Seen and not heard?

Seen and not heard? – Speech and language delayed children

Youngest of four, Auckland toddler Ruby Kinloch McQuaid didn’t say much. Others spoke for her - her siblings and then the well-intentioned people who assured her mother, Theresa, Ruby would talk when she needed to. She had her doubts.

After a round of hearing tests and a paediatric assessment, Ruby was given the all clear, and Theresa was advised to “wait and see”.

But like the estimated 87,000 New Zealand children under the age of 15 who have a speech and language delay, Ruby’s unclear speech and limited vocabulary did not improve spontaneously.

At age three, Ruby was assessed by a private speech language therapist and began intensive therapy.

She’s one of the lucky ones. Left unchecked, children with speech and language delays miss out. It’s a spiral that begins in the crucial formative years when a toddler’s communication difficulties isolate him or her, and moves through emotional and learning difficulties, to possible behavioral maladjustment.

“Children with speech and language delays are four to five times more likely to have reading and spelling difficulties,” said Gail Gillon, Associate Professor at the University of Canterbury’s Department of Communication Disorders. “The secondary consequences are huge.”

From reading recovery to health and youth offending, there is an established relationship between communication difficulties, reading and learning difficulties, and emotional, social and behavioural difficulties. The individual and social cost is high.

Stella Ward, President of the New Zealand Speech Therapists’ Association and an experienced paediatric clinician, says the message is simple: get advice and get it early.

“Parents shouldn’t feel uncomfortable about seeking advice. If there’s a doubt or concern, act on it,” Ms Ward said.

Most speech and language delays improve dramatically with intensive, early intervention by age two or two and a half. Often, the remedy is a modeling strategy that parents can use in the home.

“Children need quality, positive language interactions with adults,” Ms Ward said. “One hour spread over a day of quality, concentrated interaction should be enough to acquire language in a normal developmental context.

“But some children are not getting concentrated speech and language stimulation when they are young, or there’s a family history of speech, language or reading delay that may place a child at risk.”

Premature babies and infants with hearing loss or impairments are most at risk of speech and language delays. Delays can also be caused by congenital disorders, cleft palate, and neurological damage. And many children have unexpected speech and language impairments, where an obvious cause cannot be determined.

Speech and language delays can take on many guises. Some children may have unintelligible speech, others can pronounce words well, but are unable to combine two or more words together, and others may speak well, but have difficulty following directions.

“If you thought your child had difficulties seeing or hearing, you’d check it out, so why not do the same with speaking?” said Lucy McConnell, Speech Language Therapist and Senior Tutor at Auckland University’s Listening and Language Clinic.

Ruby’s mother agrees. “I strongly believe that as parents we know our children and we know if something is wrong, although it can take time to realize and accept it.

“I wish I’d done something sooner.”

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New Zealand Speech Therapists’ Association Awareness Day, Friday 18 August

The theme is speech and language delayed children.

The New Zealand Speech language Therapists’ Association (NZSTA) has more than 400 practicing members.

Most Speech Language Therapists (SLTs) practice in health or education. Increasingly, SLTs are moving into private practice.

New Zealand has a shortage of SLTs.

The NZSTA provides professional support and advocacy services for SLTs, including academic programme accreditation and professional regulation.

The NZSTA has a Health Practitioners Competency Assurance Act registration submission before the Government, and is pushing for urgency given the shortage of SLTs in New Zealand.

SLT is a four-year undergraduate degree, or two-year postgraduate degree.

There is a need for more research and understanding of SLT in the New Zealand context.

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