Milstein Pediatric Speech
and Language Services, Inc.
Sammy Speaks
In praise of early intervention for children with speech delays
By Lynn D. Richmond
At age 2 Sammy had a vocabulary of just one word: “neh” for “no.” He was a sweet child but emotionally distant. Now, just eight months later, Sammy has a large vocabulary and speaks clearly in complete sentences. He is wonderfully affectionate, showering his family with love at every opportunity.
Sammy and his twin brother were on a similar trajectory speech-wise until age 18 months. Both made random sounds but not much else. At 18 months, however, Sammy's brother started talking and hasn't stopped since. Sammy, on the other hand, continued making random sounds, but words did not develop.
My husband and I weren't overly concerned by Sammy's lack of speech. As the parent of three small children and the interested observers of many others, we were well aware that speech development varies widely. However, we did want to ensure we were doing right by Sammy's needs; so at his 2-year-old check-up we asked the pediatrician what, if anything, we should be doing.
Although the pediatrician felt there was certainly nothing to panic about, she did think Sammy should have been a little further along than he was. As a first step, she suggested we have Sammy's hearing tested. A thorough hearing exam at a children's hospital revealed that his hearing was within normal ranges.
We again conferred with the pediatrician, who suggested that a speech-language pathologist evaluate Sammy. There were many options available at this juncture: the children's hospital, private clinics, county services and others. With a couple of phone calls, I found out that several options for speech evaluation and any subsequent therapy were available through the county. Because Sammy's needs appeared to be limited to speech development, we chose the Speech/Language Services Department in the Fairfax County (VA) Health Department.
After evaluating Sammy, the speech-language pathologist determined that he was delayed in his speech. She recommended therapy sessions twice a week.
After being on a waiting list for a month, Sammy was assigned to Shannon Kelly, MS, CCC-SLP, for his therapy sessions. His first two sessions were mostly evaluative in nature. The speech-language pathologist quickly noted his lack of eye contact.
Sammy is a very focused child--he can figure out a puzzle in no time. We call him our little engineer. He wants to know how something works and analyzes it from all angles. It's embarrassing to admit; but, as his parents, we were so enthralled with his obvious dexterity, agility and smarts that we hadn't even noticed his lack of eye contact. However, once the speech-language pathologist pointed it out, it became obvious.
We--the speech-language pathologist during therapy and my husband and I at home--immediately began working on Sammy's eye contact, physically moving his face in a position where he would look us in the eye. The improvement was speedy and wonderful. Pre-therapy, Sammy would zoom in for a quick cuddle and then race off to his next solo activity. Now, Sammy demands substantial face-to-face time with my husband and me.
Pre-therapy, Sammy's smile was a charmer; now it is dazzling.
Once Sammy's eye contact began to improve, the speech-language pathologist began to work on his speech development in earnest. She found that Sammy would repeat a sound or word when she used the phrase, “You say (sound/word), Sammy.” Quickly, his vocabulary began to build.
Less than a month after his sessions began, he had more than 30 words. Now, after only six months of therapy, Sammy has a very large vocabulary, including many multisyllabic words, and uses complete sentences. He talks from the moment he wakes up in the morning until he falls asleep at night.
What I particularly like about the approach to Sammy's therapy is that the speech-language pathologist has been very clear that he will be successful only if my husband and I work in tandem with her efforts. After each session she details what we should be working on at home. Because I always have Sammy's twin brother, and occasionally his older sister, with me during the therapy sessions, we typically observe Sammy from behind a two-way mirror. Unfortunately, I'm unable to give my complete, undivided attention as I observe. Therefore, the "homework assignments" are invaluable.
Before Sammy started to speak, he was a very different child. He played by himself almost all the time. He rarely interacted with his siblings. He was, quite bluntly, not in the thick of things. We also noticed that his sister and brother tended to exclude him from their games.
Very quickly after Sammy's therapy commenced, however, this all changed. He has blossomed emotionally. He is incredibly affectionate, constantly seeking hugs, kisses and attention. He is a contributing participant--in speech and actions--in his siblings' games. It's delightful to watch his very elaborate tea parties. I love it when he serves me tea and waits to gauge my reaction to the “taste.” He still plays well by himself, but it's now just a healthy facet of his overall playing style.
My husband and I are now true believers in both the value of speech therapy and of early intervention.
Our insurance company--the new Big Brother in our society--refused to consider coverage for Sammy's therapy until he turned 3. My husband and I felt strongly that waiting for Sammy's third birthday would be the absolute wrong decision for him. The negative consequences of his speech delay already had begun to manifest themselves as early as age 2.
When Sammy enters preschool this fall, he will be able to express himself and his needs to his teachers and playmates.
We are so pleased with Sammy's progress in speech therapy. Well-intentioned people often will remark to us, “Oh, he was just ready to start talking anyway.” Well, perhaps, but the fact is that he was surrounded by talkers all of the time and was not developing his own language. Only with the one-on-one structure of speech therapy did his language development take off.
We happily anticipate Sammy's continuing strides through his speech therapy and beyond.
ADVANCE for Speech-Language Pathologists and Audiologists
September 18, 2000 Issue; Page 10
Copyright ©2006 Merion Publications