The 4 important and free steps to take if you are concerned that your child may have a speech/language delay

Advice from a Speech-Language Pathologist and the Mom of Kids Who Had Speech Delays

blog-1I’ve been there.  As you watch your child develop, it can be so fun if everything seems to be developing as you’re told it should. But when you see that other children are speaking much more clearly than your child at similar or younger ages, or when you have trouble understanding your child, you can start to worry.  You may try to bury that worry, reasoning that you are probably overthinking things, and very often those around you will back that up with comments about how “it will all come in time” or how there is a wide range for when kids reach developmental milestones.

First, let me clarify that it is true about the range with milestones — it is wide. But at the same time, if you are concerned, there is no reason not to take some simple, free steps to get a better understanding of the situation.  Of course, getting more information will reduce anxiety for you if your child turns out to be fine.  But it can also reduce your stress levels and result in huge advantages for your child if he or she turns out to need a boost and you know you’ve done what you can to help.  Also, know that it isn’t a black-and-white situation where the child either needs therapy or doesn’t.  There are times when it’s helpful if the parents can learn from a brief screening what they can do at home to facilitate development.  So there is every reason to get started on these steps as soon as you can.  My hope is that this blog will make the journey easier for you.  I understand completely that parenting can be overwhelming and those of us with children who don’t develop typically have extra stresses that can add to that load.

This blog post is written for those with children age 5 and younger because once your children are in school, you can discuss concerns with your school’s Speech-Language Pathologist.  I’m going to wear two hats as I write this.  One will be my Speech-Language Pathologist hat, giving you the logistical details.  The other will be a mom’s hat – because I took my own kids through all of this years ago.  The information below is about Colorado’s system and Boulder Valley School District.  That said, Child Find is available throughout the state of Colorado, and given this is aligned with a federal mandate (IDEA), this general process will be found across the US.

Step 1: Schedule an appointment with Child Find.

As a parent, you can refer your child for a free school district screening or evaluation – you do not need to have a doctor’s referral. When you call your school district’s Child Find line, you will be asked to explain your concerns.  Next, you’ll set up an appointment to get a free evaluation (if your child is younger than 3) or a free screening (if your child is 3-5 years of age).  The screening for kids ages 3-5 is about an hour in length, but leave extra time because sometimes there is a wait and sometimes children need time to warm up to the testers.  Your child will do a few simple tasks for each of the professionals they work with – a speech-language pathologist, an occupational therapist (for motor concerns), and an educator/social worker/school psychologist.  They will have their vision and hearing checked as well. If this quick screening suggests the need for a full evaluation, you can schedule that (again, at no cost to you).

A few comments as a mom – I heard rumors about long waiting lists to get in for these screenings and evaluations.  As of 2017 the office reported that they try to do screenings within a month of when you call and evaluations within 2 months of your call.   As a mom, I also wondered how they would give the feedback – would my child hear what they were saying about him?  Would I be able to really listen as they spoke to me or would I be stressed out trying to keep my son busy and quiet?  Feedback on a screening or a 0-3 evaluation is given right away, often with the child in the room. So you may want to bring things to keep your child busy.  For evaluation results for 3-5 year old children, a separate meeting is held to share the results.  You are asked to come without your child for that feedback session (though if you need to bring your child, you can).  I also wondered who would work with us for the full evaluation – it depends on your concerns, but typically those involved will include a speech-language pathologist, an occupational therapist, a school psychologist and an early childhood special education teacher.  For screenings, fewer people are involved and they are the professionals whose areas of expertise match the concerns you mentioned in your intake call.

Step 2: Bring all helpful information to the screening/evaluation.

You will be given a questionnaire to complete regarding your child’s development, and if your child is in preschool or day care, you may also be given one for your child’s teacher or child-care worker to complete.  Be sure to take time to really think about your answers and write them clearly.  If you have documentation from another therapist or evaluation, bring that too.  The more information the testers have, the more they will know as they work with your child and as they make their decisions about eligibility.

A few comments as a mom:  I know it can be hard to find time to fill out the questionnaire but doing it carefully is well worth it.  The professionals working with your child will see him or her for only a very short period on one day at this one time.  As we all know, our kids are different at different times in different places with different people.  This will be a new place with new people and new things, so it is hard to say what will happen.  The professionals are typically nice and try to make it fun, but still, your child may be too shy to talk (as mine was) or too thrown off to show his or her true self/skills.  So the more you have documented beforehand, the better.  Since my son wouldn’t talk, for instance, they had to go by what I had written on the questionnaire. Even if your child is very outgoing, you may find yourself frustrated to see that the concerning things you noticed at home just plain don’t come up during the screening. If that happens and you have written documentation of what you see at home, that factors into the team’s decision-making processes.

