My friends son has lack of eye contact and his speech therapist says he does not make choices........

[mum2twins]

My friend has asked me to post this (she has just had new baby so long typing out of the window) and is looking for some reassurance or advice on some problems with her 2.8yr old DS.

Her DS was identified as having glue ear at approx 2yrs, he was not speaking and clearly could not hear at all. Following the op 8 months ago he has started to say a few single words or two word phrases. He was given some speech therapy which was play based, but his speech therapist commented that he did not make choices. We have been offering choices but still he seems unable to grasp the concept. He very rarely gives eye contact and when you speak to him he only repeats what you say. He does not seem to do any independent speech or link any words together. My friend has taken to focusing his face on her face when she talks but he is quick to look away. He babbles away as if he is trying to talk. Obviously this is frustrating for my friend especially as she now has ds2 who is only a few weeks old. Has anyone got experience of this and the choice / eye contact thing.

is the SALT referring him to a developmental paed. Hows his non-verbal communication? Waving/pointing etc?

thanks bethron.
Jimjams - what he does do is lead you somewhere by the hand as he does want people to play with. He doesn't role play. Loves those sit in and ride cars, brio trains and fits tracks together. He is difficult to engage fully, although when last here I did manage to get him to put some pasta in a bowl whilst I was cooking. But he rarely looks at you. He doesn't bring toys to his mum and won't make choices like "do you want the car or bus"? He seems in a little world of his own. He is easy to make laugh like when being thrown around and tickled and is smiley when he first arrives and sees me and the twins. But anything you ask him he just repeats. The SALT he is under has said she will need him back in September for more work.

He needs to be referred to a developmental paediatrician really. The problem with referrals back to SALTS etc is that they never take place until months after they say they will. (We waited over 8 months for a 3 month review with ds1). If she has a firm date with the SALT for September she could wait until then and ask for a referral to a developmental pead. Although in her shoes I would be tempted to give up on SALT and ask a HV or GP for a referral- mention lack of pointing, lack of spontaneous speech (worth mentioning that he repeats everything), and leading by the hand.

Jimjams - are you suspicious that there may be something other than a hearing issue? it is a difficult thing to raise to my friend. If I suggested the development paed am I saying there may be a bigger problem? Just need to know in case she gets upset and how best to handle it?

how old is your ds

Thanks, glad to hear your little ds is getting good support and help.

I agree with Jimjams that this little boy needs to be seen by a developmental Paed. Some of the difficulties could possibly be attributed to his hearing but not all of them I'm afraid.

ok thanks, I had never heard of a developmental paed before, and I know not something that has been mentioned to her either. She just needs some advise and reassurance, no-one has stuck their neck out and said this is common in your situation or not common. Especially with the new baby it all adds to the pressure! He is a great little chap and I can't imagine how frustrating it must be for him in his little world. I know her DH has private healthcare - is a developmental paed someone that can be seen privately?

I'm fairly sure Dev Paeds do private work but I've only been via the NHS route myself. If she needs help finding one then I'm sure someone on the Special Needs board would be able to help with suggestions, depending on where she lives etc.

It's hard to take in that there might be a problem but getting some kind of assessment done at an early age like this means that he can get the help he may need much sooner. She is lucky to have such a good friend.

I think this little boy needs a professional assesment, reading through the thread my thoughts immediately turned to ASD (Autistic Spectrum Disorders).

I'm not a parent, but have been working with children who have special needs for 10 years.

I can only comment on what has been said on the thread, and there is every chance I am completely on the wrong path, but god forbid there is an issue that requires intervention, the sooner it is identified the better.

I'm sorry to be so blunt, and certainly don't want to upset or panic your friend, but wasn't sure how to say this more sensitively.

I would just recommend that if your friend is concerned, there is no harm in going to your GP and asking for a referal to an educational psychologist for assessment.

Hi Josie3 - would you mind me asking why you say that. I am obviously anxious I have not painted a inaccurate picture as he is not my child. What I would like to know is how a child should be acting that has been deaf for so long and therefore starting again, would behave? He is very affectionate and loving to his parents and does not exibit any behaviour such as rocking etc. But obviously I have no knowledge of these condtions. If there was a concern wouldn't the SALT have picked up on that?

Mum2twins, my ds1 had a hearing loss and needed grommets. Afterwards we realised his hearing must have been dreadful because he immediately started speaking in whole sentences and jumped at any noise at all. However it really settled down very quicky and he came on in leaps and bounds although he was under 2 at the time, younger than your friends ds. The unwillingness to make eye-contact sounds as if it is not entirely a hearing problem. I would agree that a referral to a developemental paed would be appropriate.

Hi,
Like I said I could be way off the mark but the lack of eye contact, and inablity to make choices concerns me. They are not typical for children of this age, even with a severe hearing problem.

You also described him leading people by the hand so they can be with him, lack of interest in role play (which is not an indicator in itself, but when looked at in combination with the other behaviours you described). You also said that he is quick to smile especially in rough and tumble play. All of these indicate to me that further investigation is needed. I'm trully sorry if this is causing panic. I'm really not sure I should say anything else, I just think that if you weren't concerned then you wouldn't have posted. Maybe your friend is concerned too?

I'm not saying that he has Autism, i just said that was brought to mind when I read the thread (I'm not trying to sound snotty - just cover my back)

All I can do is offer an opinion based on my experience (Social Work degree, Early intervention worker with children who have special needs through children's services, and more recently I became a nanny - less stress )

Incidently, the autistic spectrum covers a massive range of behaviours, and people with Autism can be very loving especially with people they are familiar with.

I have 2 boys with autism (ASD). They are both very affectionate and neither of them are into rocking. I must admit that from reading your post this was also the first thing I thought of too. Hopefully a Dev Paed may be able to give your friend a clearer picture.

mum2twins- I said to see a dev paed as I immediately thought of autism as well. I have a severely autistic 6 year old, who is very affectionate and these days happy even (and adores rough and tumble).

Obviously none of us have seen this little boy, but from what has been said I think he needs a proper assessment. I am horrified, but not surpsised that the SALT hasn't referred him on. At just over 2 my son saw the autism specialist SALT who told me that my son definitely wasn't autistic and if he did have any problems at all they were certainly mild. He's severely autistic. I would hate fomr your friend to be in the same situation as we were.

However none of us have seen this little boy, and he has had some hearing problems. That shouldn't affect pointing though. He does need a proper assessment not just to sit on a waiting list. Communication disorders need to be ruled out given the leading by the hand, not understanding choices and echolalia (repeating everything).

ok thanks. I have now called her and said my investigations have lead her to get him checked out by a developmental paed, if nothing else but to put her mind at rest - if he does end up having any problems in this area, I would have liked to think the SALT would have alerted her to the possibility. The SALT sessions have involved them playing with him and the parents watching, so you would think they would be concerned???
If it does indeed end up anything, fingers crossed it doesn't, I will certainly point her in the direction of those of you who have been through this and I know will offer her good advice, help and support. I will keep you updated.

mum2twins- at the same age that my son was first seeing the SALT (who said he wasn't autistic) my firends son was treated for glue ear. My friends son started speaking quickly and was always pointing, following a point, understanding group rules in music class, interested in playing and adult direction. My son wasn't.

I don't know what they teach SALTs to be honest

So pleased your ds is happy these days Jimjams

You have now got me all worried about pointing, maybe he does point but just can't recall it. He may have pointed at the little ride along car and said 'car' but doesn't point to excess.

Does he ever use pointing to show things to people? Usually this would mean pointing at the object and then looking back at the person to see if they are paying attention to what he is pointing at.