I have speech concerns with your child

"I have Speech concerns with your child'"

Now What??

There might be nothing more exciting to see than our children learn to be more and more like us, adults … all the naïveté, the explorations, the role playing … They seem to be going along the universe just fine. Then one day, someone tells you out of nowhere that they want to have speech concerns about your child and recommends them for a speech evaluation.

During my graduate school days when I was complete my Masters degree in Speech-Language Pathology, my supervisor briefly met my then 4-year old daughter. Quickly after being acquainted, my supervisor exclaimed in a friendly manner, “Hmm, there’s a lisp. What are we doing about that?” I responded with a nervous smile and sheepishly responded, “She does”. In my head, however, I was in sheer panic for 2 reasons.

First, I thought, “My child is perfect!!! What lisp?!? She is a daughter of a soon-to-be speech-language pathologist! There can’t be any speech concerns present”
Second, “Did I miss a clinical observation? Am I so incompetent that in the everyday that I live with her, I missed that? Omg!!! My supervisor is going to fail me!”

This conversation was brief and I defensively concluded it with “I’d rather work on her being bilingual than worrying about a simple lisp.”

As a parent and knowledgeable paraprofessional, I did not welcome that news well. Among all the encounters that I’ve had with parents, I have witnessed many other types of reactions when I or a pediatrician or a teacher, tells a parent that they have speech concerns about their kid.

You may feel all kinds of emotions and it may be different from the next parent and that is okay. The bottom line is, how can you take advantage of this FOR your child? My goal in this post is to empower you as a parent. How can you maximize this resource in front of you, instead of taking it as a judgment to your own parental skills? What can you do to support your child?

After all the emotions have subsided, I suggest asking the following questions so that you are not left feeling uncertain or anxious. You need to leave that conversation feeling POWERFUL so that you will have a TOOL you can use for your child.

“What Do You Mean Speech Evaluation?” “What Are Your Exact Concerns?”

Have them explain what exactly their speech concern is. Your child might have been recommended for an evaluation by a pediatrician, a teacher, a counselor, or other types of therapists and what they will most likely say is “speech therapy”. However, that phrase is so loaded because there is so much to speech therapy. Here’s an overview.

The communication aspect of speech-language pathology can be divided in 3 major aspects (with many more subcategories under them). These are …

Expressive language – how we express our thoughts, may it be with words or other non-verbal ways
Receptive language – what we understand from what others tell or express to us
Speech – how easily understandable our words are, if we re saying our sounds accurately, the tone of our speech, and if we are fluent or not

“Speech therapy” will differ from client to client. Some may need help with only one of these areas, some may need help with all of them, some may even need help with swallowing or feeding (but we are not going there today).

“What did my child do Or did not do that gave you that concern?”

Ask for examples because it can be easier to be more supportive and proactive when we see what they see. Perhaps, you m ight start observing the same behavior at home. Or you might find that your child does not present with the same behavior at home. These details are important in helping your speech therapist with the evaluation.

Speech-language pathologists (SLP) are trained to analyze the most subtle communicative behavior. To others, it may just seem as the “cute thing he does with his mouth”, but it may be an implicating clinical observation to a SLP. Provide examples like the following so that your speech therapist can direct you in the right direction:

Playing with toys differently than the way the toys are expected to be used
The child may be frequently changing a topic instead of answering a question
Others may have to ask the child to repeat his words frequently to be understood
The child may never respond to his name unless you say it 5 times

Here you are again breaking it down to the different areas in speech therapy. This is not by any means an extensive list, but it is sufficient enough to have your speech therapist explain to you what they see in a way that can be easily observed by others.

"How will it affect other aspects of his life ...

... if we do not address it now? is it going to affect his academics, his social life ...?

I feel that this is a big question that families fail to ask and is sometimes left out by the speech therapist from the counseling part of a speech evaluation. As the parent, you have every right to have you speech therapist, or any professional for that matter who provide support to you child, explain to you the potential outcomes or consequences of the options provided for you. In this case, “what happens if she does not receive speech therapy” or “what happens if she does receive speech therapy”. Ask, “how will it improve his life”.

"what Steps do we take from here?"

“How much time is an evaluation going to take away from her daily routine?”
“Is she going to miss out on school, swim, other activities?”
“How about if you find out that she needs regular therapy?”

Now, proceed to the specifics of the speech evaluation process before you commit. Ask these questions because it may change your routine as a family. You need to be prepared for that so that you can fully commit in ensuring that your child is receiving the support that he needs so that he can be successful.

When you take advantage of such an encounter, you may naturally start noticing your child’s communicative behavior more. You may observe that she’s very good in some areas of communication. Or you may find other areas of concern that your professional or speech therapist did not bring up. For example, the concerns that others have may just be with how easily understandable your child’s speech is (we also call that speech intelligibility). Then you notice, ‘she always gets out of topic, worse than her younger brother’. If concerns arise besides what the speech therapist recognized, make sure to bring it up before the evaluation so that they can assess that area as well. When you become this introspective about your child, it is good! This is good because you can be a more active and more knowledgeable member of his team!

If your professional does not know all the answers to these questions, then ask to be referred to a speech-language pathologist (aka speech therapist) who can answer these questions for you before a speech evaluation. Educate yourself as much as you can by asking them questions so that you can be EMPOWERED during that initial evaluation.

It Takes a tribe

As they say, it takes a tribe to raise a child. And I thank God for that! Whoever recommended your child to receive speech evaluation, remember that it came from a good place. These individuals are a part of your tribe whose only aim is for your child to be successful.