Curious Case of Speech Delay | www.AgentsofSpeech.com
Ming discusses speech delays with sensory components, explaining why occupational therapy assessment matters before speech therapy. He walks through practical examples like swinging and oral sensory work, arguing sensory regulation often needs to come first.
Chapters
Hello guys. Welcome to another Monday live back at home. Now last week I was at a different city teaching some children, getting no to getting know some of the therapists there, working with them as today. I was trying to write. I wasn't trying, I was writing down the notes of what I've seen and learned and still consolidating my, my thoughts about the children I've seen. Gonna send it to the therapist so that they can have a little bit concrete of what I've said, a little bit of record of what my thoughts are for each kid. And I wanted to share with you some stuff that I learned over at that city. So basically it's quite a. There are quite a few curious cases. So the only cases, like only people who wanted to see me were rather difficult cases. And that's because number one, it's actually, you know, like no one wants to see a foreigner unless they, if they already know a bunch of stuff, they know what to do, so on and so forth. So them having someone to come over and check out this kind of stuff, obviously it takes money and it takes time, right? So what I mean is this, there are a few curious cases I want to share with you more. I've written an email today and I'm going to write even more emails about the cases I've seen and describe what I learned there. So if you haven't, go to agents of Speech.com, you can sign up for a newsletter there. You can subscribe unsubscribe anytime. It's free. Okay. Just go there and check it out if you want to. All right, so what I want to talk about today is a curious case of speech lake. So the speech delay, as you would say, or language delay, speech disorder, whatever, is quite, you know, like there are things that are very, very common. Such as, oh, like today I did a consultation with a mother from Singapore. She's like, okay, my kid can count to 1 to 10, knows A to Z, knows like all the color, shapes and whatever, but just still pulls my hand, whatever, right? That stuff, we already have it covered in our micro course. So if you go there like agentsofspeech.com micro, you'll be able to see the course there. I don't want to spend time talking about it because a lot of people have joined already over 2000. So I'm pretty happy about that. And there are cases other than that which are curious cases which are like no one can put a finger on it. So there are times where I don't know the reason I just tell parents, hey, man, I really don't know, okay? I've seen enough children that I know that this one is a little bit different than what I'm used to, right? So sometimes it's rather difficult to put a finger on what's wrong, what's going on with the kid. And basically, that child was, if you ask him to do something, he can do it. Sometimes it's not like he's unmotivated or whatever. It's just that when you tell him to do something, you just do it. Whatever. He's just, here we go. But right. When you tell him to say something, he will say it, but only just. He's just like, imitating. He's like a parrot, which is something I'm used to, right? But at the same time, if you ask him a question, he will say the correct category of things. Like, for instance, like, if you ask, what is this? And I hold a banana, he will say banana, right? Sometimes it's correct, Sometimes I change it into orange. And he asks, what's that? As an assessment task, right? He will also say banana. And if you keep on changing it, he just. Sometimes he gets it, sometimes it doesn't. It's very on, off. And it's like, there's no error pattern. Like, you don't even know what's going on. So I've been working with this family, like, on and off. I've seen them the first time I went to the city. This is the first time I've seen. Seen them in person and, like, really, really engaging with the kid and assessing him. So my thoughts are like, hey, man, this is something that we've tried before. I've worked with a therapist before to work on his articulation. But the more we worked on his articulation, what happened was that he started to stutter, according to the therapist. So we really don't know what's going on. And a lot of times, if your child is of this kind of curious cases, that is rather difficult for us to know what's going on if something doesn't work. But so what I told the parents is like, hey, this doesn't work. What we're doing doesn't work. Let's not do it anymore, okay? Let's stop this. Because the worst thing is that if something is happening is like, if something isn't working and we keep on doing it, that's just stupid, and I hate it. And I'd rather be, like, totally upfront with the kid and the parents and say, hey, I'm not doing a good job. I don't know what's going on with this kid. I don't. Not sure if he's ready to have therapy with me or, or I'm ready to keep on doing the same thing. And I don't know if it's going to work or not. I do not know a better way when this happens, which isn't very often. I would say like, isn't because I'm, I'm a really good therapist or