Thursday, March 31, 2016

Twin speech delays in toddlers

Both Brooklyn and Bailey were pretty delayed with speech. Only saying "uh oh" at 18/19 months. I know it's fairly common for both twins and preemies to have speech delays, but generally they catch up around age 2. This did not happen. Now the girls are getting close to 3 and I'm starting to be a little more concerned.

Brooklyn seems to have finally caught up with speech but Bailey is still lagging behind. We've been doing the early intervention with the state (Help Me Grow) since they were 18 months. It's nice because it's free and they come to your house. But wanted to get a second opinion and a little extra help so we took them in to get evaluated at the Cleveland Clinic children's rehab center.

Brooklyn passed and didn't need any extra services. This didn't surprise as she's really exploded with words the last month or two. She is putting together sentences just fine and will repeat just about anything. No concerns anymore. She seems to still be a bit behind typical peers, but I know there is a range of normal and she is just on the lower end.

Bailey however needs some extra help. We counted and she can maybe say about 60 or 70 words but it's hard to really accurately count this since so much of what she says is inaudible. Bailey talks a lot, she just drops so many consonants it's difficult to make out a word without context clues. So, when we hold up the "car" flashcard, she can't really say "c" or "r" so she basically just uses the "a." And you know she is trying to say car when holding up the flashcard but if she were to say it without that clue, you wouldn't know what she was saying. It can be frustrating for her, and for us, that she can't communicate what she wants or needs. Even asking for more milk is difficult and usually results in her tugging at the fridge going "uh uh uh" rather than saying "more milk." So the inability to communicate does sometimes result in some tears for Bailey, though this could also just be toddler tears. Bailey CAN say milk, but it comes out sounding the same as mom, moo, and pretty much any m word since she drops the end consonants. Again, without context clues (her standing next to the refrigerator is a safe bet she's asking for milk) you don't really know what she's saying.

What makes it so difficult for Bailey is that her receptive language scores extremely high. She understand everything, she just can't communicate it.

So we are working on getting her to use two word phrases and expand her vocabulary. My Google adventures have pointed me to a lot of theories:
1. She is totally fine and all kids develop at their own pace.
2. As a twin and preemie, it's not super unusual to be behind. She tends to let Brooklyn (who speaks clearer) talk for her.
3. She is a smart kid and picks up that people have trouble understanding her. This makes her try less and use gestures instead to indicate what she wants.
4. Allergies. Bailey had a lot of ear infections last year and has always been a mouth breather. She seems constantly stuffed up. Could allergies be impacting her speech? Could she have fluid trapped in her ears? (We had her hearing tested about six months ago and she did pass that). Based on my Googling, yes, this could be possible. Will discuss this with the doctor and possibly follow up with a pediatric ENT.
5. She just has a speech delay and will catch up with early intervention.

The Help Me Grow program ends at age 3. Both Brooklyn and Bailey have an appointment with our school distract for evaluation to see if they qualify for the preschool program (this would include speech services). My initial thought is that Bailey will qualify and Brooklyn will not. While they do have peer models in the program, it's fairly competitive and I think we missed the timeline on Brooklyn getting in. So that leaves me with the possibility of splitting them up. I don't love this idea. I know a lot of research says it's better to split twins. But that looks at elementary aged children, not a three year old. I think it would not be good for either of them. We'll cross that bridge when and if we get there though. I would hate to deny Bailey a spot in the preschool when it would probably help her tremendously. Things to think about later.

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