A common experience for preemies is speech delay. My preemie is no exception. By the time he was 2 and a half it was really evident that he was getting further and further behind other children his age.

Speech delay is thought to happen because a premature baby’s brain hasn’t developed enough when they are born. Preemies are vulnerable as the part of the brain that deals with processing the complexities of language is susceptible to damage. This can then impact their communication skills later when they are growing up.

At 25 weeks gestation baby’s ears are formed and their brain’s auditory system will have developed enough to be functional. It will continue to develop until baby is five to six months old. There are a very limited number of studies however into the workings of the brain of premature babies. It is agreed though that there are several things that can be done to help.

My experience

My little boy is in 2 different childcare settings. He has been with a childminder ever since I returned to work. Later I introduced 2 mornings a week in nursery. This is so he can experience a school like setting and has the opportunity to mix with other children. Both the childminder and the nursery are required by Ofsted to carry out assessments.

Child colouring at the table. Photography credit: Pan Xiaozhen
Child colouring at the table. Photography credit: Pan Xiaozhen

Every assessment my little boy had showed he was behind with speech, communication and understanding. The first few assessments I didn’t worry as I knew his prematurity would be a contributing factor to his speech delay. I felt as long as we were all aware we would try and help him as much as possible and not get frustrated with him when he wasn’t understanding us. It turned out though that he was getting frustrated at not being understood.

My little boy is still under the care of a community paediatric nurse so I asked what she would recommend. It turned out there was a class she could put in a referral for him to attend. There was a waiting list so it took a few months. In the mean time the nursery and childminder worked with me on a plan to help support my son. He had extra one-to-one time with staff at nursery and his childminder introduced flash card games which were a huge hit!

Speech therapy classes

In actual fact the class was described as a pre-speech therapy class. My son was assessed by a speech language specialist at home. I had to stay quiet while the specialist played several different games with my son. The games were all designed so she could see what my son’s language and communication skills were like. The result of the assessment was that he did have speech delay and was offered a place on the 6 week course.

Young girl blowing bubbles. Photography credit: Trust Tru Katsande
Young girl blowing bubbles. Photography credit: Trust Tru Katsande

Every Tuesday morning I came out of work and took my son to his class. The class had a set programme of doing a game, a nursery rhyme, colouring, wash hands, snack time, nursery rhyme, bubble blowing and then collecting their homework packs for the week. Each activity was designed to give the children choices such as “would you like to colour the boat or the crocodile?”

Continuing the work after class

We would continue to do these activities at home. In the car I switch off the radio and we sing nursery rhymes. I bought a large bottle of bubble mix and keep refilling smaller bottles. It has taken a while but just recently my son has become quite good at blowing bubbles. This is supposed to be quite difficult for children to do but the muscles used to blow bubbles really help with speech. I have also increased bedtime stories at bed time. I also realised how much my little boy loves to take the book at the end of the story and retell the whole story back to me. Over the weeks it has really showed the how far he has come along.

He still hasn’t caught up with other children his age but we are getting there. After speaking to his childminder and nursery they still felt he would benefit from more speech therapy.

Speech therapy during lockdown

My son was all signed up to attend one to one speech therapy and then lockdown was enforced. I got a phone call to say that the appointment would be over the phone instead. I had been sent a questionnaire which I had already filled out (if I don’t do it when it’s in front of me it won’t be done until the very last minute!). Once the therapist had some more background information we talked about a plan going forward.

A child playing with cars. Photography credit: Sandy Millar
A child playing with cars. Photography credit: Sandy Millar

Because of lockdown the therapist really relied on my judgement as she couldn’t see my little boy’s reactions for herself. She gave me lots of ideas and sent a few games in the post for us to play. One of the games is a picture of a bus and then lots of pictures of a different toys that might get on the bus. Each toy has a big and little version e.g. big teddy, little teddy, big dolly, little dolly. The idea of the game is for my little boy to identify the correct toy and to get an understanding of which is big and which is small.

I was given some great tips

I was also given lots of tips. Bubble blowing is a firm favourite of speech therapists, so is nursery rhymes and giving choices such as would you like the green cup or the yellow cup. The other advice was to describe everyday things more often – can you put the green square cushion on the sofa? I was also reminded to get my son to look at me when pronouncing words he couldn’t say so he could see how my mouth moves. This is so simple but something I would forget when I got busy doing other jobs.

This therapist also like a technique called sabotage. It sounds harsh but it can be a fun game. You put a toy that they like just out of reach and when they want it you pretend to not know what it is. this encourages them to try and find the word to say what they want. Or you can try putting socks on your head like a hat. The key is to make it fun and if you can see they are getting frustrated then help them and try again later.

Helpful links

NHS advice on helping your child with speech

Great Ormond Street Hospital advice on speech delay

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