starting to come out in conversation… it’s becoming more of an art and less functional communication.
I truly hope our experience can help families who are just getting started on this road. It is frustrating to have to take so many tests to prove what you may already know but believe me, getting to the end goal of therapy is worth the effort.
Until next time,
