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Early Intervention Speech Therapy

Back in the Swing

Published January 18, 2010 3:44 PM by Stephanie Bruno-Dowling
I would like to take a moment to thank all of you who commented on my last post A New Adventure Begins. Thank you for your prayers and kind words. It is so nice to hear your voices echoing on the blog the same situations and experiences as my own. It is reassuring to know that I am not alone, although I truly know that I am not which is why I thought it was important to write the post.

As I read through the comments, I once again know how blessed I am to have both a family and a career. As one therapist, Pamela wrote, "It's a great life!"

Now, I'd like to continue the practice of answering reader questions frequently on the blog. The following question was submitted recently:

I have two kids on my caseload with similar issues:  used to have 10-15 words, but have lost them.  Now use mostly babble and do not tolerate solid foods well, either gag or can not chew them and form a bolus.  They are both active, engaging little people and a puzzle for me, because the parents say they were talking and now are not.  I do not believe it is autism.  One of these children has had two surgeries this summer with anesthesia and intubated for 8 days; the other has had no significant events. Any ideas?

I found this question to be particularly interesting and puzzling, which is why I wanted to share it with readers. I usually do not see children have 10-15 words and then lose them completely. The few times I have seen this, either the child had experienced some sort of medical trauma (i.e. a severe seizure, a TBI, etc) or the child was showing signs of autism. My guess is that the child who had two surgeries and was intubated for 8 days may have suffered some trauma that negatively impacted his/her speech and language. I am curious what type of surgery was performed.

Regarding the other situation, the therapist reports that the child is "engaging" which makes me think that autism may not be the culprit. I am wondering if something else is as play. Are other areas of development being affected?  Has the child regressed in the areas of fine and/or gross motor? Are there other important characteristics and/or behaviors being displayed? Has anything else significant happened in the child's life that would affect their growth and development - the birth of a sibling? Moving to a new home? Parents separated or divorced? 

Have other readers seen situations such as this? Please weigh in with your thoughts and questions.


Let us take a moment to pray for all the people suffering in Haiti. May they find peace, safety and healing soon in the days and months to come.


You have a great undergrad major to evalluenty go into SLP master's programs. You do have some things to consider, however:- You do have to take undergrad courses BEFORE you begin the actually master's curriculum. This is called leveling and it varies by university. Some universities do not level, they only accept those with a background in communication disorders. My university is one like this. At ours, we have a fast track program where you take all of your undergrad major courses in one year and then apply to the master's program the next   instead of taking four years for the undergrad + grad coursework, it takes three. Every university is different. These courses are required as part of ASHA certification.-As I am sure you are aware, you must take the GRE. I recommend, personally, to get 1000+ on it. I know a girl who had around 700 and she got in to one school, but she also had a 4.0-Grades are crazy. I have a 3.83 and I was on waitlists.-EXPERIENCE! If you have volunteer, personal, work experience with the populations you would evalluenty be working with, let it shine!

David David, HMBjcEGOUvkzsTvXGx - ViDcMrTFLeaJj, NjqWjwAcGDtUySQMni May 2, 2012 5:21 AM
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I agree with the previous comments and wanted to add another possibility - Rett Syndrome - as with autism, children with Rett's (more girls than boys) have skills (motor, language) up to a certain point in toddlerhood, and then regress.

Pamela, Pediatrics - Speech-Language Pathologist, Elementary School January 22, 2010 12:54 PM
Milton NH

Unless the SLP has extensive experience in multidisciplinary autism assessment, she should not assume that these children do not have an autism spectrum disorder.  She says that they are "engaging", which presumably means that she finds them engaging, but does not mention whether they use eye gaze, joint reference, or initiation of social engagement themselves.  There are also other diagnoses possible in young children that can cause regression.  It is always a good idea to make a referral to a professional who is experienced in making a differential diagnosis, whenever there are signs of regression.

Victoria Morrison, , Supervisor of Speech-Language Pathology and Early Lexington Center January 22, 2010 10:59 AM
Johnstown NY

This is quite an interesting question!  I'm curious: is it that both children cannot form a bolus and eat properly, or just the one who was intubated?  Has their hearing been checked? What is the general age range for these children (I'm presuming this is in an EI setting?)  And more info about the social/emotional background on each would also be helpful!%0d%0a%0d%0aThanks for posting this question.

Kristina Curro, Speech Pathologist January 22, 2010 6:45 AM

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About this Blog

    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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