whatever. It's just that most cases are manageable in a way that, oh, once you get the momentum and get them to behave well, listen to you and get in the groove of like just hanging out and, and working with you, chances are it's pretty easy to teach anything. But if you're talking about a kid who like, you ask them something, they process nothing and then they just repeat after you and no matter what you try to do, it doesn't work and it gets pretty frustrating for all parties, right? So sometimes speech delay and I'm like, everything is an educated guess, right? We cannot, a lot of stuff is speculation, okay? There are some things that we can, we can prove such as their, their language skills, right? Their speech skills, their behaviors. Those are provable things that we can mark and observe in real life and say, okay, this happened. Right? But there are some things that I don't know and it's going to be an educated guess, all right. Which is outside of my professional scope. So some speech delay or speech disorder cases or langstulate, whatever kind of stuff you're talking about has a sensory component to it. Okay. And what a sensory component means is that a kid is always sense like either seeking or avoiding sensory. Usually they're seeking. Well, when they're seeking, it doesn't mean that they're like deprived of sensory or they're over sensitive is usually a mix of a bunch. So who can do this for you? An occupational therapist? I am. No, I don't know much about this stuff. So. You know, I took a master's in speech therapy. I know a bit of it, quite a bit of it. Not, not like everything obviously. But at the same time I believe that the child I was describing just now required occupational therapist. And why I say this is because like obviously they already went to occupational therapist, right? They already checked out everything. But at the same time, you know, we're talking about that we are situated in Indonesia, but not saying that here. I need to put a lot of caveats nowadays, you know, gotta try to be a little more Correct, politically correct, so that people don't get me the wrong way. But what I mean is, like, we gotta get someone who is a little more specialized to take a look at that case. Because, truth be told, I'm not sure if it really is a sensory thing. I'm guessing. Right. Second of all is that, you know, like, if I try to stop him from, like, seeking sensory, he actually gets quite pissed off. I don't see this quite so often. You know, sometimes children can hold it off before we finish a task or after we learn, but that guy couldn't. He's always under a chair. He's always trying to get into, like, small, small places. He's always trying to, you know, always trying to hide under something. Right? He likes to be under something. So that's sensory seeking in my books, right? So that's something I wanted him to be checked out from OT and to have a more. What we call, like people call holistic, right? It's not really like, yeah, it is holistic, but at the same time, it's something that I cannot, like, assess. I don't know about it. So I would much rather someone do it for me, like someone who is more professional to know about that. So there are a lot of cases like this. So how does this relate to you, you might ask? Well, the first thing is, you got to remember is that all these speech cases, if they're like, they're having, like they're on the spectrum, right? For instance, there must be a sensory component to it, all right? Your child has some sort of sensory need that needs to or should be fulfilled in some way, shape or form. Okay? That's number one. If they're on the spectrum. And if they have some sort of speech disorder, most probably they have some sort of sensory needs, okay? And you have to check it out from a occupational therapist. And the. The second question you might ask, okay, so they. They might have something like that. Can't you do something about it? Like, if they're not sensitive around the mouth, then why don't they, like. Then why don't they talk? Right. Or why do they not communicate well? Well, the answer is because if someone has a sensory need that it's not fulfilled, the whole body and the whole person cannot function. Well, so let me give you an example, right? So I have a kid, I had a child, I had a student who had a sensory need of, you know, like, bouncing around, okay? So if it doesn't, like, I don't know the exact name, probably proprioceptive, whatever the names that they give they. As an occupational therapist, I don't know anything of that. So he, like, he needs to bounce, right? He needs to jump up and down. He needs to be swinged and swayed or whatever. So after he has done his, like, his routine, he can now sit down. If he can't, if he hasn't, then his legs will start to move. He'll start flapping his hands. And when he's flapping his hand and like, just like his, his legs are jumpy, it's very difficult to get them to settle down to actually do work. All right? That's why usually if you're at a center, we schedule the OT before the st. So that they get all of this out of the system. And when they can sit down, we can work on some language stuff or speech stuff, right? So it's the same as you and I. If we are fidgety, we have something