Speech and Language Assessment

On Tuesday I took Celeste to see the Health Visitor.  She was 16 months old exactly and it was to be our first trip for almost 6 months.  There were two main reasons for my visit, firstly I felt I ought to get her weighed and measured after all this time, and secondly I wanted to speak to her about Celeste’s speech.  I have tried to step back and not be a pushy parent but is does concern me that she is not making any of the sounds and babbling expected of a young toddler, let alone any words.

My experience at the Health Visitor checks in the past have been far from positive.  Most of the time I feel I am being fobbed off and I can find more useful and accurate information on the internet.  I therefore had reservations about this meeting, suspecting either to be told that I was just expecting too much of her or that it was my fault she was not speaking for not engaging with her enough.  I have Celeste on my own at home 4 days a week.  We read, sing and talk together all day long.  I therefore refuse to accept that her lack of speech is somehow a reflection on my parenting skills.  Celeste’s level of understanding is exceptionally high, she can follow complicated instructions with ease and her physical abilities are also on or above par.  Both of these make her lack of speech more noticeable in its absence.  

The Health Visitor we got to see was lovely.  She weighed and measured Celeste (10.2 kg and 77cm) and we discussed Celeste’s speech at length.  I explained that the only sounds she was making were “throat sounds” (grunts and groans) and not “mouth sounds” like baba, gaga, mama, dada etc and that I was concerned that without these building blocks she didn’t have the tools to move onto proper words.  At 15 months the average child can say 5-6 proper words.  Girls can often say more than boys by this point.  I reiterated that it wasn’t the number of words that was bothering me (which obviously varies from one child to another) but the lack of use of her mouth.

The Health Visitor studied Celeste for a few minutes and agreed with the points I had made.  Although not "concerned", the Health Visitor said there was reason enough to get her referred for a "Speech and Language Assessment" to see if anything needed to be done at this early stage.  She then asked about Celeste’s 1 year review which I explained had not happened yet.  The Health Visitor suggested while I was there we could do it there and then.  This was music to my ears as the waiting times to see a Health Visitor are sometimes ridiculous.

The Heath Visitor left the room and returned with a wooden shape puzzle and an animal peg puzzle and tipped the pieces out onto the table.  Celeste loves these kind of activities and set to work straight away.  She finished the shape puzzle in under of minute and the peg puzzle took her not much longer.  The Heath Visitor then brought out some objects to bang together which Celeste happily repeated.  She then checked her hearing by seeing how she responded to her name.  All in all, the Heath Visitor had no concerns about her development and said she was obviously thriving (proud Mummy moment).  As I was preparing to leave she provided me with a phone number for self-referral for a Speech and Language Assessment.  I phoned the number that afternoon and was amazed to be offered an appointment 2 days later.

Thursday morning came and Celeste, Daddy and I all traipsed over to the Children’s Centre for the assessment.  We were met by another very nice lady who took us into a room full of interesting looking toys.  We discussed our concerns while she observed and interacted with Celeste.  Luckily for us, Celeste was on good form and clearly demonstrated the sounds she was able to make and was not in the least bit phased by the experience.

Celeste was particularly interested in a set of large plastic toy animals and stood them all up on the floor.  She then brought them one at a time to show either myself, Daddy or the assessment office and told us the sounds they made if she knew.

The speech assessment officer then discussed her observations.  She reiterated the health visitors comments that there were obviously no issues with her hearing or social skills and that she was obviously understanding all the questions and instructions given to her.  Her lack of speech was therefore unlikely to be part of a wider development problem.  She asked if Celeste still dribbled a lot (which she does, and has done since about 4 months old) and said that this combined with the “laberal” speech issues could be caused by underdeveloped mouth muscles.  Alternatively it could just as easily be linked to the fact Celeste did not get any teeth until she was 13 months old.

She said they was not a lot they could do with her at 16 months old as she was too young to follow the majority of the speech therapy exercises.  However they would see her in 4 months’ time to assess her progress.  In the mean time we were to keep doing exactly what we were doing: talking, reading, singing etc and give her lots of opportunities to speak .  Hopefully it would all just fall into place over the next few months.

In many ways, I did not expect to get much more out of the appointment than I did.  I am glad she took me seriously, and observed and agreed with my concerns.  I feel we have our foot in the door and if in 4 months’ time there is little or no improvement, we will be better placed to get referred for further treatment.

In the 3 days since the appointment Celeste has already learnt the word “yes” therefore hopefully this is a sign of good things to come :-)

If you have any concerns about your child’s speech and language development then a great starting point is http://www.talkingpoint.org.uk