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You are here: Experts > Kids > Health for Kids > Pediatrics > 5 year old scored 80th percentile, does she need speech therapy
Pediatrics - 5 year old scored 80th percentile, does she need speech therapy
Expert: Sharon Rosen Lopez - 10/27/2009
Question
Hi, My daughter is the youngest of 3 and has been going to preschool and is now in Kindergarten. None of her sisters had any kind of speech delay, but Terri does. She pronounces all R's and L's at the beginning and middle of words as W's and sometimes at the end of the word. Also the TH sound she pronounces as an F.
I have always pronounced the words for her correctly and now based on the suggestion of the school speech therapist I have been working with her on specific words and sounds, however as a result she is now over exaggerating the L sound which starts as an L.. but eventually ends up as a W anyway. AND, she is now confusing the R and L.
I took her to be evaluated and they recommended therapy, I wrote a letter to teh school and they evaluated her and said she scored 80th percent overall and since she was only 5 they wanted to "keep an eye on her" That's when the speech therapist sent me home the print outs to work with her.
I can't afford a private speech therapist and I feel like the school may be kind of pushing me off because her problem isn't terrible... but I gotta tell you, there are times that I can't under stand what she is saying.. and I'm her mother.
I wonder what if anything I can do to get her the help she needs at school? Is 80th percentile really ok? Should I just sit back and wait like the school said and see if she "gets it"?
Any advice would be greatly appreciated!
Answer
Hi Wanda,
Thanks for your thorough description of your daughter's speech difficulties. I'm glad to hear that you took Terri for an evaluation, though dismayed to learn that speech therapy was recommended and that your daughter's school is delaying provision of services! I do understand that schools are inundated with children who appear to have more significant needs than 'just speech articulation,' however the fact that you yourself have trouble understanding your daughter speaks much louder to me than her 80th percentile score on an articulation test! It is usually a child's parents who best understand their child's speech, and I can only imagine that your daughter's speech intelligibility must be even more impaired to a naive listener.
The sounds that your daughter is having difficulty with are later developing sounds and you'll see experts indicate that acquisition of those sounds variably occurs between the ages of 4 1/2 and 8 years. In my school district, speech therapists will delay working with children on the R sound until they are atleast 6 and more often 7 years. Of the three sounds your daughter is having trouble with, the 'th' would be the sound to work on first, as the L and R share features that do cause some children to confuse them and hence make them more difficult to learn. The TH is also typically the earliest acquired of the 3 sounds in question. You'd want to work on the soft TH sound -- as in 'think, thing, thumb, thick, thin, etc,-- first, and once those 'soft TH' sounds are acquired, the 'hard TH' sounds -- this, that, the, then, these, those, them, there, etc. There is a slow and scaffolded progression in speech therapy -- success at more difficult levels builds on success at simpler levels, and to help your daughter learn, it's important that this progression be honored. That means that you'd work first on getting your daughter to protrude her tongue just slightly between her teeth, get her to be able to perform that tongue movement/positioning quickly and easily, then have her say the 'th' sound by itself, again work to getting that sound produced quickly and easily, and then have your daughter imitatively say the 'th' at the beginning of words, (include lots of repetition!). Only after she's easily able to do these tasks will you ask her to imitatively say the words within 2- word combinations -- I think, one thing, my thumb...etc, and then she'll want to imitatively say longer sentences with these words. Once that's achieved, have your daughter make up her own sentences with these words, and start to remind her at home to use the 'th' sound that she's able to easily produce in her practice sessions with you. Once she's been successful with these, you can start to work on her saying the 'soft TH' at the end of words -- with, birth, path, math, breath, death, etc -- again, using a stepwise process. And after she's able to do these, then try some words with 'th' in the middle -- birthday, bathroom, without, etc. Also, although you're working on articulation of the 'soft th', you'll want to include some discrimination tasks during your training with her --even from the beginning -- so that she's 'listening' for 'th' vs. 'f' sounds. So during your practice sessions, have a speech discrimination activity -- you can have Terri put a penny in a cup every time you say 'fink' instead of 'think', or 'fum' instead of 'thumb.' Once you see that your daughter has successfully 'gotten' this 'soft TH' in her speech, you can start working on the 'hard TH' sound.
All of this said, it is difficult for parents to know just what to do to help their children learn to articulate sounds, and how to troubleshoot a child's difficulties as they come up in practice. Are you able to contest the delayed provision of services? I am all for parents assisting with speech therapy intervention, and in fact, I routinely enlist parent carry-over of the work that a child does with me in my office. I give parents very specific instructions, and only give a home exercise program for reinforcing speech skills that were successfully performed during the speech session. Reinforcing success is key during speech therapy! Your mention of the snafus you're encountering with your daughter's exaggerated L- productions which then morphs into a W, and her confusion of R and L suggest that she needs professional intervention! One other thing I should mention is that if Terri is showing any signs of frustration at having difficulty being understood, that should definitely be mentioned to the school speech therapist. Typically, schools will reconsider service provision when a child is evidencing an emotional response to a speech difficulty.
I hope this note is helpful! Best of luck with helping Terri's speech improve!
Sharon Rosen Lopez, MA, CCC-SLP
Speech/Language Pathologist
http://www.SpeechSkillsForKids.com
http://www.SpeechArts.com
Westchester County, NY
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