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2.11 year old speech and language delay

(24 Posts)
Mum2prince Mon 02-Dec-19 21:04:52

I am still fairly new to MN as this is my second post, but I have been lurking ever since I started worrying about my ds. Ds1 is 3 end of next month and he seems to only just made a HUGE breakthrough with his language.

He is able to ask for simple things without prompting, like open, banana, drink, jam bread (usually means he's hungry) and will say 'come' when he wants to play. He has a few 3 word sentences like open the door that he says without prompting and in context. He can name almost all colours (even brown, black and white), to my surprise, and can tell you his favourite animals characters when asked 'who is this?" And can answer correctly when asked 'whats this?' E.g flower, ladybird etc. He can also pretty much say anything with a prompt and he doesn't just repeat for the sake of it, overtime he will understand and no longer need to be promted.

All this is fantastic as months ago he could barely say anything and when i wrote my last post he had a handful of words he would say bit would always need promting. We have started him on a ABA programme as I initially had concerns about ASD (Will explain further) but even when those thoughts went away over time I still could see his lack of language was affecting his social interaction with other kids, and the intensive nature of ABA therapy appealed to me.

The therapy has been going really well though he has only been having it for just over 2 weeks. The consultant who sets his targets is very pleased with him and also says he is having a "language explosion". Overall I've seen rapid progress and I'm so proud of him. It's just today I went to his Useless nhs salt, and we had a small session with her and I informed her his therapist would be visiting her family abroad and won't be here all December so I wanted to know what to do in the meantime.

She wrote down a woman's name and told me to do her attention building activities with him, only issue is as soon as I googled it this woman specialises In autism. That is completely fine as I have come to know that autism and speech and language difficulties look very similar at his age and the treatment is more or less the same (hence opting for ABA without a dx) but what I don't understand is why she didn't mention it? Or write it on the paper. She completly missed the word out!! This has got me thinking again, is there something I'm missing? I'm finding it incredibly difficult to pinpoint what attributes, are normal toddler behaivours, possible asd, language difficulties or any other factors really.. So to be pointed in the right direction from these professionals would be a great help!! His not having ASD is not the issue here, it's me wearing all these hats mum/salt/aba tutor that's draining ME.

The salt session went well in terms of him "talking" (saying words) and "attending" (I have no idea how as she is the most boring human I have come across in life). But his attention was not good if he had no interest and would just leave her and show me something else he found nice. In his defence though he did just have 3 hours of ABA that morning, the missed his lunch (no time just had a snack and bannana) and also missed his nap.

I also made it clear that we speak in no longer than 3 word sentences to him as he has a hard time understanding language (well he did, he understands everything now as long as you keep it simple) yet she did not, I mean as a salt should I be telling you this? Sometimes I strip it all the way back to 2 word sentences if it's a new concept for him. AIBU to say i took nothing away fro. The appointment other than worrying again, and nothing productive came out of itconfused.
I feel none of these professionals have experience with children who have a delay in receptive language as well as expressive, this is why I always tag @lingle as her past threads have got me through some dark times. Don't get me wrong all children are beautiful gifts from god, and asd (though it can be hard to wrap your head around as a parent at first) is not the be all and end all! But i just want the help my ds needs there are so many different types of sn and at his young age I really need a medical professional to let me know what the red labels might be as I can then help him.

Thank you if you managed to get through this long post, any thoughts are welcome

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Mum2prince Mon 02-Dec-19 21:09:54

Red flags* sorry for all the typos, no time to read over as dc2 is teething sad

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Mummy0ftwo12 Mon 02-Dec-19 23:51:57

Not a medical professional but my DS had receptive and expressive language delay, (and social com delay) - those are his official diagnoses and it was probably worse than your DS, no single words until 3 and then incredibly hard to understand - it wasn't clear until he was 3.5 that it is was a delay rather than a disorder e.g. autism.

I found a great private SALT who specialised in young children and she saw him fortnightly then monthly, it sounds like your NHS person isn't filling you with confidence, is private possible? even monthly?

Who was the person with the attention building activities? also does your DS copy/imitate actions?

