Toddler behind on verbal skills but he won't sit or focus enough for us to try to develop them

[mamma536]

DS is 2.5. His gross motor skills are brilliant fine motor skills are ok. Communication wise I think he has actually regressed. He used to try to repeat words when we asked, but doesn't anymore. He's stopped using words he used to know. His spoken vocab is probably down to milk, please, no and asking for screens (we are limiting).

We know he understands more (he'll carry out a few instructions and will occasionally fetch something for us) but he won't focus on us to even listen much less carry out any instruction. We try to praise as much as possible, but he doesn't seem to have any interest in pleasing us, which I thought most kids would have, just himself.

We try endlessly with animals, colours, instructions, books, but he has no interest. He almost never sits down for a book. I took him to a playgroup once and tried to sit down to read with him. He ran off as usual, but a little group of other kids had also sat down with me to listen to the whole story - I've never experienced that before and it makes me want to cry.

He adores pouring water and beads, and loves trains. We indulge him with a homemade pouring station and try to encourage him with trains, but it's a bit hit and miss.

We had his 2yo assessment already and were given some games and exercises to try with him to encourage his communication skills. But he has no interest, just wants to run and jump around.

It bothers me that he won't look at me much of the time and I can't get his attention, mainly because he's zeroed in on something else. That said he does look at me when he wants to and have cuddles.

I'm just frustrated that we can't do all the things your supposed to do to help them develop. We can't read with him and end up reading at him which can't be much good. So we're left with lots of physical activities which are exhausting.

Do we need to worry and look for more help? Or should just keep trying and see how it goes? His dad didn't talk until 3yo and his aunt (DH's sister) was also hyper at his age and they're obviously fine now. I thought there would be this massive leap in communication between 2-2.5 that I was really looking forward to, but he seems to be going backwards in some ways.

The public children's hospital have appointments available in 2 months - such a long wait! I'm exploring other avenues - apparently a referral from a GP can get an earlier appointment. A parent advised me to start with a public hospital because they won't have any self interests, and can move onto private later. I'm going to find out what waiting times for other options are.

ASD approach like ABA will address the focus issues. Work on those. Find something that motivates him. Tell therapists what he is motivated by. A spinning wheel a light a cookie.

We're going private. The doctor at public hospital itself said it might be a better fit for us. The doctor said only a psychologist can diagnose autism. Does speech therapist = psychologist?

I've compiled a small list made up from recommendations off the Facebook group I'm on. For all I know they could be therapists recommending each other. But a few centres and people are recommended consistently.

My DS was exactly the same! Speech delayed until 3ish. We enrolled him into nursery to engage and play with others. Nursery were brilliant at referring him to SALT etc. They thought autism too as DS was dreamy & just wouldn't pay attention.

Then we realised he was deaf. He had terrible glue ear!

Following grommets he had occupational therapy, sensory delay, lots of support to help him get used to being able to hear.

Now he's top of his class for maths, phonics and reading & can't stop talking

Also DS's regression happened at times whereby his glue ear was worse and he was more deaf & struggling to lip read.

I am autistic and I could swear I could see autistic traits in him. I was adamant!

A speech and language therapist isn't qualified to carry out the ADOS. The ADOS is what is used in the UK so I'd try to get that administered where you are. That may be a educational psychologist or a developmental paediatrician. If you tell us which country you're in we can probably help more.

The hyperactivity, especially climbing is a classic autism symptom. Nothing your husband did made it worse or triggered it. He did his best to care for his son. When our son was diagnosed DH and I went to family counselling. It's a huge rollercoaster ride of emotions from guilt to grief.

I might have missed but has his hearing been checked? Children that can't hear can present as autistic.

I'm looking into hearing and vision tests. As local GP doesn't have the facilities to do it we have to go to separate ENT and eye specialists I'm told. Along with a psychologist to diagnose possible ASD and at least weekly therapy/interventions, special preschool, it's looking quite expensive. But I'm getting a lot of good advice from my local Facebook group. I am keen to hear a UK perspective though as we are almost certain to return before school starts on a few years.

I'm curious about climbing as a classic sign (as well as spinning, fascination with spinning objects). What does the child get from it? DS was a frightening good climber as soon as he could pull himself up. I couldn't make our home safe anymore after 1yo and felt so desperate that I took him out of the flat for long stretches just to have a break. That's when I started to find motherhood really stressful and it's just escalated since.

We did speech therapy sessions around that age. Note that it is more about teaching the parents than the child at the age. A few things I learnt:

• Don't ask questions. Speaking shouldn't be a stressful test
• Use simple single words rather than complicated sentences
• Have dedicated special time for 10 mins every day where you play with your child and follow their lead. Provide commentary on everything.
• Try to tease out a word as part of a game. They are more likely to talk when motivated. For example, delay blowing bubbles to give them a chance to ask for it.

Also note that in bilingual families and ones with a history of speech delay it is quite common.

