How To Address A Speech/Cognitive Delay ?

[blandino]

I would like to know how exactly you approach talking to parents about a possible developmental delay. Better yet, what do I say.

I have only had one other time where I had to talk to a parent, and it didn't go over so well. Gave notice, and when I called her to tell her my concerns that night - the next day she paid out the two weeks and didn't bring him back. I was very professional and kind when speaking to her, but it still went poorly.

I have a 2.5 yo DCB whose speech is very limited. He can attempt to imitate words, but they aren't anywhere near clear. You can tell the intent is there, and the syllables can be on cue - but it isn't clear what the word you are asking him to repeat if you didn't already know what he was trying to say. For example (changing name for this example, but it is still an accurate depiction).

Let's say his name is Lou

Me: Who is this ? .... pointing to him
DCB: La La

At 2.5 he cannot tell you his name or age. If you ask him, you get rambling that usually amounts to "mommy - daddy". He can say his friend's at daycare names - but there is very little meaningful spontaneous speech.

I know you can't judge children against each other, but my other DCG who is 20 days older speaks in full, meaningful, descriptive sentences. My 24 month old is combining 2 & 3 words, and my two 19 month olds have already have clearer speech than he does. His mother is an elementary school teacher, but doesn't seem to notice - or doesn't want to acknowledge that there is a problem .

I am very nervous about approaching her, however - at this point the problem is so severe - I feel like I have a duty to speak to her while he is still eligible for early intervention.

[nanglgrl]

I just had to do this with a family. Dad is a teacher so the situation is similar (although my child also has problems with feeding). The child is new to my care and I was doubting my gut instincts until my friend stopped by and within 5 minutes of meeting him she asked if he was autistic (her son is autistic). I called Child Care Resource and Referral and they sent me and the parents a checklist to fill out for Early Access. I also went to the CDC website and ordered some free materials about developmental milestones.

I approached the parents by saying a lot of great stuff and then mentioning that I have concerns about his speech and problems feeding himself and eating. I pretty much said, "There may be absolutely nothing to be concerned about, he could grow out of these things and in 6 months we could be laughing about all this. If there is something that does need a little extra attention though the best thing we can do is catch it and act on it early. Early Access is free and only works with children 3 and under, they can even come to my home during daycare hours and provide therapy and show me how to work with him. I have a packet of information for you and a survey that you can send in to Early Access if you are interested."
I was scared and nervous but it went well. Mom filled out the survey that night and sent it in and now we are waiting to hear back.

[Blackcat31]

Me: Say Janice, I was wondering if I could talk to you a bit about Lou's development? I've notice he is not at the same level with his speech as some of the other kids his same age. I was wondering if this is something you have noticed as well or have possibly discussed with your pediatrician?

DCM: No, I haven't noticed, but I will definitely bring it up on Lou's next well child check.

Me: I can make a list of areas where I have noticed he struggles and give it to you so you and your pediatrician can go over it. If you have any other questions, please let me know. I am not an expert by any means but I do have lots of experience with kids so hopefully this is something that is easily addressed.

That was a recent conversation I had with a DCM in regards to her 2 yr old who doesn't say anything. ever.

[Bookworm]

I had a similar situation last year. My Director and I talked to a DCM about 4yr old DCG's speech and motor skill issues (gross and fine). It didn't go we'll. we were accused of picking on DCG and not liking her. Mom said were looking for any excuse to kick DCG out. She pulled DCG immediately. Flash forward to a week ago when DCG's grandmother came in to thank us for our concern. DCG had been evaluated by the school for 4-K and they addressed most of the concerns we tried to talk to mom about with a few more issues we didn't even think about. Grandma said mom is still in denial and refuses to believe DCG has some issues. She was told that DCG would qualify for the program but she won't let her go because she doesn't want her labeled as "special needs". I hope it goes well for you. Situations like these seem like a "damned if you do, damned if you don't. If you do address it with parents some get mad and accuse you of labeling their child. If you don't, then one day down the road when they do find out that there is an issue that could've been helped earlier, they question you about why you didn't tell them their DCK had some issues.

[spud912]

I am going to be the odd man out and say that I personally do not put much emphasis on speech until the child is three. I have had many children in my care who were not good speakers while in their 2's and are now perfectly normal older children (gosh and now they don't STOP talking :.

I would suggest giving a time limit and work really hard on improving speech in that time period. For example, give yourself 3 months to work on his speech, read a lot of books, talk to the child a lot, interact and engage the child in proper pronunciation. If there is little or no improvement after three months, then bring it up to the parents.