Mum2prince Tue 03-Dec-19 12:51:27

@Mummy0ftwo12 thank you so much for taking the time to reply. Seems our dc have alot in common from reading your post. The person was Gina Davies, and she is an amazing woman.. I will be looking into using her techniques with ds over Xmas hols. I was just taken aback when I saw she wasn't a salt but a autism advocate. Soon as I searched what the salt told me too 'gina Davies- attention activities' what came up was 'gina Davies- autism attention bucket (activities). No one (not even pead has gave me a dx of any sort) and it's clear my son has something else going on as he is struggling with language more than most children his age.

Can i ask what helped your ds improve and understand. When did he start putting 2 words together.

And yes ds1 does copy actions, as long as they look fun grin for e.g hoover, brushing teeth (finds this fun) and if I'm jumping hoping etc he will do. If this is what you mean x

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Mummy0ftwo12 Tue 03-Dec-19 20:59:27

DS started putting two words together when he was 3, he's now 4.5 and has 6 words sentences, I can understand 90-95% - he also still has problems with tenses, in/on under/over etc.

What helped was good speech therapy but it was a long road.

I asked about the imitation because I read on here (poster was JimJams) that imitation is much harder for children with autism, to me it was a good sign, probably the only one that DS was s&l delayed rather than classically autistic as the doctors initially thought.

You mentioned Lingle, she was kind enough to reply to a thread of mine a few months ago on delaying school start, it was lovely to read how her DS is doing a good few years on.

Mummy0ftwo12 Tue 03-Dec-19 21:06:04

@Mum2prince - you might like this blogpost myyellowbrickroad0301.blogspot.com/2013/02/break-it-down-for-me-fellas.html

Mum2prince Wed 04-Dec-19 00:02:38

@mummy0ftwo12 well done to your brilliant Ds!! And well done to you as I'm sure you have everything to do with his amazing progress! Hearing how far he's come along really gives me hope smile. Thank you for that i also didn't think about it like that didn't know how important imitation was. People usually put an importance on pointing which he did manage but it was late. And thanks for the blog, it does put into perspective asd vs delay (even though im aware asd is a spectrum). I can relate to her struggles though, as I'm sure you know having a child with language and communication difficulties is hard, and heartbreaking as a parent to see your child habe such a great difficulty. Though children really do have a way of surprising us and getting there in the end with a smile on their face! Please keep in touch x

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AladdinMum Wed 04-Dec-19 11:21:04

I share your sentiment in relation to same of the SALT professionals, but in their defense, some of them are really excellent and go well beyond their duty - it really is a mix bag. From your comments, I would like to add and remind ourselves that autism is not a language disorder but a social communication disorder. Autism can affect language and is one of the first things that parents notice (normally when their children are not able to speak at peer level by 3YR old), but way before language is affected so many other things would have been affected and by 18M old many of these will be clearly visible and measurable. Language delays are also very common between 2-3YR which is why deficits in language is a very poor predictor for a future autism diagnosis. Aspects around social communication like pointing to share interests by 18M, sharing experiences by showing/giving, imitation, pretend play, social referencing, and many others are much better predictors. It sounds like you DS is doing really great and seems to be picking up momentum, his language should keep improving at an exponential rate in the coming months smile

Mum2prince Wed 04-Dec-19 15:12:14

@AladdinMum hi and thankyou for your reply. Yes I do agree that some salts are exceptional and some are well... What I'm currently dealing with. Which I find frustrating as speech services are stretched as it is, if we parents don't get sufficient advice and help for what to do in the meantime (in between appointments) poor dc will suffer.

You are also spot on regarding autism being a social communication disorder. I have however noticed that the severity of my son's speech and language delay did affect his social communication skills. Although he was very engaging and loving, knew nursery ryhmes and actions and could imitate. I worried at his lack of pointing and and joint attention (though now I know he did do things like , look at the object look at me and look back at the object) and he did reach out to be picked up, reached out for what he wanted almost trying to grab, then I modelled pointing and he's been pointing ever since.

But i do notice that unless he understood what was being said he seemed to tune us out and play, or sing his nursery rhymes, and now he seems to be more and more involved in what every one is doing as he understands what's being said.

