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Is Echolalia always an indicator of autism or aspergers? Is there an age limit where it should be gone by?(43 Posts)
My close friend's DS is almost three and he's exhibited echolalia both immediate and delayed (mostly delayed now) since he first began to speak at two.
She's begun asking me now and then if I think he's ok but when she asks she does it in a way where I get the feeling she wants me to reassure her things are ok...she says "Do you think that's ok?" and sort of nods encouragingly so I have said yes...it's ok....is that wrong?
He's now a month off three and all his language is parts of cartoons and fave television shows and ads. He does also use phrases which he's heard from friends and family...so during a day out he heard the phrase "Come on Sarah!" and now, my friend says whenever she tells him they are going to visit Sarah he will say "Come on Sarah"
He doesn't respond at all to his new siblings (not unusual I don't think) except to get very upset and have a meltdown when they cry. He has to leave the room immediately one begins crying.
So basically I am wondering if the speech pattern is something some kids go through....and then grow out of or is it a real sign of something amiss by the time the child is three? I am very aware that she's stressed and when she asked me this, I said that I thought it was a normal part of speech development which I have heard to be a fact. She's just had a baby...I didn't feel like I should say anything to worry her and as I mentioned above, she seemed to be willing me to say it was fine.
Her DS likes playing with my DC....to the extent of jumping on the trampoline with them and he laughs as he does this....the game is always the same though and my DC fall down and he laughs and then he waits for them to do it again.
He has excellent fine motor skills on an iphone as well as counting, colours, recognising numbers and animals etc....he can match pairs and play quite complex games on the phone.
He doesn't line things up but neither does he point or clap....he sometimes lies on the floor and looks at his fave thomas books by lying his head on one side and looking sideways at them.
If it IS something she needs to see about, can you advise me...if she asks me again, should I say yes and ignore the vibes she's giving me to reassure her?
I would recommend getting him checked ASAP. Our son was diagnosed with a severe speech delay when he was 3.5 and showed the same symptoms as your friends son. Everyone said to wait because boys take longer. As he is a very friendly, sociable little boy who also learned the alphabet in a week, is good with numbers, pattern recognition etc we just waited for his speech to catch up. It never did. To this day, he is a good 18 months behind his peers and received a PDD-NOS assessment at 4.5 after being assessed for autism (which means that he's sort of on the spectrum but it isn't classic autism - the delay cannot be explained). Only after intensive speech therapy and starting school has he improved to the point where he can be understood about 75% of the time (he's now 6.5) - the rest of the time his speech is garbled and quite disordered as are his thoughts (ie he will also rave on about favourite shows/computer games etc at moments where it's not really relevant).
My ex-H's son is autistic. Frankly, the delay in getting a diagnosis has, IMO, caused no end of problems.
Kindest thing of course, is to support your friend. But, I would say that fobbing her off with reassurances is detrimental to her and her son (not meaning that in a nasty way).
I agree with Hecate that early intervention and some kind of plan of action is the best thing to do. I don't know if your friend is a pushy kind of person, or wealthy - it's a pretty sad state of affairs that if you're neither, your child is less likely to receive the help he or she needs and will likely fall through the gaps. But, IF there is a problem, then no-one else is going to advocate for that child, battle the obstacles and get some kind of programme (ABA or otherwise) in place. And, the earlier the intervention, the more likely it is that there could be a better outcome.
zzzzz In my LA, you can still go to your GP for a referral to the Paediatrician at any age, but the CDC (Child development Centre) services are divided into U5s / Pre-School ,and school Age children, so it's not other children at your school necessarily that you would be waiting behhind, but other children across the authority. Sorry I didn't express that very clearly.
The kindest thing you can do is to support your friend, however she copes with issues.
What she doesn't need is anyone telling her how to parent her child, or what action to take. Let her be the expert. Realise that whatever worry/doubt she is showing is a teeny fraction of what she is experienceing.
