Any experience with speech therapy to help with social interaction?

[susan198130]

My son is 3.5 and is being referred by his nursery for speech therapy. Not for his speech as they think that's fine but to help with his social interaction as he doesn't interact with other children (not there anyway). He also goes into his own world a lot (they said that he often sits by the doors that lead out to the garden (they are glass doors) and will just sit there staring out. He doesn't take part when they do singing or dance actions to go with the song. He'll just sit there looking a bit shy. They have also said that even though his speech is clear and they can understand him, he often speaks out of context. He does this at home but generally when he's frustrated. Like if he's playing and I said it's time for a bath, he'll say something like "No I'm not having a bath, there is no room". I can't think of a better example but you'll ask him something and he will respond with a sentence that does make sense but just doesn't make sense to what I'm asking if that makes sense.

When we go out, I often see him play with other children, although generally it will be the other child that instigates play. He does hate change. He's not someone who is obsessed with routine, but his nursery have also said they have noticed how he doesn't like change.

The main thing I notice with him is that he needs so much encouragement to do things. He seems to hate going out. If I say "come on, let's go out", he'll say "No, I'm not going anywhere, I'm staying here" and have a bit of a strop but will be more than happy once we're out.

So I'm just wondering if anyone has had any similar issues with their child and gone through speech therapy? What does it involve? Is there anything I can do at home to try and help him? I just want him to have fun and to know what fun is. Sometimes it's a struggle to get him to softplay - but once there, he'll love it!

Have you seen your GP and asked for a referral to a developmental paediatrician? There are lots of red flags in your post for ASD and so I would ask for a referral.My ds had speech therapy for social interaction at his specialist school as a teen. The speech therapy he had at age three was more about getting him to communicate at all so I can't really help with that,

No I haven't seen my GP. I have thought about this but I'm not sure if they'd be able to help too much as they only generally give you around 10 minutes which potentially wouldn't be a lot of time to see any of the issues. But I have spoken to my health visitor who is going to see us later this month to see if she has any concerns and then she said that she can refer him for anything that she might feel he needs help with - the only problem is that she said she has lots of children who really do need some help but they are getting declined. I explained about my son's behaviour and the issues and she said that the children who are being turned away from specialist help do have much more severe issues.

I look at his brother who is 2 and he's just so different. He's very boisterous, always looking for someone to play with, loves being the centre of attention. It just makes me feel sad as I don't want him to play on his own all the time. I want him to make friends. He gets on well with my friends' kids although most of them are girls. He's not keen on girly girls but the more tomboyish ones, he loves to play with.

I just thought I'd add that my husband was very much like my 3 year old as a child. He struggled to make friends. He says he doesn't remember having any friends at nursery and he used to go to this summer camp thing in the holidays as a child as his parents both worked and he said he remembered just wandering around the whole time on his own. He has a very active imagination as well. He said as a child they used to go on holiday and basically stayed in this place that was on its own in a field. I said that it looked like the most boring holiday ever but his answer was "No way, there were so many adventures I went on there" - in an empty field haha!

But he was always shy and quiet, whereas I've always been a bit more outgoing. Everyone comments that my 3 year old is just like his dad personality-wise whereas my 2 year old is much more like me, fiery temper included.

The thing is a lot of these behaviour issues that his nursery have flagged seem to be limited to the nursery environment. As I said, I see him play with other children, sometimes he will initiate it, and speaking out of context - at home anyway - is just limited to when he gets frustrated. I can ask him questions other times and he'll respond perfectly fine. I think if he didn't go to nursery, I'd just think he's shy but I'm definitely taking their concerns seriously as they are concerned that he will just get forgotten about once at school. In a class of 30 children with one teacher (and a teaching assistant if they're lucky), they won't have the time to give him the attention he possibly needs.

