Speech delay with autistic sibling?

[LightTripper]

Hi all,

DD is 4 with a Dx of autism. She is doing very well and had no speech delay as such (more speech differences: e.g. reversed pronouns and not asking for things she wanted). Her issues are mainly social communication and associated anxiety (not too much sensory: though I think she has some proprioception and interoception issues).

DS is 18 months and doing so many of the things that DD wasn't doing ("red flags" though we didn't know they were at the time). In particular he points at everything - at things he wants and things he wants to draw our attention to. He points at things many many times a day (whereas I'm not sure DD had ever pointed at this age). He is into everything - emptying out boxes, getting things to stand on so he can reach what he wants, exploring hidden places - all things DD never really did. He seems happier to play with other children his age than DD was too - e.g. will point things out to them and doesn't mind getting stuck in and taking something away from another child or giving something to them (whereas DD would always try to find her own space to play at that age - and at most would watch other children playing, but not try to join in).

However, on the other side, he still only has maybe 5-6 words and they are very indistinct. Quite an odd bunch. He has words for "bird", "squirrel", "poo" and "fish" but doesn't say Mama or Dada yet. He has good understanding of instructions (e.g. he will go and get into his chair or get his shoes and try to put them on if you ask him to). But whereas DD at his age could point to probably hundreds of things accurately in a book ("where's the cat?" or whatever) DS is patchy at best in his ability (or motivation?) to do that.

Given DD's diagnosis I'm obviously thinking that he could be autistic too, given his speech is behind. But he is so different to DD, and is doing well in areas that we were told were "red flags" for her, that I'm just not sure. Do you think it would be a good time to take him to an SLT - or is it worth giving it a few more months to see how he gets on?

[livpotter]

Hi light, I know I've spoken to you about this before a while ago. My dd was really behind on her speech and like you I didn't really see any other 'red flags'. I got the health visitor to refer her to SALT at her 2 year check because she was so behind.

They gave her an assessment and said although they don't worry so much about speech until 2.5 years it was definitely worth seeing her. We then got put on a 6 week course and at the end we decided with the salt to wait and see.

Anyway she's about to turn 3 and her speech has come on hugely. I think partly due to her age but also Makaton has been amazing for her and she has picked it up so quickly. Also all the visuals I use with ds has really helped her.

In my mind it was worth having her assessed early just in case we did need to get her an ASD assessment later.

[MumUnderTheMoon]

Anecdotally boys are slower than girls to speak and use more receptive language. Talking isn't the only way to communicate and if he isn't frustrated I really wouldn't worry about it too much. If you are referred for assessment the first thing they'll probably do is tell you not to let him get away with only pointing at what he wants but only give things to him if he attempts to make a sound for it. If he uses a dummy get rid of it asap and probably teach you a bit of makaton. But you can do all those things now and see how he goes. The average age of an autism diagnosis in the most recent material I could find was 4 years and 7 months he has a while to go until then and most toddlers have autistic traits that they grow out of. You just notice these traits more easily because you have experience with autism. I do it all the time.

[LightTripper]

Thanks both! Liv I should have known I had wobbled on here before about it. I just remember that DD started to get her first words much earlier and must have had dozens by now, so it's too easy to make comparisons! Great to hear how well your DD is doing.

I think I'll give it until half term (try to get DD properly settled in school!) and then revisit, but these are good tips in the meantime. We are definitely guilty of just giving him what he wants when he points to it even if he doesn't say a word MUTM (so much quicker and he gets frustrated if we play dumb... but we just need to make that investment of effort I think!) We got rid of the dummy at about 15 months, so I don't think that's a factor (he only ever had it for sleeping anyway). I know nothing about Makaton but will start to read up a bit! Our nanny taught him the sign for "finished" and he loved using it for a bit but then the novelty wore off - we should try to get him back into it...

[SpringerLink]

Do you have drop-in SALT sessions anywhere local? I did them at a children’s centre with my third DC because of delayed speech (I feel quite guilty that I hadn’t noticed... I’d only popped in to say hello to a therapist I knew from DC1 who has ASD and she picked up on it).

