Auditory processing /word retrieval /ENT Help! what to do

[smilingmum1]

Hello! I'm looking for advice.
Any input or pointer will be much help.
My almost four year old has some difficulties with language and processing although I can't pinpoint.
He has had his hearing checked after a SALT friend advised it and does have some mild hearing loss in low frequencies which is in both ears but worse in his left. His middle ear canal is also sucked in. He will have a follow up appointment and have his hearing rechecked they are not concerned as it's very mild and he speaks well. I don't know if I should push for ENT referal as sucked in ear cannal can be linked and there is a family history of ENT isssues (althoigh all different)
The problem is like this. He seems very inconsistent. He can have difficulties with what appears to me Word Retrievel example ask for the thing to cut with instead of saying a scissors even if he had just been using it and speaking about it before. On the other hand he can remember detailed occurances from a long while back or retell stories from nursery or information about different cultures that he has learnt. He is quite expressive but can get stuck on basic words.
Another thing is that he also seems to switch off at times and not know and a 10 minutes later know perfectly without him telling him.
When he is busy or distracted he often doesn't hear me and when he is spaced out won't answer what I asked even if I'm right next to him - unti I really raise my voice.
When he is anxious his words do get stuck more.
Other than that his gross and fine motor skills are fabulous. He is very lively, quite sensory seeking, loves messy play although his work is very neat.

Oh and I don't know if it comes in at all or an unrelated ssue that he needs help but he does seem to have some contradictions with his bowel movement too. His face turns beet red with effort but his bowel movement is runny (sorry for the detail). He also complains of stomach ache which passess quickly.
I don't know who should I take him to or if I should take him for an assessment. His nursery are not concerned but it does worry me and he does seem stuck and blocked from reaching his potential.
Thanks for reading my long post.
Any advice or pointers will be greatly appreciated.

Word retrieval issues can be an early sign of dyslexia. How's his drawing and mark making coming on?

Is he snuffly? Does he sound nasal when he speaks?

Do you think he might need grommets?

Do you make sure you have his attention before you speak? The zoning in and out might be respite from sheer effort or an attentional problem.

You might be describing short term memory difficulty and/or rapid retrieval issues - normally an ed. pysch or specialist teacher can test for these. Can he rhyme? Has he started spotting words he knows?

First port of call would be the nursery and ask do they have anyone who tests expressive language skills, phonological processing and attention.

Alternatively, could you afford to go private?

Thanks for replies.
His drawing is good. WHen he circles his worksheets it looks like it was done by an adult.
He doesn't sound snuffly, and hasn't got fluid in his ears as far as i was told when they checked his hearing.
Darkchocolatebuttons Could you explain rapid retreival issues and phonological processing?
We did work on rhyming with him and on hearing the initial sounds of words and he can do it well now. The only words he recognised are his name and sometimes his sisters name. Is that ok for his age?
So if I do go private is a Speech Therapist enough or do I need an Ed. psych?
Any ideas for getting his attention before speaking except for calling him which doesn't work or tapping him?

Making sure that you are in the same room helps - use what works - so, touch is good and a pause to allow for him to re-focus before speaking.

Rapid retrieval is the speed with which we can produce known information - one typical test is a sheet with a series of colours and you have to name them as quickly and accurately as possible. There are similar tests using objects, letters, numbers.

Phonological processing is basically seeing the patterns in language - so, spotting words that rhyme, use the same initial letter/sound, being able to break words down into smaller and smaller parts and rebuild them and so, it underpins reading and writing.

Short-term memory difficulties are relatively common but often not picked up in bright kids because they compensate. The reason I bring it up again is it can go hand-in-hand with phonological difficulties or rapid retrieval issues.

I would go back to your Salt friend and ask them where to go next. A lot depends on what you want out of the situation. Ed. psych's do reports and recommendations - so, an overview and you have to get it put into practice. Salts would do the language based testing and could suggest a programme - again, it would be down to you to either fund a Salt or do the work with your DS.

And finally, have you spoken to your GP about the bowel movements? That would be my first port of call.

So that's all a lot clearer now. I think that's really what's been happening to him. Bright child, short term memory difficulties going unnoticed. His phonological processing skills are good only because we have really been working on it. I work in the literacy field with young learners so I started helping him at home around when he turned three. Rapid retrieval is an issue though.
I like the idea of pausing to give him a moment to refocus - never thought of it somehow.
GP just says that all kids are different... as long as he is growing - and he is rather tall, but I'm going to push harder for some action regarding his bowel movement.
Many thanks. You've been really helpful.