STEP 3: Get all you can from the freefollow-up options (which may include therapy and/or district preschool programs).

If your child qualifies for therapy through the school system, then you will be offered one of two things – if your child is under 3, you will get free therapy in your home or a nearby facility; if your child is 3-5 years of age, you will be offered free preschool within the district.  If your child does not meet the eligibility requirements, you may be given things to do at home to help facilitate development.  If your child’s case is not clearly in one category or the other, you may be asked to come back to do the screening again at a later date to see if your child has grown into the skills in question without help.  Of course, it is also possible that your child is not in need of anything at all, in which case you will have that valuable piece of knowledge and can rest easy about your prior concerns.

p1020635A few comments as a mom: We did both of these things – starting with in-home therapy when my older son was under 3.  Yes, you feel like you have to tidy up a bit for the therapist and that can be tricky with little ones, but it’s also nice not to have to lug everything and everyone out of the house to go to elsewhere for therapy. Also, having someone come in can be a nice break in the middle of what can feel like a long day.  I remember thinking that I might get some stuff done around the house, or that I might give some attention to my other child during the session.  That was not always the case. Know that you are often asked to be a part of the therapy or to watch at least some of it so that you can follow up with home programming between sessions.  Later, when my boys were 3 through 5 years of age, they went to the preschool at the local elementary school.  It was a program with a mix of kids — those who were developing typically, those with various special needs, and those learning English as a second language.  The Colorado Preschool Program offers this at no cost for children who are eligible for help in some area(s) of development.  It is 4 half-days a week.

This preschool could be near you or not so near — you will be told where there is a designated program that currently has availability.  This worked out well for us, but I do know some people who had to go to a school that was not their neighborhood school.  I remember my kids liking this experience and their development was well-documented, which is great because I still have some of the wonderful scrapbooks they created there, with photos and drawings and kid comments that the teachers wrote down.  For one of my sons, a bonus was that it eased his transition to Kindergarten.  They had a visit-the-next-grade day.  Between that and overall familiarity with the school, he was more excited than scared to go to Kindergarten.

Step 4:  Monitor progress and advocate for your child as needed.

The schools have very strict guidelines for when they can offer how much of what – children have to show a particular level of difficulty/delay in an area to be considered eligible for therapy or preschool through the school system.  So if you go through the steps above and continue to have concerns, be sure to listen to them.  Ask the professionals working with your child about them.  Stay involved.  In the end, you are the main advocate for your child.  Therapists and teachers tend to have lots of children to help, but you are the one who sees your own child most often and knows your own child best. Hopefully the above steps will lead to a successful outcome, but if you question how things are proceeding at any time, ask.  If you don’t feel 100% satisfied with the answers, ask again.  Or get a second opinion.   It is your right and your job.  You are your child’s most important advocate.

A few comments as a mom I have to agree wholeheartedly with what my professional side said above.  In my personal case, I found it crucial to stay involved and make sure I was doing all I could to follow through on therapy activities at home.  Sometimes I had to push a bit for “homework” to do with my kids.  But if I kept at it, I got it.  My kids turned out to have a kind of speech problem that requires extra work to master the speech sounds.  Given that, it was a good thing that I did the extra practice.

Sometimes the match of therapist to my child was not optimal – in my case, my older son communicated at first only by signing.  The therapist we were given at that time couldn’t understand him because she didn’t know sign.  This is a case where you have to put social niceties aside and advocate for your child.

You will be asked to be involved in meetings about your child to set therapy goals for him/her.  Know that you are truly a part of the team, even if it seems at times like they’re a team and you’re a bystander — or they are professionals and you are “just the parent.”  That is not how it is supposed to work.  You are supposed to be involved in creating the goals and you can make the final decisions about them — don’t feel you have to just go along with what is suggested if you aren’t 100% in agreement.  Make sure the goals are in line with what you feel is important to your child and what you believe is functionally relevant to his or her life.  Be respectful of what the professionals know, but remember that you know your child better than anyone else.  Your active participation and your contributions can truly make the process work best for your child.

To contact BVSD Child Find, call 720-561-5078 or go to http://bvsd.org/childfind

For other school districts in Colorado, see the Colorado Department of Education website at https://www.cde.state.co.us/early/childfind.

Beth Langer, PhD, CCC-SLP has a private practice for pediatric Speech-Language Pathology in Broomfield, Colorado.  Visit her website at: http://www.langerspeech.com

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