Request for input in setting up EI speech plan

[longamkl]

Yesterday, my 18.5 month old boy/girl twins were evaluated for their speech development among other things and they qualify as being behind. It makes me very sad but at the same time, so grateful that we do qualify for getting help. I have really needed a break lately. Apparently, the next step is that we meet with a coordinator to develop the plan/goals etc. We can establish the frequency of the therapy and so on. Does anyone have any experience with this that they would like to share? I certainly don't have any.

A little bit about us: The twins were born at 37 weeks and did have some feeding issues in the beginning. We did briefly see a SLP for my son's feeding issues (tongue control and sucking issues) and she really did help. They have overcome any semblance of feeding issues and are now 95th and 75th percentile. I'm an engineer turned stay at home mom and so our schedule is flexible. I would have considered our home environment rich for learning to speak. It's not that I prattle away to them all day but we do read together, attend classes together, listen to music together etc. Their receptive language was good - my daughter at 21 mos. and my son at 15 mos. Their spoken language was evaluated as 10 mos. for my daughter and 8 mos. for my son.

Yesterday, I didn't even know what EI was (besides Employment Insurance in Canada) and now today I'm in it. And thank goodness. My son's lack of language definitely affects all of us - he has severe temper tantrums.

Does anyone have any suggestions on what we should include in our plan? Thanks for any help.

[sste]

I think a pretty common goal is to have age-appropriate expressive speech in the next 6-12 months (depending on amount of delay - - if your twins have a 40-50% delay I would think a reasonable goal is in a year).

Personally, I took as much EI as I was offered. We had a 40% delay and we started out at 2X per week, always with me, dh, or a caregiver attending and we requested homework and exercises to practice at home with DS each week. If they are balking at two sessions, and this very much depends on the state you are in, you could try to ask for 2 sesssions per week just to jumpstart the therapy and that you will later taper down to 1 session per week when the twins are showing improvement.

Also, it is a VERY good sign their receptive language is so great. Excellent prognosticator. Do not worry!

[erosenst]

Three things:

* Great that you're in EI. It makes such a difference

* From friends who have also had kids in EI - if you don't like/click with the first therapist, call and request a different one. A good one will work with you AND your kids, will interact well with your kids, etc.

* If your DS is frustrated, try teaching a few basic signs in sign language. It can make a HUGE difference. There are an number of threads here if you do a search, or feel free to PM me. Even though DD is now 6, DH and I agree that it was one of the two most important things we've done with/for her. (And FWIW, learning sign usually enhances spoken speech/comprehension, rather than impeding it.)

Hopefully others can give you more specific input on the speech issues/therapy. Good luck!

[crl]

DS was in EI for speech (and sensory issues and fine motor skills). We had a speech therapist come to our house once a week for one hour at a time.

It's been a long time, so I don't remember the goals exactly. But DS did have articulation issues so I think we had goals related to particular sounds (completely made-up, but something like pronounces "t" correctly in the initial position 9 out of 10 trials) and I think we also had a goal related to stringing words together (again made-up, but something like will use a two word phrase 7 out of 10 trials).

He also had strong receptive langauge skills and the therapist said that's a really great foundation for building on. DS did make progress in EI and then we moved him over to a special education preschool (at 2 years, 8 months--Arlington VA offered it at that age) where he made huge, enormous progress. So, the extra help really can help!

Catherine

[longamkl]

Thank you very much for the responses - they certainly make me feel better about the situation. I think the suggestion of twice-weekly therapy sessions makes a lot of sense - especially if there will be one therapist to my two children.

We have been signing since about 6 months of age - it has certainly helped but doesn't eliminate the temper tantrums. He's a very intense little guy. His signing isn't great but he can do "more", "milk", "eat", "play", "sleep", "up", "please", "thank you", "bird" and probably a few more that I can't think of. My daughter's signing is even better. Of course, our family and friends seem to think the signing is potentially the cause of the delay. I know that's not supposed to be the case but it does make me wonder.

Developmentally appropriate language skills - by 3 sounds like a good goal since the funding will disapper then? That's 17 months away. Sigh.

Thanks again for responding.

[maestramommy]

Your twins sound like my dd1. She was evaluated at 18 months. Tested 23 months for receptive, and 12 months for expressive. She didn't have a single spoken word, but had many signs. It really helped with the communication.

We didn't have a choice, but she had twice weekly sessions of 50 minutes each. They had goals for her individually, which were age appropriate gains in her expressive speech, and set 6 months into the future (they re-evaluate the situation every 6 months). So in 6 months there were a specific goals. There were also goals for her in the context of our family. I'm trying to remember what they might've been, but it could've been as simple as "parents will encourage DD to use certain sounds." Of course, the SLP and caseworker were tremendously helpful in setting those goals because we had no idea what we should be expecting. They always did stop to ask, "do you think this is a reasonable goal?" because as parents we know our daughter best.