People often say "I can't imagine" how "worried you must have been", or how "difficult it was". Frankly, no you can't.
Love her, help her to do a good job, be her friend.
I doubt a CM would have noticed anything wrong, ours didn't until we mentioned DD w having speech therapy and then they suddenly got very on board with the problem spotting
Hope you find a way to help your friend OP - there's plenty of things that can be done to encourage speech and plenty of reasons for funny speech patterns and quirks that don't go hand in hand with serious impairments.
Guys thank you all so much. I feel a lot of responsibility towards my friend (she's really more like a sister to me. I do babysit for her and always have done really which is another reason I've been concerned...spending whole days with her DS whilst she's at work has made things more apparent to me really.
Because she only needs childcare on odd days due to her work, I usually step in to save her money as I'm at home anyway, therefore her son has been with me where he might have been with a childminder...a professional who may have flagged things for her.
I'm the closest she's got to a female relative and the closest she's got to childcare.
Just putting it down like that helps.
mummytomog very clear description of assessment process for me too. Twins are full on too.
If OP is still reading babysitting would be really really kind as would listening to the same anxieties again and again and again.
Re assessment - this has been the most stressful year of my life. Full stop. And a giant part of that has been the 'helpful' people who keep telling me my daughter is autistic, when not a single one of them is qualified to make that diagnosis. I can't see any value for her right this second in having an official diagnosis, and the process of assessment makes me want to pull my face off.
The best incentive the EP could offer me was that it would help people to understand her 'abnormal developmental curve' which I completely disagree with actually. Right now she has SALT and she has a lot of input from Early Years. I'm looking into various private therapists in the hope of finding someone who can encourage her speech and communication without making me want to pull their face off. She has support at nursery from a TA. I don't think she'd get anything else out of a dx and she might well lose her SALT.
The OP's friend is concerned about the echolalia - I would honestly just start there with SALT. If the other stuff is of concern, I'm quite sure they'll bring it up. They did with us.
Once you are school age does assessment have to go through school then?
Can you not just get referred to developmental pead via your GP?
I do believe that my ds's language disorder is developmental. I think I can minimise the damage done by his condition, but that ultimately much of the development does take time and can't really be pushed in any significant way.
zzzzz I don't know if it's the same across the country, but in my LA, waiting lists are shorter pre-school, and the whole approach to assessment is just FAR better.
If , and I emphasise I'm not passing judgement on the original child in this thread, but if the child is going to need support in school, then the earlier to can get the referral to the EP, the better. If you can get a Statement in place before school applications, it gives you a wider choice of schools, and it gives you a promise of support once you reach school. Also extra help with transition, if that's needed. Generally, if a child starts school without things already in place, then first they are given time to settle, then they join the end of a queue of children who have been waiting for assessments for longer than they have. Just some of the reasons I agree with Hec saying getting assessment early has got to be a good thing.
Long and interesting.
Laughing at happy and sad face fatigue.....ds1 has always been good at emotions but when he was three I felt moved to teach them to him formally ..... What a mistake!
He demanded "surprise" endlessly, it was his greatest pleasure .
It had some benefits.
Let's face it pulling a surprise face is a pretty easy reward to have up your sleeve.
Oh. I didn't understand that. I'm not arguing with you at all, honestly. I was just explaining why I limited my reply to her to advice to get an assessment and take it from there, and then gave some background on my own situation, to demonstrate where I'm coming from.
Yes, when there is a child who is displaying possible speech/language problems, or signs of asd, or anything like that, it is really the best thing to get the ball rolling as soon as possible. This is because it is very well documented that the earlier the intervention - the more positive the outcome. Generally. (I hate to say 'positive outcome' but I can't think of a better way to phrase it. But I am aware it's not quite what I want to say, because I don't mean that not being able to do that is a negative outcome!)