Yes Hannibal is all about seeing what they are interested in / doing, then going for a short interaction, following their lead and introducing a little language.

Hannen sorry op not Hannibal

I also agree that you have to get him for ASD evaluation, there is some concerns and an answer will definitely help you all, if there is nothing your concerns will go away and if is a yes your son will get the services and the help that he needs. But have in mind and be careful because some people that they are working in social services there are not so expert or professional as they think ( but there also some there are brilliant ) In my case I had an experience with the first category. My son start talking at 2.11 ( before he had 5 -10 words in 3 languages that he was listening) so he was in waiting list for language evaluation (first step for speech therapy) from 18 months old. There where no concerns how ever for his development except the lack of speech. At 3 years old had his evaluation with a stupid lady ( she was mean, her way to approach kids it was awful ) my son that never had a problem with people (always he was playing with everyone) for first time he didn’t enjoy to play with her and it was obvious and he engage a little bit with her. The results from her evaluation it was to ask for an autism evaluation because there was signs of autism and red flags and she told us that she was 95% that he has autism and very severe!!!! Without make any question to us, to his daycare for his behaviour and if we notice something wrong. I was in shock!!! I start worried and for the next 4 months until his autism evaluation I thought that I will lose my mind because I was started observing his behaviour all the time and guess I thought that I was watching autism sighs. For example I call him twice and he didn’t answer to his name (because he was watching tv) he was walking on his tip toes ( it was only for 2 minutes) he put his cars in a line ( it was only 1 time) he had an ecolaila ( but it was his way to learn new words, he was just started to talk, he stoped after 1 month) he wanted to go to the daycare from a specific road ( but I noticed after that he wanted to see a dog that it was in a house yard) and the list can go on... after his autism evaluation I realized that I was overreacting. They explain to me that some behaviours are concerns when the kid is doing them constantly and there was no chance my son to have autism ( they also sent a letter to that lady to be more careful in the future and that she must do a better observation and evaluation because she was wasting hours from a department with a big waiting list) My point is that I was starting misunderstand typical behaviours that toddlers do. My son started talking when he was ready ( but always he was communicating with people with other ways) even if I was trying hours and hours to make him repeat one word, he just didn’t interested. Don’t believe that a regression is your fault. I don’t say that your son has autism or that he doesn’t I am just saying that you have to observe if the flags is the majority in his behaviour and that sometimes some kids have there own speed that doesn’t mean that they have a problem. My son is now 5 he is talking very well ( he only stammers but the SLP thinks probably is because he had a speech delay and needs more time to syntax a sentence, I hope so, we will see) I wish that your son will be like that and the communication problem will resolved as he will grow. Try to be more calm and think positive ( I now is very hard)

Climbing is something all children love to do. I wouldn't put it high on the list of pointers to autism unless there are many other indicators. Same goes for fascination with spinning objects - boys in particular love to look at wheels turning, balls rolling, tops spinning, helicopter blades rotating. They get down at eye level with wheels on toy trucks and roll them forwards and backwards.

It's hard to say where the fascination crosses the line.

Some excellent points from Sunrisemummy.
Is DS trying to communicate?
Be careful of seeing autism everywhere. There are behaviours that the vast majority of children engage in - climbing, jumping/running/letting off steam, lining up toys or cars (this is a spontaneous pre-math activity that is also related to sorting out categories such as people/plants/animals/fish/birds/cars/trucks/trains/planes. Children further refine categories into mummies/daddies/babies/cats/dogs).
Words in isolation do not make any sense to a child. They are just collections of sounds. Don't focus too much on the First 100 Words book. Read poems and rhyming stories. Rhythm and rhyme are very important ways to get a child hearing and mimicking actual speech. Sing songs, clap along.

Thanks both for your advice.

I agree, I have considered that we are seeing signs of autism because we are looking for them. But I had lots of worries before it was suggested - that he was no longer repeating words that we encouraged him to say, or saying words spontaneously that he used to say all the time. He plays differently to others - in a swimming pool all the kids are splashing and having fun, and he prefers to pour water for ages on his own. That he has no interest in most toys, just a very select few. He prefers flipping books to reading them. I don't think he likes to be touched too much, especially when changing clothes or wiping hands - I learned not to handle him too much. Eye contact and getting his attention, even for things that we know he loves, has been so hard that I question his hearing. He's never said "mummy" to me. He may have said it a handful of times to DH before we started to see regression.

I think we need to caution ourselves against false hope if anything. We are trying to make more effort now, do different exercises, read more animatedly and often even if he isn't listening. And we are noticing that he is doing a few more things in the last few days - he said a couple of (unrelated) words spontaneously. He may have possibly put two words together (second time ever, both times a bit garbled). He responded to his name yesterday. This morning he gave me two kisses when I asked for a cuddle. So I'm relieved that there's still something to grab onto. But I don't want to have false hope either. Because these little wins are so infrequent, I don't want to think he is fine if they are one-offs, which they mostly are.