[Indianamom2]

Three things:

* Great that you're in EI. It makes such a difference

* From friends who have also had kids in EI - if you don't like/click with the first therapist, call and request a different one. A good one will work with you AND your kids, will interact well with your kids, etc.

* If your DS is frustrated, try teaching a few basic signs in sign language. It can make a HUGE difference. There are an number of threads here if you do a search, or feel free to PM me. Even though DD is now 6, DH and I agree that it was one of the two most important things we've done with/for her. (And FWIW, learning sign usually enhances spoken speech/comprehension, rather than impeding it.)
Hopefully others can give you more specific input on the speech issues/therapy. Good luck!

:yeahthat: DD#1 was in speech therapy from 18 months on. She had no words. None. Her receptive language was well above average, but she was testing a full year behind in expressive language. She never babbled, but she was noisy, so as a first time parent, I didn't really know the difference.

DD was also very easily frustrated because she knew what she wanted, she could understand us, but she could not communicate with us...and that made her furious. Sign language was a life-saver. Even now, I am teaching my 8+ month old (who is developing perfectly fine) some basic signs because it just makes life easier and it absolutely WILL NOT hurt or delay speech development. In fact, it helps.

The post that I quoted also mentioned not being afraid to change therapists if you don't feel like progress is being made or personalities don't click. This is very important. Not all speech therapists are created equal. Some are definitely worlds better than others. Sometimes, the therapist you have isn't bad, but just doesn't click with your child, making the situation not work. You have to do what's best for your child...and changing therapists can make a tremendous amount of difference.

Lastly, DO NOT blame yourself or beat yourself up over this. You didn't do anything wrong. We read to our DD, we talked to her all the time, DH and I are both college educated with great vocabularies. We never used "baby talk" and yet she just could not speak.

DD was about 2 before she started using single words, and then only a handful. To say that we were overwhelmed when we began to realize just how far behind she was, would be an understatement. We were overwhelmed, sad, scared and uncertain. We were also fighting with a lot of very caring and well-meaning family members who thought we were over-reacting as first-time parents. We knew otherwise, but it took a while before the grandparents realized we were right in seeking out help at such an early age. We thought we were dealing with a pretty major problem (Apraxia), and I still believe that we are, just in a very mild form. However, EI was a wonderful program and over the years, the progress has been unbelieveable.

DD is now 5.5 years old and she NEVER.STOPS.TALKING! Seriously. She talks from the moment she wakes up to the second she falls asleep...and even in her sleep. She is still in speech therapy through the school system now, and though progress is slower these days, it's also still happening. She's now working on things that are much more age appropriate (like "l", R, and "Th"). She has, in the last month, just about mastered "l".

It has been unbelieveably hard work for her (and sometimes us), and there have been a few bumps along the way. That being said, I do not regret getting her the early help a single bit. It was absolutely the best thing we could have done.

[mom2binsd]

I'm an SLP and can vouch for the fact that you really need to feel comfortable with your therapist, but also give her (I'd say him but there are so few EI SLP's that are men) an opportunity to get to know you all. Working with really little ones I always felt that parent training and involvement was a critical component to success. It's vital that your therapist provide you with concrete examples of what she'd like you to do to model speech and language at home.

Do not hesitate to ask for examples or clarification. If therapy is provided in the home, maybe ask if you can videotape the sessions (especially to share with dad/SO who may not get to observe).

If you notice she uses specific toys during therapy that are helpful try to get your own (most therapists have a "bag of tricks") and I found that when parents had the same toy (often it's simple things like bubbles) it would really facilitate progress.

Most parents often asked me "how long do you think this will take?" at the beginning and I often felt that they thought I might be flaky when I responded that I really couldn't say, but it's the truth, each child is different. Many parents are also very concerned with "why" and again, it's so hard to say, and dwelling on that can be detrimental, but what is important is that the parent was proactive in getting services.

I loved doing EI, I found working with families incredibly rewarding and sharing in the joy of success with parents and children exciting.

I now I work in geriatrics and also find great satisfaction in providing a stroke patient with assistance in regaining communication or allowing someone to safely enjoy their meals without choking, and now I get to provide the "children" of my patient with ideas for communication-life comes full circle!)

Wishing you all the best as you embark on this adventure with your little ones!

[longamkl]

I just wanted to say thanks to everyone for replying and giving us some great ideas. I look forward to getting started and getting this resolved.