1. Speech-Language Delay
A Case Study

2. Hayden

3. Definition
Speech delay refers to a delay in the development or use of the mechanisms that produce speech. Speech, as distinct from language, refers to the actual process of making sounds, using such organs and structures as the lungs, vocal cords, mouth, tongue, teeth, etc. Language delay refers to a delay in the development or use of the knowledge of language (

4. Causes
Hearing loss is often overlooked, and easily identified.  If your child is speech/language delayed, their hearing should be tested.
Intellectual disabililty is a common cause of speech and language delay.
Extreme environmental deprivation can cause speech delay.  If a child is neglected or abused and does not hear others speaking, they will not learn to speak.
Prematurity can lead to many kinds of developmental delays, including speech/language problems. Find out more about prematurity and speech and language delays.
Auditory Processing Disorder describes a problem with decoding speech sounds.  These kids can improve with speech and language therapy (

5. Causes
Neurological problems like cerebral palsy, muscular dystrophy, and traumatic brain injury can affect the muscles needed for speaking.
Autism affects communication.  
Speech/language/communication problems are often an early sign of autism. 
Structural problems like cleft lip or cleft palate can interfere with normal speech.
Apraxia of speech is a specific speech disorder in which the child has difficulty in sequencing and executing speech movements.
Selective mutism is when a child will not talk at all in certain situations, often school.

6. Big Issues
Articulation disorders include difficulties producing sounds in syllables or saying words incorrectly to the point that other people can't understand what's being said.
Receptive disorders refer to difficulties understanding or processing language.
Expressive disorders include difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
GESTURES, WHINING, TANTRUMS!

7. Frustration!

8. Early Intervention
The Early Intervention Program offers a variety of therapeutic and support services to eligible infants and toddlers with disabilities and their families, including:
family education and counseling, home visits, and parent support groups
special instruction
speech pathology and audiology
occupational therapy
physical therapy
psychological services
service coordination
nursing services
nutrition services
social work services
vision services
assistive technology devices and services

9. Early Intervention Process
Parent-initiated PCP referral (10/2006)
Monroe County Early Intervention Program Coordinator Interview (12/6/08)
Step by Step initial evaluation (1/6/09)
Qualified for services- 2 significant delays
Hillside Children’s Center- IFSP developed
5. Individual services begin- Speech-Language Pathologist (2/3/09)

10. 2 years- “Eyes, nose, mouth”

11. Vocabulary
Language and Speech Development In Children

12. Lisa’s First Visit- Daily Note
He used a lot of screaming and grabbing for toy items= seemed to be more of a power struggle
Puzzle- was very interested and tried to say animal names
Suggestions: Try not to say “say” or give into whining
At minimum- use point or reach for item

13. Lisa’s Strategies Patience Be firm and let him tantrum- boundaries
Acknowledge his “activeness”
Incorporate learning in play
Games
Activities
“silly sounds”

14. Hayden’s Words March 2009 No mama no dada papa more
Thumbs up found it fell down
Down up paul hezer (heather)
Shrek cow car shark
Bee baiyee (bailey) mike butt bye bye light on
Juice red blue green poop

15. Quarterly Progress Report April 30, 2009

16. Standardized Test Results September, 2009
Behavioral Skills Composite….. Avg
Adaptive Skills Composite……..Avg
Verbal ability……………………..32 %ile
Speech Articulation……………...49 %ile
Auditory Comprehension………..47 %ile
Expressive Communication……..21 %ile
Sensory Profile……………………Avg

17. Lisa’s Visit 12/8/09

18. 3 years- “Eyes, nose, mouth”+

19. What’s Next?

20. Preschool IEP
Goal 1: Hayden will increase his conversational speech intelligibility in order to effectively communicate with others across all settings
Evaluation Criteria: 90% success, over 10 months
Procedure to Evaluate Goal: Structured observations
Evaluation Schedule: By June, 2010
Primary Responsibility: Speech/ Language Therapist

21. Start Again