Re: Advice please: how early for a formal evaluation?

[Guest guest]

hi

i do not know what is the appropriate age, however i do know it is important

not to waste time. if you have insurance or can afford to pay out of

pocket, i would seek out more Speech services. your son sounds very similar

to mine. we also live in brooklyn! where are you?

feel free to contact me off line for more info

pamdiamond@...

my son did not qualify for EI until 26 months due to his high expressive

language as well, but we started him privately before then since it was not

sitting well with us. go with your gut

oh, and from what i understand dr agin does not do evals in the summer.

good luck and be in touch!

pam

On Sun, Jul 6, 2008 at 1:34 PM, againjenagain <jenkruger@...> wrote:

> My 21 month old son has very few words, and relies on the first

> consonant for many of the words he does use. He uses ssss to indicate

> juice or sesame street, da for that or daddy, caa for cat or car, and

> bee for his own name (). Pretty much the only whole words he

> does say are ball (baw) and cookie (cooo-kee, often whispered), yeah,

> no, key and ma (or mama when he's upset).

>

> We had him evaluated for EI services two months ago and the result was

> that he qualified for 1 half-hour session per week. (He scored

> normal-to-high on the non-expressive areas of the test, so they would

> not qualify him for anything more. We actually had to beg just to get

> the half-hour per week, as they wanted to give him a half-hour every

> other week initially.)

>

> He has now had 3 sessions with his SLP, who has told me that it is

> hard for her to say just yet if what is going on is apraxia,

> stubbornness (he is an extremely strong-willed/stubborn child) or a

> run-of-the-mill speech delay. (Her belief is that it is a combination

> of apraxia and stubbornness, but she wants to spend more time with him

> before saying anything definitive.) Right now she is working to get

> him to imitate gross-motor gestures (like clapping) so that we can get

> him in the habit of imitation so we can start with imitating words.

>

> I live in Brooklyn, and would like to make an appointment to see a

> neurodevelopmental pediatrician (Dr. Agin would be our first choice)

> so that we can get a real idea of what is going on here (and maybe an

> official diagnosis, whatever it may be), but I want to make sure we

> make the most of our evaluation with her. So (if you're still reading

> this) my questions are:

>

> Do we wait until he is 2 (or older) before having him evaluated? Can

> you get a reliable diagnosis before 2?

>

> Is there a benefit to continuing to work with the speech therapist we

> are currently working with (although at the ridiculously low amount of

> 30 minutes per week) in the hopes that she can make progress at least

> with the stubbornness aspect which may then allow us to determine how

> much is personality and how much is neurological?

>

> I don't want to lose any more time, but I also want to make sure the

> evaluation is as productive as possible. What is the best age for a

> complete neurodevelopmental evaluation, anyway?

>

> Thank you for your help and guidance.

>

> -Jen

>

>

>

[Guest guest]

Your EI SLP can increase sessions if after working with him finds he

needs more. It may require a short meeting..but its all in your home

anyway. EI is also about teaching you to work with your child at home,

so if its only 1 session than you can take what they use with him and

use it to help him the rest of the time.

> > He has now had 3 sessions with his SLP, who has told me that it is

> > hard for her to say just yet if what is going on is apraxia,

> > stubbornness (he is an extremely strong-willed/stubborn child) or a

> > run-of-the-mill speech delay. (Her belief is that it is a

combination

> > of apraxia and stubbornness, but she wants to spend more time with

him

> > before saying anything definitive.) Right now she is working to get

> > him to imitate gross-motor gestures (like clapping) so that we can

get

> > him in the habit of imitation so we can start with imitating words.

> >

>

[Guest guest]

I know we hear and read don't waste time, now gone through the

process i disagree actually. I don't believe 30 mintutes of therepay

(21 mos old) which boils down to 30 mintutes of face to face time

with a stranger who was trained in speech pathology out of a 20 +

year old play book. Done that, and can honestly say it was a waste

of time.

On the flip side, and to do it again, which I will be since my 2nd

son is about to arrive. The first thing I will do is have him tested

for heavy metal toxicity via a urine sample and get the first baby

hair cut. (Actually, i'm going to have my breast milk tested shortly -

so I guess that's even more pro active) If this boy is late on

milestones - we would not listen to the Ped sbeal " every child

develops " nonesense when there is a bonafide epidemic going on. This

is a child who should be watched closely and evaluated critically.

At this point, no general Ped has the training to properly observe

an " at risk " kid. And with that, they certainly dont have the bank

of knowledge to offer/coach/train/ the parent in how best to abate it.

Therapy is only stimulous. If you've got a kid with a heavy metal

detox problem - my idea of early intervention would be to get a

knowlegable Dr. on board to do some preliminary testing.

