Question about speech therapy for toddlers

[jax373]

My youngest DD has been in Birth to 3 since she was about 2 years old due to not speaking (she would say a couple of simple words like mama but not much else).  She will be 3 in September.  Her vocabulary has expanded quite a bit since we started Birth to 3.  We are now working on putting sentences together (or I guess just incorporating verbs with the nouns she uses).  We used to have speech therapy every other week but we cut it down to once a month now since she has been doing better and trying to say more things. 

I feel like DD is doing a lot better and using more language but it seems like she should be progressing a bit more.  If I ask her to say a 3-4 word sentence, she will kind of fill in the first word or two with mumbles or sounds then say the last couple of words.  I've mentioned this to the therapist and she's seen it but I don't know what I could do to help her progress from that.

Her speech is the only issue. She was tested on other aspects when we first started Birth to 3 and there are no other delays.

My question for those who have had speech therapy for their kids, how did your therapy sessions look? We basically go over how she is doing each time, talk about what we can work on and we (therapist, DD, and me) will play for a while and the therapist will give me tips on how to increase her talking and language. Does that sound accurate as to how your therapy sessions worked?  Our therapist is great but it feels like we are kind of at a stand still on how to increase DD's speech.

[stephm0188]

Yeah. At the toddler age, therapy is very focused on learning through play.

I was SO TIRED of talking all the time. At home, it went like this:
"Milk."
"Milk please."
"Milk pweeze."
"I would like milk, please."
"MILK PWEEEEZE."

He'd use a one word phrase, I'd encourage a 2-3 word phrase, and then I'd follow up with a complete sentence to model it.

[jax373]

Yea, that's pretty much where I am right now. She's learning and trying more but it's still tiring sometimes.

[origami]

"We basically go over how she is doing each time, talk about what we can work on and we (therapist, DD, and me) will play for a while and the therapist will give me tips on how to increase her talking and language."

That is sort of how our birth-3 ST went in our district's early intervention program. It was at a local school in a classroom and the emphasis was heavy on getting my kids to play/do very specific tasks. The emphasis was not at all on actual speech therapy. For example, our SLP had an egg timer and my kids had to play at a rice table for 5 min. Then they had to do circle time for X minutes while she read a story. Then they had to do a craft. If they didn't want to do one of these things I had to try to make them or take the malcontented child outside the classroom for a sort of time out. Theoretically the SLP was supposed to be conducting ST during these activities but she sucked so she mostly talked to me. She gave me papers and tools and ideas though.

I was very disappointed in the lack of actual ST being done by the SLP. I thought the focus was all wrong - being so over-invested in the activities and not on getting my kids to speak. We went weekly during the school year. Our district doesn't do ST over the summer. Eventually I got a recommendation from a friend for a private SLP and I found out what real ST looks like. Our private SLP spends the entire time teaching my kids to talk, expanding their vocabularies, correcting various errors etc. it's far more intense than anything I saw in the Early On program. It's also individual therapy, whereas Early On was only groups. We go weekly and it has made SUCH a difference. I have I one kid that is pretty well caught up. The other is still behind but has made significant process. Both have no other delays. The one that is still behind probably just needs time for his brain to mature. I think maybe if I saw the private SLP more often, or was more diligent about doing exercises at home, he would improve faster. But you can't force a child to catch up if his or her brain is not ready. I saw a difference in his speech after one week at the private SLP. I saw very little progress before that. So I'm convinced having a good SLP makes a big difference. If you like your SLP but not the structure of your Early On program maybe ask for additional sessions and be specific about what you want to see happen during those sessions. Or hire someone privately. It was an easy decision for me because I did not like our Early On SLP at all.

[origami]

Oh and this:

"I feel like DD is doing a lot better and using more language but it seems like she should be progressing a bit more. If I ask her to say a 3-4 word sentence, she will kind of fill in the first word or two with mumbles or sounds then say the last couple of words. I've mentioned this to the therapist and she's seen it but I don't know what I could do to help her progress from that."

Is normal during ST. Both my kids did that as they were adding words to phrases and sentences. Over time you should notice the mumbly words lessen if the sentence length stays the same. Then when the sentences get longer you might hear more mumbly words but then they lessen again as the child gets more comfortable with longer sentences. Eventually they should go away altogether. Well unless you're like me and talk so fast people accuse you of mumbling everything my private SLP has techniques to help them build non-mumbly sentences so that's not something a SLP should just shrug off as if it can't be helped. But it's normal.

Examples of exercises she does for the mumbly words are
-repeating each word of a sentence individually, then putting them together and repeating the whole thing.
-putting colored cards on a table - one card for each word of the sentence - and hitting each card as you say each word.
-using different motions or sign language while saying the sentence

I'm trying to remember what else she does but I'm so tired I can't remember!

[jax373]

Thanks origami! This is all very helpful. I think I will talk to the therapist at our next session. I know Birth to 3 is going to submit paperwork shortly for an eval with the school district since she will age out of Birth to 3 soon.

I will also try those exercises you recommended. I do repeat words individually and put them together but I like the idea of the cards.

[mollybrown]

What's your gut feeling about the speech therapist? What you describe sounds an awful lot like my son's first speech therapist. We worked on modeling things with him for a year, and he just wasn't making progress in certain areas. Speech didn't become useful for him until he got a different speech therapist.

His 2nd and 3rd SLPs were awesome. In addition to modeling, the 2nd had him doing things like blowing into straws, blowing feathers, and would physically manipulate his mouth to help him make certain sounds. The 3rd played lots of games and had plenty of fun with him, but it always had a purpose. If he was working on making the "sh" sound, they would play a game where he would be required to pronounce "sh" words properly in order to win (but not EVERY word had to start with "sh"). He would get to do non related activities after he successfully completed an activity that she chose. She was also very good at explaining and helping him place his tongue or lips in the right place. Both had wonderful activities that they did with him, and I was just able to copy and repeat the activities during the week.

[muppetinma]

I'm not sure how productive ST can be once a month if you have decent concerns. That's just enough time for the SLP to see what's new and talk to you about what to work on in the future. My son is two and has had ST for at least an hour a week for almost a year. We use an observation room, so I'm on the other side of a double-sided mirror. He works with the SLP for a solid 50 minutes, but I can see what she's doing the whole time so I know how to incorporate it at home. The other ten minutes of the session is used to catch her up on everything else that's going on in his therapies. I feel like the progress he makes is because of the one-on-one time he spends with her each week.