Autism, speech delay, PECS

[ScrambledEggsAndToast123]

Hello all!
My 21 month old boy has recently had a health visitor appointment and I have been told that we are to wait till his 2 year review and see how he’s getting on as we (parents) have concerns regarding autism.
HV said she’s ‘in a quandary’ as he’s showing very mild signs (running back and forth, wheeling cars over hands, no speech but babbles in his own language). She said there are a lot of positives in him though and I’m to wait although by the end of the session she made it sound like she will refer him down the autism pathway. She said she’s thinking it could be more of a communication delay and that he ‘will need help growing up with this’. She’s going to sort out a hearing test.
Anyway, SALT referral paperwork all filled in (I had arranged this prior to the HV) and he’s already attended and completed an early communication class which unfortunately made no difference to his speech at all.
I’ve read a little about PECS cards and am wondering if it’s worth a go or if they will just hinder his speech further?
Thanks all!

My understanding is that PECs are unlikely to hinder but may actually help bring speech on, as the child starts to connect words to images in a more concrete way.

My DS has ASD and didn't really talk until about 3. We didn't use PECs in the true sense of the word (we didn't do the picture exchange bit) but did use PECs cards, social stories and a lot of visual images to help communicate with him and they definitely helped. Doesn't work for all kids, some do better with things like Makaton. But definitely no harm in trying.

Thank you so much for your reply. I keep being asked ‘how do you know what he wants’ and it’s trial and error, offering him food/drink/nap/cuddle etc. maybe the cards will help him to communicate with me what he wants. Do you think he’s too young?
I’ve not heard of social stories so I’ll do some googling oh that also, thank you.

I wouldn't worry too much at the moment about speech as speech delays are very common at this age. Also all toddlers will run back and forth, all toddlers will spin in circles, all toddlers will open/close doors or engage in other repetitive behaviors, all toddlers will wheel cars over all sorts of textures, unless he is doing this all day long or hours on end I wouldn't have thought that it was concerning. Autism is a social communication disorder, and what you want to be looking for at this age is his ability to follow simple instructions, his ability to communicate using gestures (so pointing to request things, pointing to show you things of interest like a plane in the sky), his ability to engage in simple pretend play, examples of social referencing (making eye contact with you when she is cautious or unsure after something has happened like a loud noise), etc.

His eye contact is really good but he won’t point at all or take either of us to something that he wants. He also doesn’t really wave much.
To be honest, I’ve no problem if he has got autism, it’ll just be a part of him and I want to be able to educate myself in what’s best for him and how I can help him. I’m not overly worried (yet) but I’m glad the hv has seen him.
I’m so grateful for both of your replies. This website is helpful too.

This sounds very much like my little boy. He has improved leaps and bounds from 3.4+ onwards.

Hello - sounds very similar to my little boy (22 months). HV refused to refer until he was 2 (I think it's a red line in some areas) so we've got a referral via the GP with support from nursery.
We've eliminated hearing and started with a private SALT who has suggested makaton to try and unlock the communication.
Sorry if this isn't my much help but interesting to see someone at a similar age and stage (my DS also has good eye contact but no waving/pointing/language). Also, you sound absolutely lovely and really open to embracing whatever the future holds. He's so lucky to have you. X

I'd just start with a few simple images and see how he takes to it. E.g. show him a picture of a cup, say the word and then perhaps hand him a cup. So he makes the link between picture, object and word.....

Obviously all kids are different and learn in different ways, but visuals were absolutely crucial to help 'unlock' my non-verbal child at age 2.5/3. The words didn't come immediately but the improvement in his understanding was very noticeable, very quickly.

I read a really good blog post about introducing the cards/teaching understanding. myyellowbrickroad0301.blogspot.com/2012/
The teachmetotalk website is also really good - and speech therapy really helped us although the SALT didn't use PECS but did use Makaton.

My DS didn't point until 2.4 and had no words until 3 - his understanding was and is equally behind, - but he doesn't have autism, (autism isn't the only cause of language delay) and taking language out of the equation I can see that at 2 he did attempt to imitate his sister - i don't mean speech but just copy what she is doing and I think, that imitation is harder for children with autism?

If you look at the teachmetotalk website there is a check list of skills a toddler goes through before speech, and lots of videos with games to practice.

Thank you to all of the lovely messages
I’ve had a quick look at the teachmetotalk site but I must have been looking at it wrong as when I tried to read an article it would then take me to having to purchase something to actually read it.
I’ll give the cards a try then, are there any particular ones that you’d recommend? I’ve looked on amazon but there is so much choice! Completely agree with learning in different ways, I know I’m more of a physical learner, I don’t learn very well just reading how to do it.
I’ll have a nosey at that blog also, thank you!

i think all the podcasts and video clips are free on teachmetotalk, the checklist you might have to sign up to the mailing list to download. I bought one of the dvd's which i could send to you if i could find it.

PECS - I think you can buy off ebay and print/laminate, Makaton is great because you don't need to have a set of cards to hand.

I did not wait for the 2.3 year review, i got the GP to refer straight to the Paediatrician at 2, in fact we skipped the HV 2.3 year review because as i told the Paediatrician it just felt like something he would fail at and we had already been referred at that point.

The hv kept saying ‘I’m in a quandary as he’s so young still and only showing very mild signs which could just be normal development’ but she’s agreed to referring him once he’s had his two year review. She said the wait at the minute is 18months, kicking myself now as I should have just insisted that he be referred now as the waits so long
I’ll go back onto that website tonight once little one is in bed for the night and have another look at it.

you could call her and say you've changed your mind and would like the referral - 18 months is a long time, if your DS needs any extra help at nursery then that process would be easier if he has already seen the Paediatrician.

So the speech and language referral has unfortunately been refused, we have to wait another 8 weeks then apply again if there’s little/no improvement.
I’ve been looking at the teach me to talk website and although I’ve found it a little difficult to navigate, I’ve found some videos which I’ll practice with him. I’ll also get some of those pecs cards ordered.

So the hearing test that the health visitor said she was going to arrange......hasn’t been arranged! I called the hv as I haven’t had anything through the post and have been told shes gone off sick and hasn’t arranged the hearing test. I now have to wait to hear back from another hv who will come round to the house again and then arrange a hearing test. It’s so frustrating as the wait for the hearing test is very long and this has set us back once again. I keep telling myself though that at least I called to chase it up.