4.5 yr old development - normal or should I get him assessed

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I have some concerns about the development of my 4.5 year old DS. He starting school in September and I think its brought it up in my mind more.

He is a very sweet boy, polite and loving but he seems very behind to me when I compare him to others in his year group. He is loud in groups and does struggle to sit still in some situations. He is never quiet - we are always reminding him to use his indoor voice.

He has struggled with his hearing and speech development but was signed off by the speech therapist in September last year. They had concerns about his understanding and there was a significant speech delay but felt last summer that he was where he should be.

My main concerns surround his seeming inability to either listen to what I've asked him to do or his lack of understanding of what he has been asked to do. I have taken to asking him to repeat back what I have said and more often than not he can not repeat it back.

In addition he seems to struggle to remember names - he will ask a child over and over what his/her name is and often then get it wrong later when playing with them.

He has also become very whingy and often replies to children or adults by screaming at them if something doesn't go his way. We have spoken to him about this and I'm a stuck record... please use your words.... maybe I'm expecting a change too quickly but it does seem to be taking time.

He also seems very angry sometimes when asked to do something he doesn't want to, I have been putting this down to testosterone surge but how long realistically does this last?

His pre school don't seem to have any real concerns, he is reading already and loves numbers/maths games but I am concerned that these issues will affect him when starting school and with is social interactions.

Maybe as he is my PFB I'm just over reacting but would love some feedback from other mums of 4yr olds!

Does he behave the same at home and at school?

How is his hearing now?

www.nhs.uk/conditions/auditory-processing-disorder/Pages/Introduction.aspx

Has he been assessed for APD? It might help to try some of the techniques to see if they help him?

He sounds a lot like my DS. Doesn't pay the slightest attention to other people's names. He was determined a girl that lives near us was Amy but she's actually Sophie. He doesn't sit still and if he's busy he just blanks me out completely. He's also alternating between rage and whining. But just at home. When he's out he's charm personified.

I think that it does sound as though he's having some issues with receptive language. The screaming at other people could be an indicator of his frustration at not being able to understand what's being said to him.

What is the consensus on his hearing now? Can he hear well?

He had a hearing test that was clear but my general feeling is that it 'comes and goes'.

It takes a while to remember names/words often having to repeat many many times.

Could it be glue ear? Ds suffered from this on and off and it really affected his tollerance to noise, his ability to hear, his ability to process instructions and all sorts. simply because he couldn't hear properly but it came and went with some days being worse than others.

Sounds like a typical child to me...my 4.5 yr old is just like that. I am hoping she grows out of it (am pretty sure on some development chart I read once it was deemed normal whatever that is ). Like you, I am keeping an eye out. Unlike you, time is on my side re primary as where I am dc will not start until Sept 2017 which has its pros and cons.
But when I was in the UK my pfb was similar at that age and reception year knocked it out of her (not literally I hasten to add). Please post if you end up with an early diagnosis...the paediatricians here don't see any underlying issues and despite having three, my maternal instinct is shot to pieces due to sleep deprivation.

Actually I don't think it is typical, but I have seen this type of behaviour in children. I think shouting is frustration and it could be hearing or he is unable to articulate what his feelings are. Therefore his speech delay might still be impinging on his progress . Your nursery seems a bit
Complacent to me and I would ask to see how he has been assessed in terms of hitting the targets or exceeding them. Have they given you precise feedback? I think I would try and see your GP or health visitor to talk through your concerns. I would definitely see if they think he is needing more interventions, for speech, glue ear or something else.

Totally normal. My 4.5 year old is just like that.

With known hearing and speech problems in the past, problems with receptive language and the reactions he's having to certain situations, I don't think there's any harm in going back to your GP or health visitor and exploring whether he's still in need of additional support or intervention.

Does he go straight into full time school in September? Are you happy with this? Is there wriggle room if you want to do things a bit differently?

I'd say his receptive and expressive language are not ideal. The inability to remember a name or other nouns is a little worrying as well - have you seen a developmental paed for this? It may be a very specific inability to remember nouns (it's rare but is a recognised condition).

I think his speech delay may have gone but he seems to still have a speech/language difficulty which may need reviewing.

I know a child who behaved well at nursery/school in that they had worked out that if they stayed quiet nothing happened to them and the school totally failed to notice the child was not learning anything. The frustration and screaming in other environments may well be when he can't keep it suppressed any longer.

My 4.5 year old is similar. The anger at being asked to do something or not getting his own way, the loudness (oh, the loudness), whingey, whiney, unwillingness to take on board requests.

He also seems to take a while to process what's been said. (We get a lot of automatic "huh?" - but a second later he's got it. In fairness, I'm the same a lot of the time).

But he doesn't have trouble with names. And it's definitely mainly that he doesn't want to follow an instruction rather than not understanding it.

Maybe there's something there, maybe it's his normal developmental trajectory, maybe not?

Thanks all for the replies. I've got a small update.

After posting this my DS's behaviour seemed to start improving, whinging stopped completely and no screaming.

I did take him to the Drs as I wanted to consult and discuss options for referral. DS was wonderful with the Dr, totally charming as if I was a total loon for bringing him in!

The Dr checked his ears and was concerned as he felt that they were "very white" inside and has referred us to ENT as he suspects that glue ear is the issue here.

Miggsie I agree that I think there is an issue, I think that there is a possibility that the glue ear is coming and going and that this is whats causing the issues. One day he hears well then next not well. He has been nailing names for example in the last week or so - I think the name issue is simply he can't hear it properly and so is asking again and again and now with his ears clear currently he's finding it no problem!

He has been chatting to us and others about things that happened to us on holiday over a year ago and from a holiday in May and seems to have no real issue with long term memory, it really does seem to be names!

We do now have to wait until October for the ENT appt which is frustrating but I'll have to keep his new teacher in the loop I think.

All advice on next steps very welcome!