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Can anyone comment on the speech therapists report?

(64 Posts)
nikos Fri 18-Jul-08 19:01:00

Ds (3.5) is currently being assessed for ASD. We have thought he might have language delay which is showing as autistic traits as he doesn't have the core traits.
Speech therapist spent 2 hours with him at nursery (her second visit. She has found him to be nearly a year delayed in speech.

She concluded 'X is experiencing considerable difficulties with expressive and receptive language skills and with social interaction and understanding, especially with peers.'
But their is no mention of ASD and now we are left confused. We are going to speak to her on Monday for clarity. She is an expert in ASD so she must have a gut instinct.

But what can we be looking for to differentiate between language delay and ASD? Anone have any comments about what she wrote?
I just wish we could get to the bottom of what is wrong. This has been going on since last SEptember sad.

jimjamshaslefttheyurt Fri 18-Jul-08 19:17:02

She's not allowed to diagnose ASD. SHe almost certainly can't tell you her gut instinct either (for reasons of who's allowed to diagnose what). I would say that her line about social interaction is a signpost to other professionals that ASD needs to be considered.

You could ask her whether he shows signs of language delay (late but developing communication 'normally') or a language disorder (all over the place).

THings that might distinguish would include things like ability to point and communicate without words. I know a boy who has (I presume) GDD. He is about 6 or 7, can't talk at all but he communicates really well, by pointing, gesticulating, vocalising and badgering people until they understand.

jimjamshaslefttheyurt Fri 18-Jul-08 19:17:58

Do you have other consultations lined up with paeds etc? It's best if a paed diagnoses although a clinical psychologist could do it too.

nikos Fri 18-Jul-08 19:28:24

Ds shows us things, has joint attention, can actually talk non stop. But would find a complex sentence difficult to unpack 'Point to the elephant next to the giraffe'. In her words 'he needs simplified and concrete language related to a clear context'.

Her first report seemed to be pointing to Aspergers but this one seems to be more that his language might be causing the problems.

thanks for the point about language delay or disorder. Will definitely ask that.

Tclanger Fri 18-Jul-08 19:54:05

Message withdrawn at poster's request.

Tclanger Fri 18-Jul-08 19:55:18

Message withdrawn at poster's request.

nikos Fri 18-Jul-08 20:10:49

He also has real trouble processing questions. It's important for us to know what he has because then we will know what we are dealing with.
He is always surprising us with the things he does which seem not ASD like. For example, I was going out on Saturday night and when I came down all dressed (quite glam I have to say wink) he said 'That's a lovely top mum'. That is such a complex thing to do if you think about it - noticing what I'm wearing, knowing it was different to normal and knowing that a compliment would make me feel good.
Yet he does still prefer solitary play and show some of the fringe traits.

Tclanger Fri 18-Jul-08 20:56:41

Message withdrawn at poster's request.

nikos Fri 18-Jul-08 21:11:13

What sort of exercises do they give our ds to help with his language?

castlesintheair Fri 18-Jul-08 21:37:59

He sound's like my DS at that age. The reason for the solitary play is that the language disorder (my DS's diagnosis) means that social interaction is difficult.

DS had SALT for nearly a year plus he has had 1:1 support at school. Like your DS he had problems understanding questions/instructions of more than 2 parts. Don't worry too much about ASD (until and if you have an official diagnosis by a developmental paed) just concentrate on the areas where he can receive specific help, such as SALT.

nikos Fri 18-Jul-08 21:59:47

Thanks castle. So was your ds's language delay a developmental thing? Did he get better at language processing with time? Also was your ds suspected ASD at one time?
Thanks

bullet123 Fri 18-Jul-08 22:10:10

I can give you a perfect example of the difference between language delay with good communication skills and language disorder.
Ds2 is three in September. Today he wanted a drink, so he went and got his beaker from the cupboard, handed it to me and said "mu muh" ("more milk"). That communication and interaction would have been impossible for Ds1 at that age.
Ds1 also wanted a drink today. He stood and shouted out "Course you can! Course you can!" several times. I didn't know he wanted a drink at this point so I asked him what he meant. He then realised he'd have to ask me.
"Mummy, say 'course you can!'" he requested. I did so, hoping I wasn't going to agree to him watching the entire of his Teletubby dvds.
"Want some water" he continued.
"Oh!" I replied, "of course you can!" .

castlesintheair Sat 19-Jul-08 08:06:20

DS had (has) a language disorder so not a delay - great example bullet.

He had private SALT for a year whilst we were doing his statement and this academic year (year 1) he has had 4 hours of 1:1 support a day. The change has been amazing. His understanding is normal for a 6 year old now. This has had a knock-on effect on his confidence: he's very happy and has lots of friends. Academically (not an issue really aged 6 but an example) he has gone from below average to average/above average.

To put it simply, he is pretty 'normal' now.

We had many lay suspects of ASD but never from professionals and we didn't believe it either, except when I read too much on the internet grin

My advice to you is get a proper assessment to find out if you DS has a delay or disorder. If it's the latter get some SALT now. Good luck and try not to worry - he is still very young smile

nikos Sat 19-Jul-08 08:34:53

Thanks for that. Can I ask what behaviours your ds had that were ASD like. The reason we are so keen to get the right reason for hi behaviour is just what ou said - so that we can start the right treatment programme.

