Wednesday, May 28, 2014

Speech Delay

Last week, I posted Naomi's 20 months old developmental milestones and in that post, I mentioned that my first born is currently experiencing a speech delay.

20 months old and now into playing with pencils and paper.

In early April, my husband and I brought Naomi to the government clinic where she normally has her routine health check-up and vaccination. During this visit, the health officer who handled Naomi thought that then 18 m/o Naomi was a sort of behind when it came to her speech development because toddlers at her age, by right, should be able to say few basic words including Papa and Mama. Naomi was not able to do so. She said Papa Mama without understanding what those words mean. She could say san (三) but the only word that she could say on purpose was : Bye-bye. Naomi could say bye-bye, wave goodbye and throw flying kisses when we were leaving one's house or parting with someone. Naomi could listen, dance and mimic the kids songs on TV but she could not really imitate the sound of the lyrics that the singer sang. Other developments were up to her age and sometimes, Naomi could follow our simple commands too.

Based on this scenario, the health officer suggested the both of us to see the practising doctor at the clinic that day. And we did.

The doctor ran a brief examination on Naomi's tongue and asked us some questions about how Naomi normally communicated with us, called us, asked for something, etc. Then, Naomi still talked or babbled her baby language and didn't begin to imitate and approximate any sounds that we say to her on daily basis. She also lost her interests on books when we read to her incredibly fast so it's difficult to teach her new words using baby books. Shortly after, the doctor told us that Naomi was likely to have isolated speech delay, which is generally nothing to worry about. She mentioned that the main causes of Naomi's speech delay were possibly the facts that:
  1. Naomi's presently so attached to her pacifier
  2. Naomi is our first and the only child in our family (no peers to talk to at home)
  3. My husband and I could be using too many different languages (Mandarin, English and Bahasa Indonesia) to Naomi, which could be confusing for her

Moving on, the doctor advised us to use just one language when we speak to Naomi and introduce one new word every week to build her vocabulary. On top of this, the doctor also suggested my husband and me to bring Naomi to the speech stimulation therapy at the government hospital near the clinic. Before we left the clinic, she wrote a reference letter for Naomi to see the speech therapist at the hospital but this was not an urgent notice so we could bring Naomi to the hospital any time we found the time to do so.

In the beginning, my husband and MIL thought that it was not necessary for Naomi to do any speech therapy because there are many kids in this world who are just not early talkers. They convinced me that Naomi would catch up and outgrow this speech "slowness" and somehow, one day she'd start talking in our language. We believe that each child is different and they have their own pace in meeting their developmental milestones. To us, Naomi is just more interested in physical things, which is true. Her physical developments are way more advanced than what the books say about the normal physical development milestones of kids at her age.

While I thought that it was harmless and perhaps better to just go to the speech therapy as early as possible and see how it goes, in the end I followed my husband's idea to postpone visiting the hospital. Why? Because my husband is very busy with his work on weekdays and I didn't want to go to the hospital alone as I can't handle Naomi in public area all by myself these days. In the meantime, I also told myself that probably it's good to give Naomi some time and observe how she progressed with her speech development when we're not seeing the speech therapist as yet.

Almost 2 months had gone by since we received the doctor's advice to see the speech therapist. In these two months, no new word has been mastered by our little girl despite our efforts in teaching her simple words, talking or singing to her more, only using 85%-90% Mandarin when we speak to her (Mandarin is not my first language and am more conversant in English), reading "First Words" books and building new vocabularies through flashcards. None works thus far. Naomi still babbles and talks using her baby language.

Naomi playing with the flashcards when she's bored with them.

Just recently, I shared with my husband that I began to be a little concerned about Naomi's speech delay. I think Naomi is way behind, about 6-7 months behind, her peers or toddlers slightly younger than her in her talking development area. Kids at 20 months old normally would begin to string two simple words together and form a sentence but this is not the case for Naomi. Well, at least that's what I noticed from my friends' and relative's toddlers around Naomi's age. Naomi still can't even talk our language yet nor imitate the sounds of our words. Only"Bye-bye" and san (三) to date. In addition, since I am still pregnant now, it's easier for me to go to the hospital for Naomi's speech therapy sessions. Things would certainly be more complicated once we have a newborn in the house.

This morning, finally my husband spared his busy time and brought us to the government hospital to meet Naomi's speech therapist. When we arrived to the hospital, we were directed to ENT (Ear, Nose and Throat) Department and after we took our number and queued, we saw the ENT specialist doctor there for Naomi's preliminary assessments. The doctor ran a brief check on both of Naomi's ears as well as questioned us about Naomi's birth and what she can do so far.

Soon, he told us to bring Naomi to the Audiology room for hearing assessment just to make sure that Naomi has no problem hearing, which could be the culprit of her speech delay. In the audiology room, the audiologist performed three hearing tests on Naomi. The first two tests involved putting earphones to her ears (I don't know what sound she heard) and the last test involved playing some sounds from "normal to soft" to find out how Naomi reacted to the source of the sound. Thankfully, Naomi's hearing assessment result came out normal. Naomi has no problem hearing.

Next, we were then asked to see the ENT doctor again and he informed us that Naomi could now proceed with making appointment to see the speech therapist.

A rather disappointing ending to our 3 hours' hospital visit today was the fact that the earliest appointment for Naomi to start speech therapy is early November! I was like "Are you kidding me?!" This is like 5 months from now and I would have just given birth to my second baby by November! But no, the therapy assistant was not joking. My husband asked for earlier dates than November but there was no more slots available. The therapist assistant then stressed that if my husband and I didn't take this November date, Naomi would have to see her speech therapist beginning next year.

That's all about the first treatment to Naomi's speech delay for today. I shall update more when the speech stimulation therapy takes place.

On second thought, I'll see how Naomi improves with her speech development in the coming months first. Should she be able to say few basic words, even they are not perfect, or begin imitating the words we say, we might as well let the speech therapy in November slide.

By the way, the first consultation at the government hospital here is waived. Moving forward, I think there would be small fee charged to the patients but I don't think it will be much.

P/S: Some mothers have been so kind in giving me advice and sharing their experience in handling their kids' speech delay. To read what these Moms had to say about toddler speech delay, hop to my Instagram account and Facebook page. You are most welcome to leave comments below this post too to share your thoughts about this matter. 

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