Hello, I wanted to ask your advice as we are just beginning this journey.
My son is 3 years 10 months and has been exposed to 3 languages since birth. We knew that he was always going to take longer to speak properly, however the nursery recently voiced their concerns about his lack of comprehension and also some repetitive behaviours. We did a full assessment with the speech therapist and paediatric neurologist (including screening for ASD), and so far established that his main problems are language-related. No ASD diagnosis. His motor skills are also lagging behind.
Specifically, he is about a year behind in his receptive language and seems to take a lot of visual cues to understand what's going on . When we talk to him, sometimes he seems not to listen/hear and not follow instructions. His hearing has been checked and is good. His expressive language is ok, but is made up of phrases that he has heard before (he is using them mostly appropriately, although sometimes they are a bit irrelevant). When he talks, he can describe what's around him (look, there is an airplane!) or (I don't want cereal for breakfast), but never speaks more spontaneously (for example, he would never ask "why are apples round?") He has a difficult time with describing what he did at the nursery, other than answering yes/no to our questions "did you paint" or "did you play outside". He is also unable to maintain a conversation beyond one question / answer exchange. He also is obsessed with certain games like playing the lift or bus, and likes the clock and asks a lot "what time is it". I find the latter a little ASD-like, but the experts who saw him said that he could easily be transitioned to a different activity and sometimes is making jokes about it, so it is not enough evidence to suggest ASD but could be just a soothing mechanism given his other difficulties.
Other side issues are his lack of focus / concentration and sometimes difficult behaviour (I don't want to brush teeth, I don't want to get dressed, I want to sleep, etc).
We are keen to intervene, and so far are doing the following: - Dropping other languages, focusing mainly on English - Intensive private speech & language therapy (3 times a week) - Starting occupational therapy to help with motor skills
I would value very much any advice someone could give who had a similar experience, especially in a child with receptive / pragmatic language difficulties.
What did you do? What therapy / intervention worked best? Has there been any progress? Shall we also consider ABA given his other traits / behaviours? Listening therapy? Biomedical / diet?