Scheduling therapy may make you feel better.

This is just my opinion based on my recent experience. I opt to heal

the physiological problems and added Montessori school for the

stimulous.

>

> Your EI SLP can increase sessions if after working with him finds he

> needs more. It may require a short meeting..but its all in your home

> anyway. EI is also about teaching you to work with your child at

home,

> so if its only 1 session than you can take what they use with him

and

> use it to help him the rest of the time.

>

> > > He has now had 3 sessions with his SLP, who has told me that it

is

> > > hard for her to say just yet if what is going on is apraxia,

> > > stubbornness (he is an extremely strong-willed/stubborn child)

or a

> > > run-of-the-mill speech delay. (Her belief is that it is a

> combination

> > > of apraxia and stubbornness, but she wants to spend more time

with

> him

> > > before saying anything definitive.) Right now she is working to

get

> > > him to imitate gross-motor gestures (like clapping) so that we

can

> get

> > > him in the habit of imitation so we can start with imitating

words.

> > >

> >

>

[Guest guest]

How early for an evaluation? It depends on the severity of the

delay. My one son was in therapy from 3 weeks old and was in

intensive care and under the care of various pediatric neurologists

from birth.

For speech you can read The Late Talker book and/or read this online

for information as to some signs of delay

http://cherab.org/information/latetalkerhandout.html

There's tons of research on the importance of Early Information which

proves indisputably the importance of getting to that child early.

My son Dakota was in therapy from 3 weeks old and he went from a

child that was at risk for mental retardation -distorted growth of

his limbs where he would have to be in a wheelchair the rest of his

life -a child with eating a breathing problems, severe head, neck and

facial damage to one that you can't tell he ever went through

anything. I credit that 100% to his amazing therapists that worked

with him for an hour at a time and taught me how to follow through at

home. There is a sad number of misdiagnosed with autism apraxic

children who never received appropriate speech therapy yet got tons

of biomedical treatments and are still nonverbal. That type of

information over the years from our archives here is priceless and it

shouldn't and and probably couldn't be proven in clinical trials

because it's unethical to not provide speech therapy to a child that

needs it. To the untrained eye speech therapy to a preschool child

may look like nothing -but the goal is to keep the child happy while

meeting goals.

Unless the child has eaten lead paint or something I do not believe

the first step is heavy metal toxicity testing -especially for a 21

month old who statistically speaking in 75% of the cases is " just " a

late talker with a simple delay in speech. In those and many other

cases all of that testing will cause stress on the family/child and

will be a waste of time and money.

First step -evaluations to rule out hearing loss and a speech

evaluation.

Next step -if qualified early intervention therapies

Third step -if there is loss of language or skills at any age, or if

apraxia or autism is suspected an evaluation by a neurodevelopmental

pediatrician or pediatric neurologist.

You could probably start fish oils whenever as they are a food

supplement needed by almost 100% of humans of every age from birth to

seniors -even in utero.

http://cherab.org/information/indexinformation.html#diet

Again over the years and still the majority of children in this group

respond to therapy and fish oils/vitamin E alone. There are always

exceptions and for them there are more extreme biomedical means to

try.

Here's some archives on Early Intervention the first one from -

Khalid's mom. Khalid is now in his twenties and in college with tons

of friends, a girlfriend, a side job. His story of how he got to

where he is today is in The Late Talker and once in awhile does

post here -but like many other old timers she is lost in the

discussions of today of extreme biomedical because most of us didn't

have pressure on us from this group that you needed to go this path.

You probably don't. Early Intervention on the other hand -no matter

what the reason for the delay -YES!!

The Importance of Early Intervention

Sat Mar 20, 2004 4:18 pm

Hi Everyone,

In a recent discussion I agree with the importance of

awareness, to stay informed. Today there are several

credible resources, not like years ago. Today it's so easy

for all to find information to read, ask professionals and

other parents, explore what types of therapies and

strategies are out there to help if needed and learn if any

of the above can help your child.

Like most things in life, early detection and treatment

leads to better a prognosis. How I wish I had the advantage

of early detection and intervention when my apraxic sons

were younger. Not much information was out there 17 years

ago and what little was, was a grim prognosis for Khalid,

who once was severe apraxic.

As some of you read in the Late Talker Book, it took years

for my oldest son Khalid to overcome his Apraxia due to

lack of knowledge and appropriate early intervention. He

went through some very difficult years, especially from 1st

grade through 4th, they were the toughest. Fortunately for

Khalid, with the guidance of an amazing school speech

therapist, lots of love and support, in later years, he was

able to rise above.

As