Of course, if you can't get the assessment/support then there's nothing to be done but fight! If the diagnosis is given and then the support is withheld from the child, then it's a long battle and sometimes a legal one. This whole thing all takes time. But my point to her was that it's best to do your (general your not specific your) part as early as possible. If a parent thinks there may be something, then they shouldn't wait and see if the child catches up. They should go and ask for a professional opinion.
Then begins the battle, in many cases.
But the longer they leave it to begin the battle, the worse it may be.
SALT is, I think, a problem nationwide. In my area they try to tell you there IS no provision after primary school of course with that, as will all things, I ignored them. and my son (younger) has not been discharged because I refused to allow them to. But really, it just consists of a few sessions and telling me stuff I already know and advising me to do stuff I'm already doing. Getting an autism specialist is hard.
I found the home visiting teacher amazing. 3 sessions a week each, doing basic skills training. eg turn taking. she had a pig that you put coins into and every so often it would oink. she used this to develop turn taking. there was play with little animals. bubble blowing to get eye contact - she wouldn't blow the bubbles until they looked at her. Lots of things that I watched carefully and did on daily basis with them too, to aid their development.
PECS (the picture exchange). That was good. give me the picture of the drink and you can have the drink. I will also say the word drink. Taught them that some communication and interaction is needed to get what they want
did not find makaton helpful. Couldn't get on with it.
Didn't like opportunity class - it felt like they just gathered up all children of any age who happened to have any form of disability whatsover and shoved them in a room.
I did quite a bit of the dreaded sonrise as well! - people on here prefer aba, I think, but I found sonrise really good. I don't agree with their opinion of what autism is and it's not all I did with them, but I liked a lot of it.
I find those things that teach basic skills to be most helpful. These days, I'm working on my eldest going into a shop and buying something. And working on my youngest to not ignore people when they talk to him!
I just think that lots and lots and lots of work with them is the key. The hours you spend on the floor with them, actively teaching them the stuff that NT children just seem to pick up without trying.
I remember when I was first teaching them about feelings. I did happy face sad face happy face until my face was about to fall off
hecate I'm looking for understanding/information not to upset/disagree. I too have two children with sn, and I'm interested in your experience of early intervention. Of course you can't diagnose and recommend a treatment plan for this child , but you did say "cases like these, the wait and see approach is the very worst thing someone could have". Thinking about my own experience, I'd like to understand why you feel that.
In my area SALT is not offered to children with ASD. In fact after dx, many are discharged. But even for those tha aren't and have multi agency input, what is that input? I guess what I'm asking is for you to look back at your experience and say what was helpful and what wasn't. Also what with years more experience of language disordered children you would put in place?
My ds1 was Echolalic but his only words were numbers/colours a 2. He first said dada at 3.5 and mama took another year. NHS salt was unhelpful, but private SALT was the best mone I have ever spent. Assessment was gruelling and inconclusive, parts of it were very helpful, parts infuriating.
I didn't say the assessment WAS the intervention. I said you need the assessment in order to determine what is needed.
I can't possibly say what if anything the child in question needs. An assessment would do that.
My children were diagnosed with autism at 2.5 and at 3. My youngest was exclusively echolalic for years. My eldest didn't talk in any form for years. Just squeals and grunts and things. They didn't come out of nappies until they were 5 and 6.
They had a home visiting teacher from the early years team 3 times a week from diagnosis until they started school. We worked on getting statements right away so they had 1:1 in place for when they started school (they got funding for 1:1 in nursery too). At 12 and 13 they both still have full time 1:1 (youngest 2:1 offsite). They had SALT (don't get me started on how useless THAT has been!) sssen. Autism advisory service. specialist paed. child development centre. my eldest recently had some camhs sessions. ed psyc-not seen one of those for years, mind. 'Opportunity class' - which we withdrew them from because we didn't like it.
That sort of thing.
But that is my kids, based on their diagnosis and their needs. Some or all of that may not be appropriate for this child.
That's why I advised that she just at this stage, request assessment. That will let everyone know what if anything they are dealing with. Then they can look at what the options are.
