First Parent Consult - Paed Speech Pathology

Date: 1 November 2024 Presenting Concerns Mrs. Thompson, mother of 4-year-old Leo, reports concerns regarding Leo's unclear speech and difficulty being understood by unfamiliar listeners. She notes he often gets frustrated when not understood and occasionally avoids speaking in larger groups. She is seeking guidance on how to support his speech development and improve his communication. Family background Leo lives at home with his mother (Mrs. Sarah Thompson), father (Mr. David Thompson), and older sister (Mia, aged 7). The family identifies as Caucasian Australian. English is the primary language spoken at home, though Mr. Thompson's parents occasionally speak Italian when visiting. There is a family history of speech sound difficulties on the maternal side, with Mrs. Thompson herself having received speech therapy as a child. Case History Pregnancy and birth: Full-term pregnancy, uncomplicated vaginal birth. No reported complications during the perinatal period. Developmental milestones including physical and speech: Leo met most physical milestones within typical ranges (e.g., walked independently at 13 months). Speech sounds were noted to be delayed, with first words appearing around 18 months and phrase speech emerging closer to 30 months. Feeding as infant and any feeding/eating current concerns: Leo was breastfed until 12 months. He has always been a somewhat picky eater but currently has no significant feeding or swallowing concerns. Educational context Leo attends 'Bright Start' childcare three days a week. His educators have expressed mild concerns about his ability to participate fully in group discussions due to his unclear speech, sometimes leading to him becoming withdrawn during circle time. Activities of daily living Sleep: Leo generally sleeps well, from 8 PM to 6 AM, with occasional night awakenings that resolve quickly. Extra-curricular activities: Leo attends weekly swimming lessons, which he enjoys. Overall regulation: Leo is generally a well-regulated child but can experience meltdowns when he is not understood, particularly when tired or overstimulated. These manifest as crying and mild tantrums, usually resolving with parental comfort. Health and Medical Any developmental diagnosis such as Autism, ADHD, Global Developmental Delay: No formal developmental diagnoses. Hearing concerns and testing: Hearing screening at birth was passed. A recent audiological assessment (6 months prior) indicated normal hearing bilaterally. Previous speech pathology intervention: No previous formal speech pathology intervention. Other health or medical professionals involved: Leo sees his general practitioner for routine check-ups. No other specialists are currently involved. Communication skills Pre-verbal skills such as play, interaction, vocalisations: As an infant, Leo engaged in typical babbling and joint attention. He enjoys imaginative play, interacting well with his sister and peers once comfortable. His vocalisations have progressed but his speech remains largely unintelligible to unfamiliar listeners. Current communication skills and concerns: Leo uses 4-5 word sentences but frequently omits or substitutes sounds (e.g., 'tat' for 'cat', 'poon' for 'spoon'). He can follow two-step directions. His expressive vocabulary appears age-appropriate, but his articulation significantly impacts intelligibility. Current academic/literacy concerns: N/A, as Leo is not yet in formal schooling. Interests Leo's play or special interests: Leo loves building with LEGOs, playing with toy cars, and enjoys reading picture books with his parents. Plan Plan as discussed with parent: Discussed initial assessment findings regarding Leo's speech sound difficulties. Recommended a comprehensive speech assessment to formally diagnose and identify specific error patterns. Parent agreed to proceed with booking the assessment. Provided initial strategies for encouraging clear speech at home and managing communication breakdowns. Scheduled a follow-up appointment for the full assessment and to discuss a therapy plan.