HV's don't have any specialist knowledge of child development and all concerns should be raised with a GP at the very least.Please don't rely on a HV making necessary referrals.
I can tell you that if your child has any sort of difficulty you are going to have to be a fighter to get his needs met so see the first GP appointment as an opportunity to practise.
So firstly make a double appointment when you book. Secondly make a timeline of when he met his milestones so when he smiled, when he sat up, rolled over,crawled,first words etc.
Then make a list of your concerns and give examples so any behaviour issues, his speech difficulties,his need for routine, anything that you think not quite right put it on your list in bullet form.
Give the GP time to read it and then say nursery also have concerns regarding his speech and social interaction and you have been advised to seek a referral to a developmental paediatrician (I am advising you but you can be vague and imply it's nursery )
If he doesn't agree straight away you repeat that you and nursery have concerns and you would like him to be seen by a paediatrician. Make yourself comfortable, make it obvious you are not leaving without a referral (the GP will be thinking about the waiting room) and like a broken record repeat you have a list of concerns,nursery share them you want him seen by a paediatrician.
You will get your referral I'd bank on it,hopefully your ds will be bored and fed up and will start playing up a bit too so don't be too quick to pacify him as that will help the GP to get rid of you quicker andgive himthechance to see some of your concerns.

The lady I'm seeing at the health visitors I don't think is an actual health visitor. She remembers me but I have no idea who I was speaking to as I don't really go to the health visitors now that my boys are that bit older (plus I'm back at work now so don't have as much time to go) but I don't think she's actually a health visitor, she said she's a nursery nurse or something like that and said that she would be able to look out for any red flags and can refer for any specialist treatment. Maybe I'll book a doctors appointment as well anyway as it can't hurt to get their input as well. I think I want them to get his hearing checked too as although I think he can hear, he does like to have the television up a bit too loud and sometimes I have to call his name 3 or 4 times to get his attention - but I think this is because he's zoned out and isn't paying attention!

I just googled typical symptoms of ASD:

Difficulty with verbal communication, including problems using and understanding language - I don't have this problem but his nursery sometimes say he doesn't seem to understand what is being asked of him sometimes. The only time I have issues with his communication is when he throws out sentences that aren't relevant to the conversation.

Inability to participate in a conversation, even when the child has the ability to speak - When I went to his story time the previous time, all the children were sat down and he did speak up and started talking about the story. And he will speak to other children, especially if they are playing something that he likes - like cars or lego.

Difficulty with non-verbal communication, such as gestures and facial expressions - he seems fine with this, he knows when things are funny and laughs, loves watching funny clips of cats on YouTube and will have a giggle, smiles when smiled at, definitely shows me when he has the hump with something.

Difficulty with social interaction, including relating to people and to his or her surroundings - he obviously has issues with social interaction but more limited to nursery, I've always just thought he was a bit shy.

Difficulty making friends and preferring to play alone - Definitely likes to play on his own and doesn't have much interest in making friends. His nursery have said there is one boy there who he does seem to like but she said this boy is quite quiet and mild mannered so she thinks this may be why he's drawn to him.

Unusual ways of playing with toys and other objects, such as only lining them up a certain way - He doesn't do this, plays with toys normally

Difficulty adjusting to changes in routine or familiar surroundings, or an unreasonable insistence on following routines in detail - He doesn't like change but will adapt to it pretty quickly, like he doesn't like to wear clothes that he's not used to like button up shirts but he will wear it then in the summer, switching him from trousers to shorts (last year, he told me "mummy put these legs away") but then he will adapt pretty quickly. Also simple things like just changing the style of plate he eats from. He used to just eat for your standard child's plate but then I bought some that have sections. At first, he told me he wasn't eating from that but I told him he eats from it or he doesn't eat but he ate from it and has been fine ever since. It only seems to take once or twice to adapt him to changes. He doesn't obsess about routines at all.

Repetitive body movements, or patterns of behavior, such as hand flapping, spinning, and head banging - Doesn't do any of these

Preoccupation with unusual objects or parts of objects - None of these.

So I guess he does have some traits and I'm hoping that any help I can get him will help him. I'm also hoping that maybe once he starts school, it'll be different as at nursery, from what I see, it's 30 kids just running round playing whereas at school, it'll be more structured, he'll have to sit next to someone so hopefully he'll make some friends. My 13 year old niece used to be similar to this. She never mixed very well, hated nursery, didn't have any friends at all then went to primary school and made friends, although not loads but now she's 13, she's always out with her friends and is fine.