Hearing test and speech therapy for a 20 month old...

Dawn - posted on 11/04/2010

Thanks Renae :) Can you tell this is my first child?? I more often feel everything is normal but then I start to think about all the possibilites and get stressed out!! And of course, I now have my husband on the worry boat, so I keep hearing his thoughts on the matter!!Well, the hearing test will at least set my mind at ease....I too plan to hold off from speech therapy if everything checks out OK with his hearing test. :) Thanks again for your support!

Renae - posted on 11/04/2010

Oh Dawn well that is very different! Now that I know your whole story...

The first thing for you to know is that speech development and physical development can not develop at the same time, the easiest way to explain it is to think of speech and the physical as competing for brain activity. This is why speech usually appears to go backwards just before babies start walking. The developing brain will automatically give its attention to the area it is currently developing and leave other areas alone for a while, then switch its focus to another area for a while.

Appearing to "forget" some words is also normal. Babies practise things until they master them, in speech this is more obvious in some kids than others, but they all do it. While they are mastering that word (and more to the point the concepts and patterning surrounding that word) they will use it a lot, once they have it all fully processed in their little mind, they stop using it as much, but it is still there.

Your baby sounds perfectly fine to me. Shame on your doctor for not telling you all of this. I'm sure the speech therapist will and will explain it in even more detail - its not my expert area.

Dawn - posted on 11/04/2010

Thank you all so much!! I was offered a earphone test by the speech therapist but told them I was going to wait on the outcome of the pediatric hearing test before starting any speech assessment. To go more in depth on our situation.......shortly after my son turned a year old, he seemed like he would be talking early...he was already saying "mama" and "dada" correctly and quickly understood most of what we were saying. Over the next six months he seemed to be making process with building his vocabulary....he would say and sign "bird", "doggy", "eat" and "brush"..he was saying "outside", "Dorothy" and "book/ball" (these sounded almost the same!)....and could sign "banana", "milk", "more" "cracker" and "friend". The difficult thing was he would learn and use a word/sign for a few weeks, then drop it and hardly not use it again. As we neared 19 months, I began to notice he wasn't using any words anymore, besides "mama" and "dada"...it seems as if he has regressed if not just stalled. I have always given him the benefit that, "he is just not ready to talk", "he is so active he is focusing on being physical", "he is being cautious and wants to get it right"....I am now using my mothers instincts I guess....or finally letting my feathers get ruffled by others!! I stay at home with my son, so we constantly read and "talk" with each other. I point out everything we see on walks and out and about or anything he wants named for him. He seems very smart..he still understands most everythign I say...he is curious about most everything and can communicate by pointing, he just doesn't seem to be able to get to or past a certain hump in the actual speaking. This is what made me want to get his hearing checked...maybe he can hear us but can't hear it clearly...this would explain why he is very responsive to us, but can't speak the words. Another thing...he gets very aggravated when I ask him "can you say it?!" or "what's this?!"..I can't tell if its frustration because he can't or attitude because he doesn't want to!! Part of me also thinks I may be a bit to blame as I seemed to communicate well with him without him using words..any suggestions there??

Renae - posted on 11/04/2010

In Australia a toddler that young would be referred to a specialist hearing clinic who has the facilities to test them, most hearing centres can not test a toddler of that age. In my state there are only 2 places that can do it. What happens is the child sits on your lap inside a sound-proof testing booth. You are told to stare straight ahead and not to react when you hear anything. Then they play different sounds and frequencies and whatever (I dont know all about the technicalities) through different speakers positioned around the booth. When the child looks in the direction of the noise a positive stimuli (or "reward") appears (usually a cartoon on a TV screen) so that the child quickly learns that if they look towards the noise they will see the cartoon. There is an additional test that they try to do if the child will tolerate it which is a very small bug which vibrates and it is inserted just inside each ear, but most children under 3 will not put up with it and will pull the bug out so they are usually not able to do the test. It is not supposed to hurt, it just feels funny in their ear.

A speech therapy assessment does not involve much at this age. It will mostly consist of asking you questions about their comprehension, how many and what words they can say, how many words they can understand and what sounds they can make. The therapist might recommend that you make various mouth movements and noises (like blowing raspberries) at your child and try to get them to copy you to exercise their mouth and throat muscles.

My baby is 19 months. He is not talking and can only say mum and dad. He just started saying mum a few weeks ago. At this stage I am not bothering with taking him to speech. His comprehension is excellent, he understands lots of words and he can follow instructions with multiple steps. I did have his hearing tested because sometimes delayed speech is a sign that even though they appear to understand everything you say they are not hearing it entirely clearly and so they learn some of the phonetics incorrectly and this then has to be rectified with speech therapy later. So to ensure this would not be an issue with my son I had his hearing checked. Being that his hearing is normal I am giving him another year for his speech to catch up before I take any further action.

Louise - posted on 11/04/2010

I don't know where you are in the world but in England it is not normal to have a speech assessment until the age of 2 as each child develops at a different rate and at 20 months he would not be classed as having problems if he was only saying the odd one word. As long as your son was saying between 30-50 words he would not be seen as delayed. Sentence forming does not really start until 2 with two word sentences then very quickly 3 and 4. If you are worried about his speech then you are doing the right thing by having his ears checked. Children that I have seen in clinic with speech delay quite often have undiagnosed glue ear or some sort of hearing problem. Easily treatable and nothing to worry about. Before your appointment comes through spend a lot of time singing with your son things like Row Row your Boat and See Saw, songs that have actions to, to capture his imagination. Talk to him as much as possible and encourage him to speak by asking him what things are called. Good luck with the appointment just remember he is very young still.

Julie - posted on 11/03/2010

I'm not sure how uniform things are, but the following was the case with my son: At that age, your son may or may not tolerate headphones for a hearing test. If not, he'll sit on your lap and tones will sound from speakers on the wall. A light-up toy will "reward" him seconds after that so he learns to look towards the sound. If you're like me, you'll find that your son looks when you can't hear, the toy lights up and you realize you need to go back and have YOUR hearing tested;). If he can tolerate the headphones, the scenario is the same, only you cannot hear the tones. Our audiologist was in the pediatric ENT's office and she was so nice to work with for the testing!

Speech therapy assessment is quite low-key, too. First, they ask you a bunch of questions to assess what he seems to comprehend/say/etc ... at home and then they talk to him a bit. Again, the therapist(s) who evaluated my son and his speech therapist were excellent. If you aren't keeping track, it might be good to start jotting down words he says, what kind they are (noun, verb, etc..) if he puts any together, if you do signs, etc... I remember being asked those and not quite knowing for sure.

I would say the only time I was ever frustrated with evaluations was when my son was not given enough time to make his response. I KNEW he was going to say something, but then the therapist would butt in just a second before he could. It didn't happen too often, though. I think a hesitation is normal for these little guys.

Way to be proactive! If he needs any assistance, the earlier, the better.

Katherine - posted on 11/03/2010

I haven't but ECI can't hurt!