Over the years, several of our children have had speech delays. Ruth at age two spoke without using consonants. Katherine was a late speaker, not saying much until two and a half. So in many ways, especially since twins are often late speakers, we were not surprised when William and Jonathan didn't talk all that much by 2. Over the last six months the boys have visited the audiology department associated with our doctor's office and begun weekly visits through Early Steps in order to address their speech delays. I thought today I would share a little about our experience, for those who are wondering if their child might benefit from Early Steps.
Our story starts at the pediatrician's office where the boys were at their two year check up. The gold standard for speech therapy is to have 16 words by 16 months. However, since twins often lag behind in speech and two of our other children were late talkers, we decided to wait until two to allow them more time to mature. So when they only had two words other than naming family members at two, we decided it was time to check into our options. The first step was a referral to audiology to rule out any hearing issues.
While we made the appointment we didn't expect there to be any issues, after all we had two others that were late talkers, but didn't have any hearing difficulties. To our surprise the hearing test showed that Jon had some hearing loss. After the follow up examination, both boys had fluid in one or both ears. The audiologist described having fluid in your ears similarly to trying to hear underwater, sound is distorted and it's more difficult to understand. He explained that the simplest answer to both issues was to have surgery to place tubes in both of the boys ears. After researching our options and looking into the alternatives, we agreed and had the surgery back in April.
Both boys prior to surgery turned when addressed and responded to simple directions, even multi-step directions, so the hearing loss was definitely a shock. But post surgery, Jon who never really responded much to music began to dance and interact with music on the tv, and both boys began using more sounds when babbling, so it confirmed to us that they were having some trouble hearing, and that tubes were the right move for them.
We followed that up with an evaluation with Early Steps to see what if any services the boys might qualify for to help with their speech. By the time of the evaluate Jon had 1 consistent word and 1 occasional word, while Will had 2 consistent words and 2 occasional words. This difference barely edged Will out of qualifying for services; however, Jon qualified for weekly visits. Now, Early Steps is a federal funded program that is administered by the various states, under different names. (When we lived in Indiana their program was called First Steps.) These programs exist to address developmental disabilities or delays in children between the age of one and three. Through an interview with the parent they access their level with adaptive, cognitive, communication, physical, and social-emotional skills and compare it to typical age levels. If they have a delay in any two areas, or a significant delay in any one area, then they qualify for free services. A child development specialist will come to where a child is at home or in day care and engage in play based therapy to address any identified needs. Now we lucked out with Ruth and Katherine in that their assigned child development specialist were also licensed speech therapist. I believe that made a difference in how quickly they progressed. Our specialist this time is working on speech goals, but she isn't a speech therapist by training, so just be aware that while they are trained in general child development they may not have the additional specific detailed training as a speech or occupational therapist among other specialties that you could address in the private medical industry.
In the last six months, even though Jon is the only one who qualifies for therapy, our Early Steps provider has graciously allowed both boys to work together and interact with her, and so we have seen improvement in both boys language skills. William in particular has taken off. He has gone from using no and yes, occasionally saying something like go and shoe, to a whole host of words. He uses no, yes, bye, please, cup, go, door, shoe, help, and a few other occasional words, even if they still bear his own peculiar pronunciation. Will also will attempt to mimic words now. Jon has gone from using no and sometimes go to using no, yes, bye, and go regularly, and now pointing and gesturing to indicate wants. Because Jon is still not using many words and has only recently begun gesturing, they have just approved him for services twice a week. He enjoys playing with Ms. Griselle and always asks for her keys to walk her out to her car at the end of the session, where Will opens her car door and they both hug her bye.
At three when Jon ages out of the program, he will be eligible to continue services through the local elementary school in their VPK program. Now, we homeschool, and have never been interested in an all day, five day a week pre-school program for the children. When looking into transitioning services for Ruth and Katherine the local school systems didn't offer any other option, so we declined to continue services. However, when Ruth was older and still needed speech therapy, the local school system that we were zoned for at that time, could accommodate her attending for 45 minutes each week. At that time, we homeschooled, but brought her to school for speech therapy and it worked out wonderfully. With Jon, the local school system has said that depending on what he qualifies for, there wouldn't be any need for him to be there all week, so we are going to look into what they offer next month.
Last Friday, both boys had follow ups with the audiologist. Their tubes were still in place and they were pleased to hear that their speech has improved. The gave them the green light for another 6 months and wished them the best with Early Steps.
With all three of our children who have qualified for services we have had a good experience, and the kids have made progress toward speaking. Since services are provided at home, with me in attendance, I don't have to worry about anything untoward happening with my non-verbal children. Additionally, they encourage the primary caregiver to be a part of sessions, so it's easy to pick up strategies to help encourage them to speak, that you can then use throughout the rest of the week. Furthermore, if anything were to make me uncomfortable, whether it's a particular provider or approach I can ask for changes to be made, as the primary authority still rests with me as the parent. I can even discontinue services at any time for any reason, meaning there is no reason to not give Early Steps a try.
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