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3yo speech delay or something more?

(18 Posts)
haverer Thu 19-Sep-13 00:35:39

I'm worried about DS (3.3). He's got a speech delay, been seeing SALT for a year. There are some other behavioural issues and the SALT has referred him to a paediatrician, hinting at possible ASD. I know he can be hard work but I wasn't expecting that.

We are waiting for the paediatric appointment but in the meantime what does this sound like to you?

His behaviour can be challenging. He loses his temper easily (e.g. whenever I say no to him), hits me or whoever is around, pulls hair. He often ignores me when I'm speaking to him. Taking turns and sharing are usually beyond him. He has just started nursery and has hurt some of the other children.

His speech is delayed, but several times a day he repeats chunks of movie dialogue and story books. His comprehension seems delayed too, but its hard to tell as he's so resistant to following anything resembling an instruction. He prefers to pull me by the hand to the kitchen rather than ask for something to eat (which he is capable of verbalising).

He seems to play alone at nursery but he can play with other children (not just siblings).

He can be fairly concrete and here and now in his understanding. He never talks about the past or the future. He can identify boys and girls, but if I ask if he's a boy, he thinks that's a ludicrous idea - he laughs and says no, I'm x[name]. His understanding of consequences is limited, e.g. The concept of a reward chart is beyond him.

He was quite late to sit, walk, babble, wave, point etc. Just on the cusp of the normal range for these things. Good fine motor skills but still cannot jump or ride a trike without a bit of help.

I cannot describe how very lovely he is. (But I'll try grin) He is very affectionate, gives lots of hugs and kisses, not just to me. He is the first to notice if someone looks sad and will give them a hug or stroke their face. Has a great sense of fun and humour: loves visual humour and makes up 'hilarious' jokes of his own. He loves babies and behaves beautifully with even slightly younger children: he never hits smaller children, and even if they hit him or pull his hair, he gently asks them to stop. He plays imaginatively; loves small world play and also happy to make believe that e.g. a cardboard box is a spaceship.

I should also say that he's had a lot of upheaval, perhaps even trauma in his life.

I'm going crazy googling all these symptoms. What I really want is for everyone to say he's just fine and will get there in his own time. But if not, please be gentle.

katese11 Thu 19-Sep-13 00:53:50

No wisdom to offer but he sounds a lot like my ds who is a year older and just being assessed. Watching this space I guess. How was your son's potty training?

haverer Thu 19-Sep-13 01:07:06

Have you seen a paediatrician, katese11?
Potty training? Haven't even started. Point black refuses to go near the potty no matter what bribe is offered. How did it go for your DS?

katese11 Thu 19-Sep-13 07:21:43

Yes just seen one a week or two ago. Pt was a bit of a nightmare but he got wees by 3yr 3mth and then poos took another 6 mths grin it's one of many nursery had but like your ds he doesn't fit the typical asd profile (affectionate, Sociable etc) He did play alone a lot at nursery but I think he just got v absorbed in what he was doing. Soooo.... we'll see! Apologies for typos - new Phone!

katese11 Thu 19-Sep-13 07:22:31

hmmm Def didn't mean to put a smily face in that. ...

WilsonFrickett Thu 19-Sep-13 09:40:28

I think a referral is the right thing to do, to be honest. It can't hurt your DS to be seen and it might put your mind at rest. If not and there is a diagnosis (dx) then you will be able to access help for him.

I'm about to be blunt and you may not be ready to hear this, so apologies in advance thanks. There's a piece of advice I never got with my DS (dx'd at 4.5 with Social Communication Disorder, which is similar to high functioning autism). I was like you, looking at the pieces of a puzzle that didn't 'fit' together. Unlike you I was left to twist in the wind for 18 months while professionals hummed and hawed and wait and seed.

Anyway, the advice you often hear here, which I wish I'd had, is to treat DCs as if they already have the dx you fear for them. Using, for eg, techniques to manage autism won't hurt your DS (or any DS for that matter). It won't make them catch it either! And it could make a real difference to their behaviour.

And please beware of assumptions wrt to 'profiles'. Very, very many children who aren't neurologically typical are extremely affectionate, sociable, funny, etc. On the surface (especially at this young age) they seem to be playing on exactly the same level as their peers too. It's often only later on that the more subtle difficulties arise. I'm absolutely confident my DS (now 8) would be dx'd much more quickly at this age, because it's so much more obvious he has real, obvious difficulties with social communication.

Try not to worry. Keep a diary. But there's lots you can try to help with the challenges you've mentioned above without waiting for a dx.

whenwilligetsomesleep Thu 19-Sep-13 09:43:42

I would go to your GP to raise your concerns and ask for a referral to a developmental paediatrician. It can take a while to get an appointment though.

haverer Thu 19-Sep-13 13:07:17

Thank you. It sounds like any dx can take some time - I had been thinking I'd get answers on the first paed appointment.