Tclanger Sat 19-Jul-08 09:10:15

Message withdrawn at poster's request.

nikos Sat 19-Jul-08 11:06:00

Do I get the assessment for language delay or disorder privately? Can I ask what sort of work a sppech therapist does with children with these sorts of delays?

We have had an initial meeting with a paed but TBH she is just following the SLT lead. Paed has never seen him in nursery. We have an appointment for October to arrange for a more detailed assessment for ASD.

Aefondkiss Sat 19-Jul-08 12:47:46

hello Nikos, my ds (4.2) also has severe language delay/disorder (I am not actually sure what the right term isblush) and ASD "traits" according to the paed last September...

DS has been under investigation for two years now and no dx, we might get one after clinical psych observations which are due to happen in August, at home, nursery and in observed play session - but the thing is your SALT can't diagnose ASD, it has to be clinical psych/paed as far as I know.

my ds's speech has improved a lot in the last 4 months, but he is still not like his peers, he can initiate conversation, has 5 word sentences.

Can you phone the SALT to ask her about the things you want to know?

nikos Sat 19-Jul-08 16:58:05

We're going to email SLT on Monday and express our confusion.
I'm still not sure how you work on language delay/disorder. Particularly if it is on receptive language.
Can anyone recommend any good books or websites?
Ds chatters all the time but only using short sentences. So he might say 'I'm going to the shop' but never 'I'm going to the shop with mummy to buy some bread'. He has a wide vocab but only uses it in simple sentences. He would also have a similar problem understanding a complex sentence if someone spoke it to him. I think, unconciously, we are breaking our language into simple sentences for him.

castlesintheair Sat 19-Jul-08 17:02:27

Sadly we didn't get anywhere with the nhs (spent 2 years seeing people) until we saw a private developmental paed and an educational psychologist (expensive) when DS was in Reception. Then everyone agreed with what the private paed said! This meant DS started school without a statement which was not ideal.

If you can see a (private) developmental paed now you might be able to start the ball rolling now and if necessary your DS will have help in place when he starts school. The Developmental Paed will be able to tell you the areas that your DS needs treatment, it is not something that you should be expected to work out for yourself.

DS had no ASD traits except for a language disorder. People (as I said before often non-professionals) are very quick to mention ASD with language delays/disorders but a child has to tick more boxes than that. There are far more knowledgeable people on the sn thread who can answer your questions on that.

castlesintheair Sat 19-Jul-08 17:14:58

Nikos, I think it's best to ask your SALT about exercises at home. Your DS sound's very like mine at that age (and others). DS's speech/vocab was ok it was understanding that was the problem especially long instructions.

My private SALT played games like Simon Says with DS. She brought along pictures of a seaside scene for example. She started with 1 part instructions such as "DS can you colour the starfish yellow" to "can you colour the starfish yellow and the beach ball green" (2 part instruction) to "colour the donkey's right ear purple, the little girls icecream pink and the sea red" (3 part?) and so on. She also had picture cards and she'd ask DS to put all the vehicles in one pile, all the clothes in another.

All sound's quite simple but you can really build it up so it gets quite complex and it helps develop their confidence. Lots of firework/ketchup claps and stickers etc grin

I'd really speak to your SALT first and get her to recommend stuff. Mine used to photocopy pages out of books and leave it with me.

Tclanger Sat 19-Jul-08 17:33:13

Message withdrawn at poster's request.

nikos Sat 19-Jul-08 17:34:39

The things he is doing that are raising concerns about ASD are no joint play at nursery. He will do it with his siblings at home though. But at nursery he chooses to play alone.
He can also be very angry. He can shout at staff and will not sit for register. But I think this is not to do with not wanting to be in a group. But because the teacher chats to the children at register and he knows he won't understand.
He also seems just generally young for his age re potty training, life skills.
Did any of our children with speech disorder show similar things.

Tclanger Sat 19-Jul-08 17:53:55

Message withdrawn at poster's request.

Tclanger Sat 19-Jul-08 17:55:16

Message withdrawn at poster's request.

TotalChaos Sat 19-Jul-08 21:14:42

DS (4.4) has a current DX of moderate language delay. He is about 12 months behind with both his expressive and receptive language. According to paed, he probably doesn't have ASD, but they want to monitor him, as he has social communiation difficulties, and want to see whether they are solely related to his language delay. I asked NHS SALT about language disorder - she didn't think DS has language disorder as she doesn't think he is sufficiently behind (not 2 standard deviations below the mean, whatever that signifies), and she doesn't think his language development is all over the place. Apparently the criteria for language disorder vary from area to area - it's not like ASD where there are set international diagnostic criteria - it's much vaguer.

When DS's private SALT first saw him at 3 she was very concerned about ASD (but didn't say so in exactly those words) so what she wrote to indicate that was that she felt DS should have a multidisciplinary assessment before school.

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