Speech Evaluation

I was starting to feel really good about where Justin was developmentally but J had his speech evaluation last week and he was diagnosed with a moderate to severe expressive and receptive speech delay.  So when the speech pathologist told me that J has a 6-12 month speech delay I felt like a complete failure.  His expressive language (use of language) is between the 18-21 month range and his receptive language (understanding of language) is between the 21-24 month range. And since preemies should be caught up by the age of 2 his evaluation was based on his actual age of 30 months and not adjusted for his prematurity.

Between 24 – 30 months Justin should be able to do the items below and I highlighted the things he's currently doing:

• Imitate 2-3 word phrases
• Begin combining words into simple sentences (i.e. go bye-bye, more cookie, no nigh-nigh)
• Speak more and more new words each week
• Use 50 or more words
• Change intonation to ask questions (i.e. cookie?, mine?)
• Understand size concepts (big & little) and number concepts (one)
• Understand action words
• Point to most body parts
• Use most toys appropriately in play
• Speak clearly enough for people to understand him most of the time
• Use words with many different consonant sounds
• Follow two-part requests (i.e. please take off your boots and put them on the shelf)
• Know a word for almost everything he wants to say or identify and ask for or indicate objects verbally

So if you were to grade J on the above he’d obviously fail; 7 out of 13 (54%) isn't even close to acceptable.  And you all know me by now; this of course freaks me out so I discussed my concerns with J's Early Intervention teacher.  Since she sees J on a weekly basis I felt she'd have a better feel for where J is developmentally versus someone who evaluated J after only 45 minutes of observation.   In short, she does believe there is some speech delay but no where near where the speech pathologist put him.  And since he has a rich home environment, where he is being exposed to language on a regular basis, she didn't feel there was a need to rush into therapy.  She also mentioned that J will get a thorough speech evaluation during his year-end review.  So that made me feel better.  I'm also going to talk to my boss' daughter who is currently working on her master's in speech pathology to get a 3rd opinion. 

In the meantime I’m going to try and relax, look at the positives and work on the things the therapist suggested.

Positives

 - J has good social/communication skills and makes meaningful eye contact

 - J can properly use objects (i.e. uses a brush to brush his hair, feeds himself, stacks blocks)
 - J knows his ABCs & 123s
 - J understands and completes requests upon demand (i.e. step back, don’t touch, clean up)
 - J identifies/recognizes pictures in books
Items To Work On
 - Imitate or match J's sounds, words and actions
 - Label what J sees, does, and hears with sounds and words
 - Use short, simple words and phrases
 - Repeat, repeat, repeat
 - Wait, wait, wait (pause & count to 5 before saying/doing something else to give J a chance to figure it out)
 - Tempt J to talk (i.e. put a desired item in sight but out of reach, create minor obstacles)