I personally don't see assessment as a therapy/intervention, though I take lights point that if you have misjudged the level of language, clarity as to where your child is could be helpful.
I'm genuinely interested in what therapy is available for a 2 year old with these kind of issues. In my area there simpley isn't any, so I guess for my ds we effectively did "wait and see" ie the worst approach.
I've had 3 small children under 3, in fact I had 5 children under 7 including twins, I think it is important to understand what you will get out of assessment and picking your moment carefully.
zzzz- at this stage with my DS, the massively important thing to emerge from SALT assessment was being told that my DS's receptive language was 12-18 months delayed at 3, and he was at one word level. This meant that I knew I had to dramatically change how I communicated with him. I was in massive denial about how little he understood.
First of all, an assessment.
Then everything would depend on what the outcome of the assessment was.
hecate what intervention do you think might be needed/offered?
She needs to get him seen.
If there's no issue, then having him assessed won't hurt.
If there is somethjng then I promise you that the earlier its picked up on, the better.
Cases like this, the wait and see approach is the very worst thing someone can have
I wouldn't waste her time with a random HV or GP till she knows what to ask them for, and how to insist if they try to reassure her too quickly. Most health professionals will realise this is a red flag, but not all... and unlike you, they probably don't have access to mumsnet for second opinions
She can phone and discuss with a speech therapist or a if that's too scary, a trained parent volunteer.
Or you can ring the local speech therapy department and find out when they're next running a drop-in triage/advice session in the local children's centre (not every area has this, but lots do).
The TAMBA boards usually are a great source of advice, as lots of twins have additional needs.
I agree with others. There definitely sounds like there are enough concerns there to seek further advice. I also think the fact she is asking you (and others?) shows that the Mum is already concerned, and I think that telling her you wouldn't be isn't what she needs now. By supporting her to ask for a Paediatric Assessment - or at least a Sp&Lang Assessment, you are not diagnosing anything yourself, you are just saying "Yes, I see what you are a bit worried about, I think if it were me Id like to be reassured everything is OK, or, if it isn't, to know that he's started in the system, so the right professionals can give us some support."
agree with the others, by 3 you would not expect this sort of echolalia, and it's particularly concerning since his general language/understanding seem behind for his age. I think it's worth you suggesting that your friend looks for a hearing test and speech therapy assessment, she may be able to refer directly for speech therapy rather than needing HV or GP to "permit" that.
Btw my DS was v similar to how you describe your friend's child at 3, his language and understanding of language were delayed, he didnt quite have all the traits for an autism diagnosis, just traits. Over the years, his language is now pretty much age appropriate, his social skills not quite there yet, I would not be surprised if he ends up with some sort of Autism diagnosis before adulthood. If I hadn't gone for NHS and private speech therapy for him, he probably would have not made as much progress (also v good infant school).
yes I would think a small conversation would be expected although if a child has a S&L delay this may not be attainable. However as I said earlier I think there are other issues that would give cause for concern.
Although DS did have good appropriate speech at that age, I suppose it was around that age or maybe a bit later that i started to notice how he lacked the intuitive, non taught ability to interact with his peers. He still lacks the banter type conversations that 11 year olds engage in and looking back I suppose his conversations even at aged 3 were a bit onesided and a bit factual. However I was a bit in denial I suppose and always looking for evidence that there was nothing wrong. So I would see his great vocabulary and how every report would arrive with "DS is a very sociable and popular Boy" and I would convince myself that all was Ok. On the surface he was and is but mainly on his terms and mostly with adults. After DS' diagnosis last year I vowed never to ignore my gut instincts again as I suspected from a very young age that DS was ASD and no prof ever mentioned it until he was 10. i dont think it was any ones fault as his traits are pretty subtle and masked by many non asd traits and he had been having ASD type therapy such as OT and help at school . Sorry for too much info but all I'm saying is that often if a mother thinks there is something not quite right , she is correct.
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