Anyway, it turned out to be caused by hearing loss. In the end it was glue ear, which cleared up and DC3’s speech improved lots around 2.5 to 3.

There are lots of reasons for delayed talking, including being a younger sibling and a boy. But there’s nothing lost in dropping in to get things checked out.

[123bananas]

There is some great information on how to encourage speech and language on the Talking Point website.

Ds (4) has asd with speech delay and he was interacting much less at 18 months with no words at all. We were told not to worry until he was 2.5 then they would refer to SALT. It is not just about what they say, non-verbal communication is important and it sounds like he is doing that.

Complete these development questionnaires to see how he compares (these are routinely used by Health Visitors). If you have concerns you can show these to the HV.

<a class="break-all" href="https://www.google.com/url?sa=t&source=web&rct=j&url=www.southernhealth.nhs.uk/EasysiteWeb/getresource.axd%3FAssetID%3D99660%26type%3DFull%26servicetype%3DAttachment&ved=2ahUKEwi4rovcx8_dAhXsLcAKHRRdAxYQFjAAegQIABAB&usg=AOvVaw3xYVll43focfSamDrlkmjE" rel="nofollow noindex" target="_blank">18 month ASQ-3 score sheet

18 month ASQ-3

18 month ASQ social and emotional

Score sheet for 18 month ASQ SE on pg 28

[LightTripper]

Thank you! We'll take a look at those. I was much more tough with him at the weekend (making him say something beginning with "m" as an approximation to "more" before he could have another breadstick, etc.) and he seemed to actually get a real kick when he managed to do it and it wasn't too bad. Good reminder how easy it is to slip into bad/lazy habits!

We do have a drop in Springer which is brilliant and we used with DD. I may leave it until after half term as work is a bit manic with time spent settling DD into reception and it will take a full morning realistically (you can't book, so if you're unlucky you turn up and then wait an hour or the SLT hasn't come in that day!) But I think it would be worth getting some advice even if he's just being a bit slow.

[Wwwomble]

Hi light. Sorry to hear you have concerns about dc2. You may remember I’m in a similar (but also very different) situation with mine. You seem very very on the ball, so don’t mean to sound patronising, but have you done the m-chat test with him? Might either put your mind at rest or give you focus. He sounds like he’s very communicative though, which has to be a very positive sign. (And I don’t know why m not allowed paragraphs today?!?)

[LightTripper]

Hi Wwwomble! Yes sorry, I've been wibbling on this for a while but not doing much about it. He is definitely coming on (a few new words even!), but I'm still just not sure.

I have done it but the problem is the "sometimes" questions.

E.g.

• He sometimes tries to get my attention to look at something he's doing but not that often
• He sometimes responds to his name but I don't think he does it any more than DD did (who is autistic and definitely now responds to her name less than her peers)

If I answer those "sometimes" questions with a "no" he scores 3, which they say you should take for an assessment, so I probably should do that ... but I'll spend a bit more time over the next couple of weeks making sure I really know what he is and isn't doing in that regard first I think!

I'm not super-worried because he's a very happy chap, engaged, seems sparky. So whether he is autistic or not that is all good stuff I think. Just trying to work out when we should start to get some input, and it seems like it probably wouldn't hurt to start to get some advice now whether he is or not...

Thanks all!

[SpringerLink]

@lighttripper - when my DS was diagnosed, we were told that there are kind of bands in age for diagnosing autism, and that HFA (that would pervisouly have been Asperger's) is commonly diagnosed around 7-9, where as classic autism is often diagnosed before 4.

It's not always obvious to parent, professionals or anyone, really, at such a young age if a toddler has HFA. It's completely normal to notice traits in your other children once one is diagnosed, and to worry.

I would say, though, that at 18 months it would be hard to say anything definative. But if you are anxious about it then get it checked out.

On the other hand, you sound like a very engaged parent, and with experience with an older child you are probably already doing all the right things. What would a diagnosis change for you now? Would it matter if you waited to see what things are like in 6 months or a year?