Just had a really depressing speech therapy session

[HumphreyCobblers]

with 2.6 year old ds. He wouldn't engage in any way with the therapist, he just kind of side stepped her and continued to do exactly what he was already planning to do. She said his lack of engagement was giving cause for concern.

I knew all that already really, but it really hits home when you hear a professional say it.

I had been feeling positive about his increasing speech (although still about a year behind) but I am totally floored by today. He really does not engage unless he wants to and his eye contact is minimal. He is very cuddly with his family and plays lots of games like hide and seek/peekaboo etc, will do the actions for songs and really enjoys reading but his non verbal communication is really not right

He gets hearing aids tomorrow, but his hearing loss is only mild and I can't see that as being responsible for his communication issues. Also I think he will rip the aids out, people keep suggesting bribery to me but he won't understand bribery so that makes me feel worse.

[GruffaloPants]

I'm a Speech Therapist (not with kids though). I'm surprised the SLT is concerned about your son not engaging. He's 2.5, s/he's a stranger. Most paediatric SLTs don't expect consistent engagement from preschoolers. Your SLT may have other reasons for saying this, but If not it is a little strange IMO.

Are you getting advice about what you can do at home/in your communication?

[GruffaloPants]

P.s. Even mild hearing loss can have a big impact on communication development. Will the hearing aid clinic give advice on getting him to use them? It may take time, but he will get there eventually.

[cestlavielife]

well she is saying she is concerned about ASD isnt she?
have you gone thru the CHAT checklist?

i would go straight for getting on a wait list for a full ASD assessment using the ADOS diagnostic schedule.it is a really good diagnostic tool. then you can get straight on to ASD support if it is relevant and if it isnt relvant you will know if it is not relevant.

how is his joint attention?

when you read a book with him, try closing your eyes and continuing to read...does he notice and push you and show you he notices your eyes being closed?
does he brings things to show you?
does he pretend a stick is a telephone and pretend to call you?
put a teddy and bowl and spoon on the table and say "teddy is hungry!" - does he feed the teddy?

[HumphreyCobblers]

Thank you so much for your kind response. I think she is probably going on what I say as well as her own observations. But it is nice to know that even mild hearing loss could have a big impact, hopefully the hearing aids will help.

I should be clear, I am not cross with the therapist, more distressed that a professional has confirmed what I already feared.

I have lots of information about what to do with him to encourage speech, one of my worries is actually that I had done my research about effective ways to promote communication with my first child, and I think I have been giving ds optimum language environment from early on - and he still doesn't speak much.

Thanks again, I really appreciate the input. I think all my worries about him have come to the fore today.

[cestlavielife]

sorry that sounds a bit harsh..but it is best to get the right support and it is far better to get into early interventions specialist ASD support if that is the issue.... my son got diagnosed via the ADOS age five and it would have been far better had he been diagnosed younger... there are specialist nurseries/units and groups etc with a diagnosis. the earlier you can get the right support the better... and if ADOS says actually no he doesnt meet the criteria then you are also a step ahead.

[cestlavielife]

www.hogrefe.co.uk/autism-diagnostic-observation-schedule-ados.html

[HumphreyCobblers]

hello cestlavielife, his joint attention is not bad as long as it is on his terms, he will read a book for ages and do songs on my lap over and over. But there is no point trying to engage him if he doesn't want it. His imaginative play is sporadic, he does pretend to phone and babble down it, he will pour a cup of tea and give it to me (when I ask) but mostly he likes cars/anything with wheels.

He seems to have no sensory issues and is advanced in his gross motor skills.

I have done online checks and he comes out as moderate risk for asd.

I think I am coming to terms with it today.

[HumphreyCobblers]

cross post, I didn't think you sounded harsh!

[Cakescakescakes]

He sounds very like my ASD son at that age. He is now five and has come on amazingly. It took a while to get my head round the fact that he might be autistic. I cried a lot. Even though in my heart of hearts I knew it was true from very early on. What I will say to you is that you are in the hardest part. Coming to terms with the possibility and getting the diagnosis was the worst year of my life. We are out the other side now and he is in a specialist school unit, sees an ASD speech therapist and is doing really well. I would suggest asking to be referred for ASD assessment. Your SALT should be able to refer. The waiting lists can be huge and if it turns out he doesn't have autism then nothing lost, but if he is autistic then you will be well on the way early and able to get the support he needs when it can have most impact.

I was you 3 years ago and I wish I could go back in time and give myself a hug. I'm not saying things are a bed of roses now but things are not the nightmare I imagined. But take time to process the thoughts. It's like a type of grief and it will pass.

[scandichick]

While I know nothing about ASD etc. and think you've been given good advice to push for early assessment, I just want to say that my non-speech delayed, assumed NT DD who also is 2.5 sounds almost exactly like your son. No way would she engage fully with someone she doesn't know, unless it's play on her terms. She also does a little bit of imaginative play, but prefers to play with her cars for hours. She does understand bribery, but only tge 'Get into the pram and you get a biscuit' variety.

Best of luck whatever happens!

[HumphreyCobblers]

Thank you all very much for your responses.

