Anyone else's DC have speech delay connected to motor delay?

[Ceepa]

DD was found to have motor delays as an infant. Now at 2 yo she was evaluated by EI for speech delays.

I don't have the detailed report yet, but in a nutshell they're thinking DD has acceptable comprehension, receptive language, etc., but she struggles to speak well largely because her mouth and tongue aren't forming the words correctly. They even mentioned her trunk strength and breathing might play a role in her delay.

Ironically, I'm not explaining this clearly, but does anyone here have experience with this?

We're going to pursue the speech therapy for which DD qualifies. I understand we'll meet with a therapist who can help us teach DD to strengthen and "fine tune" her speaking motor skills. What would that entail?

Thanks for any insight.

-Ceepa

[Sugar Magnolia]

My oldest ds's voice box is partially paralyzed. That is not the proper medical term, but I can not remember what the official dx was.

And his tongue is tied in three places.

So, we have had our share of speech therapy. Ds is now 6, and has a hard time with some sounds. But you would never know that he was physical problems with his speech.

And he was not dx'ed until he was 2. His ped said it was something he would grow out of. Dh and I disagreed and took him for an eval(we paid out of pocket because our ped would not give a referral, we dropped her right after!).

With ds, we worked a lot with popsicle sticks. Pushing on them, moving them with his tongue. Ds could not even stick his tongue out when we started.

I hope that helped some!

[Ceepa]

It does help. Thank you.

I'm glad to hear your DS is doing so well. Can I ask how a partially paralyzed voicebox affects speech?

-Ceepa

[ethansmom]

I know if a child's core(trunk) muscles are weak, that can affect the smaller muscles of the body, such as those used to speak. This was my son's case and we saw an OT to work on strengthening his core muscles.

I'm probably not explaining it well, but I think they said first the larger muscles of the body need to work properly and then the smaller muscles can follow. If the larger don't develop properly/fully, the smaller ones will be limited in function.

If EI doesn't mention an OT, I would definitely bring it up.

[sidmand]

We were inititally told that some of DS's speech delay was from low oral motor tone. I'm not sure that's still totally the case, but if we look back on pictures of DS from when he was really little (and we knew this at the time and didn't realize what it meant), his mouth was always open. Still when he concentrates, his mouth is usually partly open. So any words that he had to close up his mouth for were particularly difficult.

It also tied into his lack of variety eating foods, which in turn went back to not being able to pronounce certain letters (for instance, if you had something sticky on the roof of your mouth, yiur tongue would naturally make the same form as the letter "L").

We did a lot of blowing exercises (blowing cotton balls with a straw, blowing bubbles). They had suggested an electric toothbrush to stimulate the sides of his mouth, but that scared him (he also has some sensory issues, especially with sound!). There are other things to stiulate and strengthen his mouth and trunk (one therapist mentioned Pop Rocks (!), but thought he was probably too little. I think that would have freaked him out anyway).

Something has definitely helped. DS entered EI when he was about 15 months old and in the past few weeks we discovered he knows and can say all his letters and colors and numbers! Are they totally clear? No. But people besides just us can understand what he's saying.

Debbie
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[Sugar Magnolia]

Ceepa-For ds, a lot of sounds did not come "natural" to him to make. He had to learn to move his mouth and tongue to "make" the sounds. His tongue tie made it even harder to make the sounds.

I asked dh what other exercises we did with ds. We also had him suck on yogurt sticks (like the Yo Kids ones). In ST they used lollipops, but we did not want to use them at home. Also we had him use a straw when he drank. If I remember anything else, I'll post it!

[brittone2]

Yep...a child can have motor planning issues that carry over to oral motor issues, for example. As a PP mentioned, low tone can also have an impact.

For certain speech issues, speech therapists will do a lot of mirror play, having the child mimick different movements with the tongue, lips, etc. They'll have them practice licking something off of their lips, sticking out their tongue, making fish lips, puffing their cheeks out really big, blowing, etc. They might encourage drinking thick smoothies or milk shakes with different straws to work the mouth muscles.

Fine tuning could mean a lot of things, but sometimes they also give them little physical prompts to refine/encourage certain sounds (the therapist will place a finger or hand on certain parts of the chin, mouth, etc. to assist in getting the "correct" sound).

It is IMO not uncommon at all to see a connection.

[Gena]

It sounds like your child may have apraxia (also called dyspraxia, depanding on who you talk to). This is a motor planning disorder where the child has a problem controlling the muscles. It can cause speech delays (mouth and tongue muscles) and other motor problems if the arms, legs, and hands are also affected. Many children with apraxia/dyspraxia have low tone and some have sensory processing issues.

My son has global dyspraxia, meaning that all his motor planning is affected. He had speech delays and has fine and gross motor problems. We need to practice the same motions over and over many times for him to learn them. (He also has PDD-NOS, but many, many children have apraxia without autism.)

A great book that about apraxia of speech and related motor problems is "The Late Talker". It has a lot of really good info and advice. Amazon has it or check your local library.

http://www.amazon.com/Late-Talker-What-Child-Talking/dp/0312309244/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1195052533&sr=8-1

I hope that helps.

[Ceepa]

I'm definitely bringing up an OT if they don't first. Thanks.

[Ceepa]

Debbie,

I'm not certain the nature of DD's oral motor tone issues. She holds her mouth closed well, but she doesn't open it a lot when she's eating or speaking. All her mouth movements are small.

Pop Rocks sounds scary. :o But she may like an electric toothbrush.

-Ceepa

[Ceepa]

Beth,

I really can see the connection. I was surprised when they mentioned it, but it makes perfect sense now.

Thanks for the examples of exercises. DD would like the fish lips and she likes using straws so I'm hoping for enthusiasm from her.

-Ceepa

[Ceepa]

Thanks for the response, Gena. I'm going to do some research on apraxia and see if our library carries "The Late Talker."

-Ceepa

[Eloise36]

DS has been diagnosed with speech delays, fine motor skills delays and gross motor skills delays. He now receives speech therapy twice a week and occupational therapy once a week, and I feel that the ST and OT work hand-in-hand to help him. I think it would be a good idea for your DD to be evaluated by an occupational therapist as well as a speech language pathologist. Good luck!

[NewGrandma]

Ethansmom:
I just sent you a PM with a few questions that I hope you don't mind answering.
Thanks,
Linda

[spanannie]

"They" say that what's going on with the hand goes on with the mouth.

In our experience, a speech delay, which we thought was solved ended with the beginning of a year of OT, for fine motor delay. He's in speech again, for some language tweaking. They still say that his tongue is weak?

IME, once you start on the road of speech/OT, it can lead to all sorts of things. DS is still in therapy, and to any person that would talk to him, he would appear to be a normal to above average speaker. At 5.5, they are still encouraging speech for the "l" and "th" sounds. That is all that he is lacking and we are still in speech.

For mouth strength, there are all kinds of exercises like holding up a fruit loop with your tongue, but I'm not sure that a 2 yr old would grasp the exercises that we've done. DS didn't start any of those sort of things until 3.5.

Best of luck!