Guest Blog: Should My Late Talker Get Speech Therapy? Depends on Who You Talk To!

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By: Becca Jarzynski, MS, CCC-SLP

Editor’s Note: Becca’s wonderful article is directed at caregivers rather than therapists.  We include it on our blog and site for you to share with the parents of your late talking kiddos!

There’s a debate a brewin’ in the world of early intervention. Seeing as how we work with young children, we’re generally pretty easy-going folks. But that doesn’t mean we don’t have our professional disagreements. And this is one of them.

It all started with this study, which was published in the journal of Pediatrics and released into the press in July. The Australian study followed 142 late-talkers as they aged; the researchers measured problem behavior at the ages of 2,5,8,10,14, and 17. They found that, despite having poorer behavior at age 2, the late-talkers exhibited no significant behavioral concerns at any of the follow up ages. Articles about the study were written up in the press and ran with headlines such as “Late Talkers Do Fine As They Grow Up.” Many of the articles also suggested that the “wait and see” approach for late-talkers might be the best option after all.

That wasn’t the end of it though. The Hanen Centre, a non-profit organization that focuses on helping parents learn to teach their children to communicate, responded. They put out this press release, cautioning parents to be wary of these overly simplistic headlines. As it turns out, the study had looked at the emotional and behavioral outcomes of the late-talkers only. The Hanen press release noted that, while it was reassuring that late-talkers appeared to have no long lasting emotional or behavioral difficulties, the study simply did not measure whether or not the late-talkers had persistent language delays or other academic difficulties. The Hanen Centre press release urged parents to seek help for their late-talkers early.

So what do I think of all this? I can see both perspectives. I do think that, in some cases, we over-serve children with expressive language delays. Many late-talkers really will be just fine, even without formal speech-language therapy. Have you seen the film Babies?

A colleague of mine wisely pointed out that, despite their varied backgrounds, all of these babies–those who were quizzed with flashcards in their kitchens, and those who spent their babyhood dancing in fields next to goats– probably still somehow grew up, developed the necessary skills they needed to function in their world, and flourished. Sometimes–sometimes–I think that we in the Western world do families more harm than good by focusing so much on what the child is not doing instead of letting the family just love the child for who she is. I know we do much good in our field, but I worry that sometimes, against our very best intentions, we steal moments from families that could be spent dancing through life with their children.

BUT (and this is a big but), there is sound rational behind our tendency to push back against the “wait and see” philosophy. First, talking late is a risk factor for other, more significant diagnoses, such as autism and apraxia of speech. There are ways to tell if a late-talker is at risk for a larger delay, but it is often hard for parents, and even physicians, to differentiate between those children who have an expressive language delay only (and are therefore, just “late-talkers”), and those who may have a bigger diagnosis that warrants early intervention. The “wait and see” approach, when applied too broadly and blindly, can lead to children being missed, to parents who are blind-sided by a diagnosis later in their child’s life and are frustrated that they didn’t get a chance to act on behalf of their child at a younger age, and to problems that could have potentially been mitigated through early intervention.

Further, as the Hanen press release points out, most late-talkers will catch up. 70-80% of those who are truly just late-talkers will outgrow their language delay. But not all will. And therein lies the rub: we just don’t know yet how to tell which late-talkers will catch up on their own. We do know, however, that the children who don’t catch up on their own are at significant risk for later language-based academic difficulty. And we know that the strategies we have to help late-talkers can work, especially when they are used at young ages.

So what would I do if I were the parent of a late-talker?

First, I’d make sure that the child was “just” a late-talker. This can be more complicated than in sounds (Take a peek at this post, which describes the things that I would look at as a pediatric speech-therapist to help me determine of a toddler was a late talker). If I were not well versed in the world of young children, I’d probably ask my pediatrician for an evaluation through my local early intervention program, if for nothing else than to confirm that my child was, indeed, just a “late-talker.”

If I did get an evaluation from my early intervention program, I would ask them to teach me the strategies for working with my child and help me learn to integrate them into my day.

I would read about and try out the different strategies for working with late talkers here, on Child Talk! (You had to know I’d plug this blog, right?).

I would check out books such these, two of my very favorite books on working with children who have communication delays:

Finally, I’d make sure to balance any and all of the above with lots of love, laughter, and dancing.

References
Whitehouse, A., Robinson, M., & Zubrick, S. (2011).” Late Talking and The Risk for Psychological Problems During Childhood and Adolescence.” Pediatrics: 128 (2): e1-e10.

http://www.reuters.com/article/2011/07/0…OZ20110704

http://www.marketwire.com/press-release/…538680.htm

Featured Guest Blogger: Becca Jarzynski, MS, CCC-SLP

About Becca: (From The Child Talk Blog) I’m Becca, a pediatric speech-language pathologist. This long title simply means that I spend my days teaching parents the best ways to help their children learn to communicate. Since graduating with my Master’s Degree in Communication Disorders over 10 years ago, I’ve worked with hundreds and hundreds of children and their families. The children I work with all have delays in communication– some have diagnoses such as Down Syndrome or Autism, others have no diagnosis but still struggle to use words or produce speech sounds, and still others have difficulty with stuttering or using their voice well. Although I work with all kinds of children, my area of expertise is in autism; in addition to my M.S. in Communication Disorders, I have a graduate certificate in behavioral intervention for autism spectrum disorders. I love my job because it allows me to help parents build their child’s communication skills. There is nothing more rewarding than watching a child say a word for the very first time, especially when that child and her family have worked so hard to get there. When I’m not working, I’m busy being a mom to a kindergartner and a toddler. I’m lucky to have gotten a front-seat view of their communication development as well. It’s taught me that no two children are alike, even if they have the same speech therapist as a mom!

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3 Responses to Guest Blog: Should My Late Talker Get Speech Therapy? Depends on Who You Talk To!

  1. Such an important message for parents and SLP’s alike. I never dreamed I’d have a late-talker myself, but lo and behold, I did. Glad I got it checked out when I did–she has Childhood Apraxia of Speech. In fact, it’s because of my beautiful late-talking daughter I decided to write a book about it. “Speaking of Apraxia: A Parent’s Guide to Understanding and Coping with Childhood Apraxia of Speech” should be available in early 2012.

  2. C. Monoker says:

    When I was in school I was taught that it is not necessarily the disability that determines the need for therapy but rather the handicapping effect. If a molehill of a degree of disability appears mountainous, which for language issues would manifest as frustration resulting in behaviors such as tantrums, then therapy is warranted. If the person is fine with their disability and is functional then therapy may in fact not be necessary. For children where the question is whether they will outgrow the issue, which requires allowing time, or intervening early the real question is, “what is the underlying cause”? The two crucial areas to examine for language delay is hearing (as per speech diagnositics 101) and praxis (as mentioned by Leslie). Unfortunately most people don’t appreciate just how often otitis media is the reason for the language delay and that a parent’s efforts would be better spent managing the health aspect of this condition. Very often once the otitis media is resolved the language skills immediately emerge. The other misconception is that with hearing it is all or nothing. In fact hearing is analagous to vision, there are degree of loss. “Mild” losses are usually not recognizable and only identified through audiological testing, often to the surprise of parents.

  3. Mary Fitz says:

    Awesome article! I am an SLP of 34 years and agree that there can be an ongoing struggle to intervene or not intervene. In my opinion, it’s better to be safe and get more information. At the least, I suggest an assessment by a professional and obtain more knowledge. Then, as a parent you can feel more at ease about your informed decision regarding your child.