He now gets therapy so I'm much more laid back as we are all being proactive in helping him and he's doing well. But i know autism is a spectrum, and children can be diagnosed who have perfect eye contact, respond to their name, affectionate etc. So when she reccomended that woman I wish she would just be honest and tell me, if she noticed a trait in him, or maybe even reassure me that he is doing aswell as I think he is! ( and I'm not one of those parents who sugarcoat, as I like to find the problem and try to get him help)

But Thank you for your advice and I hope to see his language grow, he seems to be flourishing before my eyes. It's amazing to see as any progress before this was very slow x

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Mum2prince Wed 04-Dec-19 15:17:48

Also, I am aware that i could be looking too much into the bucket activity, as this could just be a standard speech excersise. And even then ds1 co operated as he said everything he was meant to, he just wanted to touch the toy after grin, I suspect because that is what we do at home to encourage speech he has to say or atleast try to say everything before he gets it. So I guess in his head he was like I'm co operating! Why cant I have it Now. This may have made her think he's in capable of waiting? Idk, but please let me know if I'm being too harsh

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AladdinMum Wed 04-Dec-19 15:57:39

@Mum2prince I totally understand, once autism is mentioned once, even if the child is progressing very well thereafter, it will always linger at the back of your mind for years to come (and moves back to focus whenever your child does something quirky which objectively is probably totally normal) - as parents, I do not think we ever stop worrying. One thing to note is that at this age children have a big arsenal of communication tools, speech is a really small part of that, over 90% of communication is non verbal so a speech delay should normally not affect social communication too greatly (though they can struggle to keep up with peers). Also to note is that social communication is not about playing with other children or other adults or carers, that is a very very small part of it and it will increase as they get older and become more confident (just looking at other children is enough at this age) the majority of their social communication will be directed towards their primary carer (normally mum and dad). Be careful not to mix social communication with social motivation, i.e. many children with autism are very socially motivated (very eager to interact with other children, other adults, are cuddly and hug-able, etc.) but seem to struggle to read the invisible social cues which are required to navigate the social landscape.

Mum2prince Wed 04-Dec-19 20:55:13

@AladdinMum thank you for reply so in detail, I'm finding your comments extremely helpful! And yes once you suspect asd it will linger as it's hard to pinpoint hfa with an untrained eye. And with knowing early intervention is best and appointments and dx taking ages these days I hate to think he needs more help than that is being provided to him and I'm being dismissed by professionals.

But now he's getting therapy I'm taking it easy (trying to anyway). And you are so right, from when he was a baby he would pick up on social ques like my tone of voice, my facial expressions. And he always comforted me if I were hurt or pretended to be crying from very early on. He also now knows 'that look' so on a good day I don't have to shout grin. He equally gives me the is mummy looking glance before he would do something naughty from quite early on. That made me think he was really aware of his surroundings. Is that the kind of thing you meant?

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AladdinMum Thu 05-Dec-19 10:37:51

HFA is certainly more difficult to see to the untrained eye as it normally does not come with the speech or intellectual impairments that people associate with classic autism and it tends to get even harder to see as they get older and they start masking and using copying techniques in their behavior to compensate for deficits (girls are particularly good at this). However, at it's core, the social communication deficits will be there and are normally best seen between 18M - 3YR old.

Yes, as per your examples, that is exactly the sort of social cues that you are looking for. It sounds like he is doing great! his language and composition of language should really start picking up in the months to come smile

Mum2prince Thu 05-Dec-19 12:02:04

Thank you @AladdinMum , I suffer from anxiety and today I woke up in a panic. Over absolutely nothing.. (I think it's hormonal) and all it takes for ds to babble, sing and talk to himself and I'm convinced something is wrong with him sad. I'm also anxious as his therapist will be away all of this month, when I was feeling okay. I thought i would be able to cope and take over confidently.
But since I had ds2 6 months ago I seem to be struggling with anxiety and panic. Sorry for offloading on you sad

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AladdinMum Thu 05-Dec-19 14:13:46

Totally understandable, no need to apologies, it can be a roller coaster! And it is not unusual for toddlers to talk to themselves where they appear to say random or out of context words/phrases (while looking at the wall, or while playing, or looking at their hands, etc), it's a form of them practicing sounds and is very normal language development. Some people confuse this form of practicing with echolalia (which people tend to also link to autism), but echolalia sounds very different and is also very normal in toddlers (it peaks at around 2.5 YR old), it is only ever concerning if it's excessive and after 4YRs old.