For example, when we did his 2y assessment, we had no examples of role playing. The HV tried to squeeze an example out of us until DH finally recalled one time that DS put a box on his head. So the HV ticked it off. But it's the only example of "role playing" we've ever seen.

Finally DH had always been the optimist and "defending" DS against my pessimism about what he can't do. But he started reading a book on autism and yesterday he said he's changed his mind - that he's ticked too many boxes.

What makes me sad too is that I'm looking my son differently now. Last week I had concerns but I thought of him as just a difficult toddler with some fun quirks. Now I see them as signs and causes for concern. But he's still my lovely boy - he's smiley, funny, and more affectionate than he used to be and I love him so much.

Pouring while others seem to be engaged in far more active play at the pool is not unusual. He might be the child tearing around a playground while another child just wants to sit in a swing and be pushed for 2.5 hours.

Children go through phases of interest in toys too. Some will play with a little wooden train for months, then switch to their blocks for months. Or write on walls and furniture for months.

You can encourage role play by letting DS participate in your household activities like cleaning and cooking - give him a little broom for instance and provide equipment such as your own pots and wooden spoons for him to pretend with alongside you. When you play with him, make sure you make animal noises when playing with his stuffed animals, introduce scenarios such as a bear with a hurt leg that needs a kiss and a bandage and a trip to the hospital (run to another room or use DS's truck or toy bus, making ambulance siren noises), pretend to be the doctor, give a shot. Build him a little house under a table using sheets or blankets, or use the couch cushions. Use recent events that DS has experienced as scenarios. Don't expect this sort of play to last more than a few minutes per episode. Attention spans are short at this age.

childdevelopmentprograms.ca/elearning-modules/the-power-of-play/story_content/external_files/Developmental%20Milestones%20of%20Symbolic%20or%20Pretend%20Play.pdf

This might be useful to you.

Children of 2 can also be very impatient with wiping hands, drying hands, having nails trimmed, getting dressed.

Hi, I am in a similar situation to you. Ds is 2 this month and has no words, despite being able to say 20-25 at about 16/17 months. He makes strange movements too, almost like spasms where he flings his arms out and bends forward. Because of this, doctors have taken it very seriously and he's had lots of tests (brain scan etc). So far no cause has been found but he's still being investigated.

We keep reading about autism but there are lots of things that don't fit - he is very affectionate and will give eye contact and smile etc. But understanding as well as speech seems to have regressed. I feel like he is a much younger child.

So no real help to you, other than to say I completely understand the worry and self questioning that you and DH are going through right now. It's very stressful.

@DanceMonkey19 thanks for sharing - it's been such a sad and though time but also a comfort to talk to other parents. I hope for the best for your boy.

I was just reading about hand flapping in toddlers when they are excited - DS does a LOT of this. I know its normal for many toddlers too.

I've made a few calls today, got one appointment at a clinic and waiting for two call backs now.

For those who decided on home-based speech or occupational therapy, how did you choose your therapist? Did you meet them before you paid for an assessment? I would feel more comfortable to meet the therapist and have a bit of a chat and introduce them our toddler before we commit to anything, but I'm not sure how feasible it is.

I'm just calling around therapists now and realised that I'm not sure what to say to the home based ones apart from describing my toddler and asking what approach they follow - (they all sound fine!) I'm not quite ready to book an assessment and I'm feeling very underprepared to ask the therapists any useful questions at the moment.

It's hard to say where the fascination crosses the line.

This is what I'm struggling with. The pouring is a bit obsessive. He was such a good eater until maybe 18m, then he started pouring his water into his food. Which is fine. But then he was requesting water specifically to pour into his food, and interest in eating. We gave sippy cups that couldn't pour, so he got around this by suckling out the water and spitting out into his bowl so he had enough to pour with! (I had to admire his ingenuity!)

We tried to work around this by giving him water after his meal and two bowls at the start so he could pour food from one to another (rather than onto the floor) and hopefully eat something at the same time. This behaviour with food has not gone away, and has spread to pouring anything that is pourable. Most recently he will suck from his milk bottle and spit it out onto the sofa or on the mattress, or dribble it down his shirt in his stroller.

We've asked him not to, gently, firmly, taken his bottle away, but he often screams and has a tantrum and tries to retrieve it.

For those who decided on home-based speech or occupational therapy, how did you choose your therapist?

We went to a free drop in session with a speech therapist. She then referred us to have some more sessions with her on the NHS.

The M-chat is a good place to start. It's a screening questionnaire for toddlers.

www.autismspeaks.org/screen-your-child

The M-chat is a good place to start. It's a screening questionnaire for toddlers.

Ah thanks, I did try it and it said toddler is high risk.

It's tricky because some of the answers to the "does your child do this" is sometimes but not very often. I took it twice, last week when I was pessimistic, and again just now trying to be optimistic. Both times came back with the same score as high risk for autism.