Speech-Language Delay A Case Study

Hayden

Definition Speech delay refers to a delay in the development or use of the mechanisms that produce speech. Speech, as distinct from language, refers to the actual process of making sounds, using such organs and structures as the lungs, vocal cords, mouth, tongue, teeth, etc. Language delay refers to a delay in the development or use of the knowledge of language. (http://en.wikipedia.org/wiki/Speech_delay)

Causes Hearing loss is often overlooked, and easily identified.  If your child is speech/language delayed, their hearing should be tested. Intellectual disabililty is a common cause of speech and language delay. Extreme environmental deprivation can cause speech delay.  If a child is neglected or abused and does not hear others speaking, they will not learn to speak. Prematurity can lead to many kinds of developmental delays, including speech/language problems. Find out more about prematurity and speech and language delays. Auditory Processing Disorder describes a problem with decoding speech sounds.  These kids can improve with speech and language therapy. (http://www.med.umich.edu/yourchild/topics/speech.htm#causes)

Causes Neurological problems like cerebral palsy, muscular dystrophy, and traumatic brain injury can affect the muscles needed for speaking. Autism affects communication.   Speech/language/communication problems are often an early sign of autism.  Structural problems like cleft lip or cleft palate can interfere with normal speech. Apraxia of speech is a specific speech disorder in which the child has difficulty in sequencing and executing speech movements. Selective mutism is when a child will not talk at all in certain situations, often school.

Big Issues Articulation disorders include difficulties producing sounds in syllables or saying words incorrectly to the point that other people can't understand what's being said. Receptive disorders refer to difficulties understanding or processing language. Expressive disorders include difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way. GESTURES, WHINING, TANTRUMS!

Frustration!

Early Intervention The Early Intervention Program offers a variety of therapeutic and support services to eligible infants and toddlers with disabilities and their families, including: family education and counseling, home visits, and parent support groups special instruction speech pathology and audiology occupational therapy physical therapy psychological services service coordination nursing services nutrition services social work services vision services assistive technology devices and services

Early Intervention Process Parent-initiated PCP referral (10/2006) Monroe County Early Intervention Program Coordinator Interview (12/6/08) Step by Step initial evaluation (1/6/09) Qualified for services- 2 significant delays Hillside Children’s Center- IFSP developed 5. Individual services begin- Speech-Language Pathologist (2/3/09)

2 years- “Eyes, nose, mouth”

Vocabulary Language and Speech Development In Children

Lisa’s First Visit- Daily Note He used a lot of screaming and grabbing for toy items= seemed to be more of a power struggle Puzzle- was very interested and tried to say animal names Suggestions: Try not to say “say” or give into whining At minimum- use point or reach for item

Lisa’s Strategies Patience Be firm and let him tantrum- boundaries Acknowledge his “activeness” Incorporate learning in play Games Activities “silly sounds”

Hayden’s Words March 2009 No mama no dada papa more Thumbs up found it fell down Down up paul hezer (heather) Shrek cow car shark Bee baiyee (bailey) mike butt bye bye light on Juice red blue green poop

Quarterly Progress Report April 30, 2009

Standardized Test Results September, 2009 Behavioral Skills Composite….. Avg Adaptive Skills Composite……..Avg Verbal ability……………………..32 %ile Speech Articulation……………...49 %ile Auditory Comprehension………..47 %ile Expressive Communication……..21 %ile Sensory Profile……………………Avg

Lisa’s Visit 12/8/09

3 years- “Eyes, nose, mouth”+

What’s Next?

Preschool IEP Goal 1: Hayden will increase his conversational speech intelligibility in order to effectively communicate with others across all settings Evaluation Criteria: 90% success, over 10 months Procedure to Evaluate Goal: Structured observations Evaluation Schedule: By June, 2010 Primary Responsibility: Speech/ Language Therapist

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