My older ds, who is NT at nine years was VERY similar in his refusal to engage except on him terms. I think this has confused things slightly from my perspective, as I just thought 'Oh, he is like his brother' about DS2. But the eye contact was there with my older ds and his speech was earlier to come, although I would say not fluent until way after three.

I think I will phone the therapist and ask if she will refer on.

I am not at all ignorant about ASD, my DH owns a company that specialises in helping adults with autism and I am training to be a SN teacher. It is an entirely different kettle of fish when you are on the other side of the desk, isn't it? I will remember this feeling at least it has given me some useful insight.

[Witchend]

Ds has glue ear and I've been told many times over the years that hearing loss can make a child behave similarly to a child on the AS spectrum.

However, I remember ds' speech therapy at that age. He had one who got down on the floor and played with him and if he said some of the words they wanted they were pleased. He worked well with that, they just noted what he said and took notes throughout, and occasionally encouraged him to say certain things.
Then we had one who wanted him to sit still in the chair and work through the book with her. So he refused to say anything, and she wrote a report saying he wasn't ready to access speech therapy. I also wrote a report requesting we didn't have her again, and thankfully, they adhered to that.

[PurpleAlerts]

Even mild hearing loss can have a big impact on communication development
Ds has glue ear and I've been told many times over the years that hearing loss can make a child behave similarly to a child on the AS spectrum

I can agree wholeheartedly with these comments. As a ToD with many years experience I have come across a number of young HI children who make poor eye contact and have delayed social skills. One little girl I work with recently has made huge progress since being aided- prior to this she had been in a special needs nursery where professionals suspected ASD. Her hearing loss had been missed and or deteriorated as a baby they thought she was ignoring everyone and it turned out she just couldn't hear.

I always tell parents that not being able to hear is only part of the problem for a child with a hearing loss- it's often the inability to overhear social language that can compound the problem.

I really would wait until he has settled with the hearing aids before you start to panic too much. Good luck!

[originalusernamefail]

for you OP. I know my son is different and not developing as he should but every time someone else remarks on it (esp professionals) I feel myself welling up. He is 2.8 and has one word (Me-ow ) and also has trouble engaging when he is not the instigator. We have just been referred for ASD assessment but have been told the wait is 6-9 months which is killing me as I first raised concerns a year ago at 18 months and I feel like the window for early intervention is slipping away. It's times like this I am soooo happy for MN my friends all have NT children so find my DS hard to understand and I definitely feel judged at times. One of my closest friends said to me "Communication is sooooo important we made special effort to encourage the girls" (both early talkers). I am so proud I managed not to lamp her!

[iwillnevereatspaghetti]

the hearing loss will make a huge impact, in terms of "switching on to speech". Any form of hearing loss will also mean that certain parts of speech are difficult to hear and therefore kids switch off. Get the hearing sorted as a first point of call.

[HumphreyCobblers]

thank you all I am so grateful for your input.

I am very glad we have the aids coming tomorrow, I will also suggest putting him on the list for grommets asap as I am pretty sure he will just take the hearing aids straight out, although hopefully not.

God yes originalusername, I had a GP friend who said her son was an early talker because she gave him no choice but to communicate! So annoying.

[cestlavielife]

as the wait list is long for assessment it does no harm to get on that list early - if then dont need the assessment you can cancel (and allow some person who desperately needs it to be grateful for a cancellation appt!)

[HumphreyCobblers]

Just back from hearing aid appointment - as suspected he wouldn't tolerate them in for even one minute. On the list for grommets now.

[Twistedheartache]

I can't comment on and front at all, but in terms of the hearing aids persevere & build up slowly & let him & maybe look at/talk to ndcs. They run weekend events for families & have all sort of support options.
My Dd2 was diagnosed with mild/moderate hearing loss & with some glue ear now her hearing has deteriorated.
I fought for 8 months to get her to wear her aids & failed miserably but now 6 months later she is wearing them full time apart from sleeping and she is much more engaged. She's not speaking yet (only 18 months) but her understanding & following instructions is coming on so quickly. I'm sure it is easier because she's so young but it's not impossible that the hearing loss is having a big impact

[HumphreyCobblers]

thanks! I will certainly persevere with the hearing aids, but this is a child who has pulled off every hat I have put on him throughout his whole life. Hopefully he will calm down around them, I have just tried again (after one session with the audiologist) and he cried, screamed, grabbed the aid from me and threw it on the ground I seem to have v strong willed dc, my older ds once left A&E with an undressed cut as the staff failed to persuade him to have it done!

[iwillnevereatspaghetti]

it may be that the sound is over-whelming. Start by putting them on, switched off (I know that sounds perverse). Get him tolerating the idea of wearing something.

[Gutterflower]

I used to have to take my son (now 6) to speech therapy in a Strange building and the room
In which the sessions were held had a one of those sinks where all you have to do is move your hands slightly and they turn on. What plonker decided that would be a good place to hold them? I used to get so flustered, he wouldn't want to do anything, all he was concerned about was the sink. He wouldn't look at anyone very much and everything was done quite clearly on his terms only bit now a few years later he has made HUGE progress and although still behind all the concerns we had back then seems very distant. Hang on in there OP, your son is still incredibly young. Persevere and he'll get there xx