Monday, November 9, 2009

What should I do if my charge's speech or language appears to be delayed?

Have You Worked with Children with Speech or Language Delays?

Last week we began discussing speech and language development in children. The discussion included baby sign language and Dunstan Baby Language. We also reviewed the book How to Talk to Your Baby by Dorothy Dougherty.

Today we start the most difficult discussion of all -- what if the child you care for has a delayed speech or language development?

The biggest hurdle for a nanny or au pair that believes a child in their care has delayed speech or language development is talking about the topic with the parents. The best scenario is when the parents will already recognize their child's speech is delayed and be willing to tell their caregiver how she can help. The worst scenario would be that the parents become offended or defensive if you bring up the topic. Sometimes the parents simply aren't aware of the speech or language delays. They believe their child is a late bloomer and not delayed in development.

If you are concerned that the parents are unaware of the problem you need to find an appropriate time and manner to talk to the parents about your concerns. Prepare what you want to say. Be sure to reference the November, 2009 Be the Best Nanny Newsletter which lists typical speech and language development milestones in children.

Present the facts and your concerns in a professional and respectful manner. Approach the parents with love and concern for their child, but do not become too emotional. Bring it to the attention of the parents at a time when neither of you is tired. Talk in a polite and helpful manner. Don't blame the parents, instead phrase your comments positively and ask for the parent's help and advice. It will also be easier for the parents to accept your comments if they know that you see their child's good points too. The worst reaction would be to sound aggressive or defensive during the conversation.

Hopefully, the parents will speak to the family doctor. The doctor may decide to refer the parents and child to a speech-language pathologist. A speech-language pathologist is a health professional trained to evaluate and treat people who have speech, language, voice, or swallowing disorders, or hearing impairment that affect their ability to communicate.

The speech-language pathologist will talk to the parents about their child's communication and general development. The pathologist can perform speech and language tests. A hearing test is often included in the evaluation because a hearing problem can affect speech and language development.

Depending upon the test results, the speech-language pathologist may suggest activities for home to stimulate speech and language development. Nannies and au pairs can help perform these activities which may include reading to the child regularly; speaking in short sentences using simple words so that the child can successfully imitate you; or repeating what the child says, using correct grammar or pronunciation. For example, if your child says, "Ball baybo" you can respond with, "Yes, the ball is under the table." This allows you to demonstrate more accurate speech and language without actually "correcting" the child which can eventually make speaking unpleasant for him or her.

The speech-language pathologist may also recommend group or individual therapy or suggest further evaluation by other health professionals such as an audiologist, a health care professional who is trained to identify and measure hearing loss, or a developmental psychologist.

Whenever you suspect a child in your care may be delayed in development you should share your concerns with the parents. Take the time to prepare what you will say. Always speak to the parents in a professional and respectful manner to ensure the child is receiving the best care available.

Have you worked with children with speech or language delays? How was the child treated? How did you talk about it with the parents?

6 comments:

Anonymous said...

The worst case happened with me. A boy I used to care for had many development delays not only language and speech issues. The mother literally yelled at me. She got very angry and defensive. I do not regret bringing the topic up because it was the right thing to do but I never spoke up again. It took public school before mom listened to teachers, doctors, and me and probably family. She fought with the kindergarten teacher too but eventually I think testing forced her to finally listen. Terrible because kids need intervention early but mother would not allow it. Please understand why I can't post my name wouldn't want to hurt family in any way.

Anonymous said...

The girl used to have poor muscle tone and still has some speech issues in school. The regular speech therapist really has helped.
Lisa F. Portland

Anonymous said...

I have history with two families where there were speech issues.

The first was a summer part time temp assignment where the little boy did need to do exercises at home to help him, I didn't know about this until the job was almost finished. MB was always to busy to ever share this with me and other caregivers.

The second one was a preschool age boy with a stutter, DB did take him in for testing, etc. and they gave him advice sheets on how to help the child, coach him, etc.

What I got from these experiences is how hard it is to be in an environment where the parents aren't on board with what needs to be done because they have other priorities.

When things like this happen in any type of situation where there is a developmental delay and parents are in denial, I have learned to research the issue online and get information on what I can do for my charges to the best of my ability while they are in my care.

Lisa W., DC

Anonymous said...

It is difficult to tell parents anything about developmental problems in their children. I wouldn't sound preachy. Just kind of mention it slowly a little bit at a time. If you schedule a meeting it will be too formal and so informal working as a nanny. you know?

Always best to get professional intervention for these types of matters. The more you can help the parents see that the better.

Anonymous said...

I think there is usually more than one problem. With kids I work with seems speech or language delay comes alongside other developmental issues. Autism at times, mine were major hyperactive and A.D.D. so parents have a lot more to hear then kid is failing in speech, etc. Much more complicated then just speech delays at least with my kids that I work with.

Anonymous said...

Honestly the parents hired a really bad speech therapist who arrived late and left early. She would leave homework to do but I didn't see an improvement in the girl I was a nanny for. I think she had more developmental issues than just her lack of speaking. Very frustrating for me I left the job and moved on to healthier kids.