Wilson I've googled Social Communication Disorder and depending on which site I look at, it could describe my DS...
or not at all. confused. If I knew what the dx might be I could start looking for helpful techniques.

whenwilligetsomesleep the SALT has already referred to a paediatrician (I assume developmental) but I'm trying to stop myself going crazy whilst I wait for that appointment.

haverer Thu 19-Sep-13 13:08:14

Sorry for double posting.

WilsonFrickett Thu 19-Sep-13 14:05:41

grin the site is very glitchy atm.

If it's clear cut it can be quick, if it's not you may be referred for further tests, observations etc, all of which have their own particular waiting list. Which is fun.

In terms of googling, I would look at SCD, autism, ADHD. I am not saying your DS has any of these I just think it will give you some ideas to help him. And tbh I'd start my search on this board, there will be lots of advice for newbies which will help you.

Don't try and do too much at once, think of one issue to tackle and deal with that. So you mentioned his temper. You'll need to do a bit of detective work, to try and work out what triggers the tempers, then look at what you can do to modify.

So my DS hated transitions (still does) so to stop him having a meltdown he needs predictablity, countdown warnings when we're going to stop or change what we're doing, transition activities (like washing hands before dinner, which gets him used to the fact he's about to have dinner, which can be challenging for him).

And post on here, if you post 'how can I do x' you will get lots of advice.

(On a side note, I've just googled and looks like SCD has become a bit of a hot potato. I knew dx criteria were changing, but as we already have a dx I'm not in that space, iyswim. That's my afternoon gone then.)

And sorry my posts are so long!

haverer Fri 20-Sep-13 20:50:35

Thanks wilson that's very helpful. I find myself googling this stuff when DS is asleep and have to stop myself waking him up to check if eg he can point.

It sounds like from what you're saying, if a SALT has picked up a concern now, the differences and difficulties are only going to get more pronounced?

WilsonFrickett Sat 21-Sep-13 12:38:16

Yes and no.

In my DS case, his difficulties are round social communication. So as his peers become more socially mature and adept, I can see his differences more clearly. However, we are all better at dealing with them, so I can also see the progress he has made. And children with my DS type of issues do mature as well - they aren't 'stuck'.

haverer Sat 21-Sep-13 23:26:16

Thank you thank you. My biggest fear is that he will be stuck at this stage. He's constantly moving forwards (at his own pace) so I shouldn't really need reminded of that.
I guess I just want an idea of what I may have to face when we see the paediatrician.

Zipadeedoodah Mon 23-Sep-13 12:46:41

Haven't had a chance to read through all as site keeps sticking but just wanted to say get his ears checked. My DS has SEN and we chugged along for years thinking it was a speech delay caused by prem. he is now 6 and found out six months ago he had really bad glue ear, and no other bugger had noticed - any hoo, has now had grommets put in and he still has issues but speech is improving daily. He couldn't speak because he couldn't hear. Am going to park fury for this not being picked up earlier for another thread but just wanted to say might be worth getting it checked out by ENT specialist. We ended up seeing someone privately just for the initial check - which was around £100- we don't have private but the letter meant that we couldn't be fobbed of by "bored of kids and their whiny Mothers "GP when we returned with our letter

Zipadeedoodah Mon 23-Sep-13 12:49:59

Also, just to say that we have seen lots of people and the biggest anticipated meeting which turned out to be a fat waste of time was dev paediatrician. She just wrote lots and observed but offered no advice or idea what was wrong with him. Perhaps it was our naively but we thought we would come out with sme idea of what was wrong with him. Nice lady, but just seemed the cock her head to one side, nod slowly and write a lot. I've got an Aunt who does that and it doesn't take me having to take a day off work to see her.

haverer Mon 23-Sep-13 23:15:04

Zip your last sentence made me laugh! Will try not to get my hopes up in case I get someone like your aunt.

Interesting about glue ear - I've asked 3 times to have it checked as DD and lots of cousins have grommets, and I thought this might be an issue (but hasn't been done). Have been told the paed will check it, but hadn't thought of going privately. Will do that if the paed doesn't.

katese11 Fri 11-Oct-13 21:26:32

How's it going haverer?

haverer Sun 13-Oct-13 06:20:16

We saw the paediatrician last week. She asked lots of questions and played with DS. DS behaved beautifully! The paed said he doesn't have a lot of the markers for autism, but that we were to come back in 6mo.
Nursery had flagged up his lack of eye-contact, but the paed said his eye-contact was good - obviously affected by the stress of a new busy noisy nursery.
He also showed lots of shared enjoyment - another positive.
But I found the paed was using much more complex language than DS can understand so I wonder if she had overestimated his comprehension - I think his processing is as big an issue as his expressive language.
Finally, she said he has hyper mobile joints, Whig explains his motor skills and unwillingness to walk very far.

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