that we want to get out of our system. It's very difficult to fully concentrate, not to talk about toddler, you know, it's very difficult for them and not to talk about a toddler who cannot talk, who cannot say, hey, I want to do this first before doing this. Usually when there's a sensory need, they're already like very in a hurry, in a rush, they want to get to it. And then when that, like, when that happens, they usually get into a tantrum already. So the kid I was talking about is exactly that. If he doesn't get it right now for the sensory needs, he actually gets pissed off. All right? And he stay on the swing like they have a swing at home. They stay on it for a whole day non stop. Just non stop. So think about that. Every kid will want to get off the swing some way somehow, right? Some. Like, they cannot stay there forever. Yeah, you and I, we like swimming, but one day we want to like to stop. Like at a student who was a girl, she loved swimming so much, she could swim for like hours on. And her skin started to just get really wrinkly and it became a problem. You know, there's different. Like tiptoeing is also a problem as well. It's a sensory problem too. I don't know this, this student, but it's also a girl. She had a tiptoeing issue. She's on a spectrum. And then she tiptoed so much that her bone structure changed and the, the legs couldn't come down. Like the feet, the ball of the feet couldn't. Couldn't touch the ground anymore because that's changed. Permanently. So all these sensory issues are real. All right, so if someone is like, let me say, if it was a girl, right, if she wanted to swim or she's swimming or she wants to swim, how do you get her to sit down with you to work and learn something? Nearly impossible. So sensory is something that you have to take a look into. It doesn't matter about. If they're not sensitive around the mouth. I don't get it. Like, why. Why is it a problem? Then you. You got the wrong idea. Okay. Also, on the other end, you might see a lot of oral massage or myofasio. That's what they call myofacial. I don't know. There are a lot of therapists out there, especially speech therapists, who. Sorry, that there's a mosquito. Sorry if I scared you. Anyways, there's a lot of speech. Speech therapists out there who do this kind of facial massage thing. And there are. There is therapy behind it. But I personally, I. I haven't learned about it. I haven't done it, so I'm not gonna talk about it here. Those are also to do with sensory. And why sensory is important. Because when you talk about moving, talking, doing something, it's called sensory. Motor. Sensory comes first and then motor. If you cannot feel, then you cannot move. Yeah. So if you guys been to a dentist, you guys had that. What's that called? Painkiller. After you get it, like, you remove your tooth, you can't really talk because you can't sense your mouth anymore. And it's the same as one of the students we have, that he couldn't sense where his tongue was going. Right. So therefore, when we asked him to do like. L sound like. Like that, he didn't know where to put the tongue, Right? So therefore, he goes like. Like that. So what we need to do was to establish the fact that. Hey, man, it's right here. And we rubbed it with, like, a piece of sponge just to let him know. And then slowly, as he, like, he understood. Oh, it's here. And he tries to, like, normalize his sensory. Because I've really aggravated it on the top. Not telling you to scrub it, right? Just lightly touch on it. And then as it gets a little ticklish, he'll. He'll go up top and try to touch it. And then that's when you tell him. That's right. That's where you should put the tongue. Okay. And it's always sensory and then motor. So that's why if your child has a sensory problem, you got to deal with it first before everything. So in my mind, before, because I started off as an APA therapist, I didn't think about this stuff. I thought like, sensory was only how to say it's not something that is like. Like it's gonna. It's not gonna break the whole therapy. Right? It's like partial to it. But now that I've seen, I've worked in this field for quite some time, I believe sensory is one of the most important things. And sensory dealing with it is something that sadly, I don't have a lot of experience in. But at the same time, learning about it and knowing this before going in is very important. So that's why if you're a parent watching this, you gotta check it out. All right, so this is my little live that I'm gonna do tonight. I have nothing else to say for now. I'm gonna write up more about it on email. So go to agents of Speech.com and sign up for email and also go there and check out the courses. If you haven't, then join one of them if it suits your child's needs. Okay, so that's it. I hope you have a blessed Christmas month, a holiday month. Looking forward to talking to you guys next week, Monday. And I know it's gonna. It's Christmas weekend this, this week. Let me know how I can help. If you guys need help, I'm always here. Just. Just email me or email is the best. PM is very difficult for me and that's probably it. I'll see you guys next week. And wishing you guys early Christmas. Bye bye. Early Merry Christmas. I mean, bye bye.