Mum2prince Thu 05-Dec-19 19:07:35

Thank you for listening to my concerns! Really can't thank you enough, I've noticed speaking about my concerns with ds helps calm my anxiety as I can see my irrational thoughts. Looking back o was that laid back mum who believed children were all different and had different strengths and developed at different rates. But when I realised ds1 was behind it really hit me hard and now I over think everything. I would never compare even now I still know all kids are different I just would want to see what a typical developing 3 year old is like I'm considered a young mum so I've not got any friends with kids, I'm the eldest so none of my siblings have dc and my dc's paternal cousins live in Scotland so we don't see them much at all due to busy schedules all round.

But Thank you again for putting things into perspective for me halo. You seem very knowledgeable regarding speech delay, if you have any tips on how to encourage speech please let me know.

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AladdinMum Fri 06-Dec-19 15:28:59

Traditional speech therapy, as you might have seen already, relies on a reward system, i.e. words mean rewards. It is all play based at this age, for example, you might put a car at the top of a slide and say "Ready, Steady, Go" before releasing it down the slide. If the child likes this, you would repeat it a few times and then you would do it again but this time just say "Ready, Steady" and stop while looking at the child. The child will get a sense (or the pressure) that he needs to say "Go" if he wants the car to roll down the slide. At first they might just grunt but that counts and you roll the car down. Eventually, if done enough times over a few days the child will start saying "Go". This can be replicated with balls, bubbles, etc while using other words. Another popular technique is using songs while you sing together and say something like "twinkle twinkle little" and then stop and look at the child, again the child will 'eventually' start saying "star" if he wants the song to continue. You need a lot of patience, as this can be slow, it really depends on the child, it can take months but it tends to be a positive experience and children learn from it. This type of technique can be used in many different scenarios with increased complexity depending on progress/level.

Mummy0ftwo12 Fri 06-Dec-19 18:44:53

there are lots of video clip examples of the kind of things AladdinsMum mentioned on the teachmetotalk.com website - is your little one starting pre-school / nursery soon OP? you might want to have a chat with the SENCO - couple of things my DS find usual at nursery when he was 3 was a 'stop' sign for when he couldn't say stop, I think this prevented escalations of toy fallings out! and also a 'first, then, next' picture board - both were super useful.

Mum2prince Sat 07-Dec-19 02:17:21

Thank you both for your replies!! @AladdinMum his therapy is those techniques you have received above and I'm pleased to say he has caught onto it Now. I will carry on whilst his therapist is on holiday, I just want to help him join more words, so far he has 'open the door' 'open it' 'I love you' with a couple more short sentences. Everything else is at a one word level, 2 word when prompted. He does not like structure, for example he loves puzzles and will happily play with me, but as soon as I demand he finish or I try to teach him numbers on the puzzle for example whilst he's bored.. He will walk away. I don't know if this is an age thing hmm but everything I do has to be play based. Also physical activities like catch, tickle monster, jumping on the trampoline work best with him.

@Mummy0ftwo12 he used to go nursery mon- friday half days. But i realised he was learning nothing there , and as he was 'well behaved' (their words) I feel he was over looked. Poor thing didn't say a word there. Spoke to the send many times but she insisted he was fine and she spent all her time in the 3-4year olds room (He was in the 2 year old room). Senco said speech delay had become very common and most the children in the older classroom needed help so she was waiting until he reached that class. I was not happy and decided he needed 1-1 interaction from therapist and family to bring him on. He also occasionally goes to a toddler group.

I considered putting him in nursery during the afternoons but he was missing his afternoon nap and was going into this zombie like state which he learnt nothing from therapy nor nursery. If next term his language continues to grow and he seems to outgrow his nap, I feel he would benefit greatly from the social factor of attending nursery. But when he used to go he was just not ready, and they did nothing to help himsad

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Mum2prince Sat 07-Dec-19 02:18:49

Mentioned * not received

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Mum2prince Sat 07-Dec-19 02:20:24

Senco* not send, sorry for the typos. I'm exhausted

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Mummy0ftwo12 Sat 07-Dec-19 10:07:11

He said 'I love you' that's awesome! I didn't get that until 4

Mum2prince Sat 07-Dec-19 10:43:33

@mummy0ftwo12 I don't think he quiet knows what it means yet, he knows it's something endearing. His dad lives abroad so he learnt to say it on FaceTime 😂 .. thinking about it he says it just so he can get on with what he's doing and not have to stay on the phone. And he only says it back to us, rather then coming upto to me and saying 'I love you mummy'.. stop waiting for that day !

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Mum2prince Sat 07-Dec-19 10:44:12

Still* not stop. Autocorrect

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