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.

Embracelife is right. Although early or late birth might be associated with autism, in real terms it probably means a slightly increased chance in children who already have a genetic predisposition.

and there's no point in blaming yourself anyway - it'll leech energy from you - focus on how best to help your son in the now -you can't change the past.

In terms of too young for a label/diagnosis - in the UK if the paediatrician etc thinks a child is too young to diagnose then they are more than happy to say so. A diagnosis of speech/language delay can be made without an autism diagnosis, where appropriate.

About the choice of professionals - I'ld say opposite to agnus - your gut instinct is that you found the SLT and OT there not to your taste, and I'lld follow your gut instinct, and choose the professionals you found more empathetic.

Thanks. I am not going to focus on the post-term stuff but on finding the best therapists for my boy.

I reviewed the day with DH and he didn't care for the OT/ST from the same centre either. But I take your point that the setup is really nice. The location is not ideal - we have to take a taxi and pay another £15 each way. The preschool setup is something to consider - I'm not sure DS will handle drop offs well. We tried nursery from 12-18m and it took months for him to adjust so maybe we'll wait see another 6 months. Anyway, we might make another visit just to speak to specific therapists that have been recommended to me, not just whoever was available at the time.

Is this common, "interviewing" lots of private therapists and looking for a rapport before settling on one? I'm trying to avoid expensive assessment costs and stopping/starting the process as much as possible.

Because we could go with whoever we like best and start OT next week or visit a free more OTs and start the week after.

Several of the OT/STs suggested that we do OT for a month or two until DS is able to settle himself. Otherwise ST sessions might be a wasted and expensive effort.

The first ST said to prioritise OT but she takes a floor based play approach and this could be done concurrently. DH said that from the way they described it, there didn't seem to be much difference between OT and ST at this stage. One of the OTs said yes, there was a lot of overlap at this stage.

So it makes sense to proceed with just an OT for now?

I was lucky that the first speech therapist I found (via a website listing) was a lovely, very experienced lady, so I didn't feel any urge to explore further.

I was in a different situation to you, in that finances were very limited, as health professionals had persuaded me to put my dc into private nursery as that would supposedly bring their speech on , so all I could afford was 3-6 monthly reviews from SALT with me doing lots of the hands on work myself. I didn't have OT as my DC's sensory issues were minor.

I had an amazing first speech therapist for dd also private as there was minimal local nhs provision

But I would only have used someone who both dd and I clicked with

Ours just “got” dd which was great. I could tell after the first session

Hi, he sounds really similar to my son at the same age. Now at 3, his speech has improved massively in the last 6 months and is nearly on par with his peers. I was concerned about autism as I already have another child on the spectrum, but now I am not so sure. He has a few soft markers still (runs on his toes not his whole foot, extremely fussy eater, meltdowns about getting dressed, lines toys up often but not obsessively, poor eye contact with others but good with me, and seems ahead with letter and number recognition but on the other hand, seeks out play with peers now, very affectionate, has excellent imaginative play, nursery haven't expressed any concerns). Just wanted to say I think the cause in my son's case was a blocked ear. Everytime a doctor checked his ears for infection they could not see inside his right ear as it was totally blocked with wax. So when they asked questions about hearing he appeared to be able to hear but it would have been muffled. I've also discovered I have mid range hearing loss which is hereditary and likely from birth and not often picked up in hearing test, particularly in children, so I do wonder about this with him. I would definitely reccomended a thorough ear examination and test for glue ear and hearing test before spending hundreds on therapy.

I would use someone you feel is a good match for your son and you. A therapist who won’t answer a simple question with a couple of examples, explaining the variables that might come into play does sound a bit annoying to me too

You have had so much good advice on this thread I just want to say that you are doing the right thing by intervening now. No one regrets action. We delayed getting help for our son and I kick myself for it now.

We ended up getting a private diagnosis for him and moving counties in England to a place where the SN team were better. He had no shared attention or speech/language at all but an ABA therapy has worked absolute wonders for us and his speech has gone from a pre 18 month level to that of a three and a half year old, with a great deal of voluntary communication. Had to pay for that privately but have done a lot of it myself.

Have just read the whole thread and you really are doing the right thing by seeking intervention. Best of luck.

Thanks, it's good to hear other experiences and I'm glad to hear that so many parents found good therapists.

Yeah I really need to convince my DH re hearing tests. He's adamant that DS hearing was tested at birth and was fine so it must be fine now. DS does occasionally show that he has heard us. But I would like to rule it out.

You are absolutely right - my day also had really bad glue ear, which although was not the root cause of his delay, certainly contributed to his lack of shared attention and responding skills. Glue ear can come on at any time and my ds did not have any ear infections.

Glue was can be very hard to spot - my dd’s definitely was!

It could be auyism yes, speak to the gp or paediatrician.

But for now, dont put pressure on him. He doesnt like stories so dont read to him. Just talk to him naturally as he plays with his trains and water.

Try not to overload him with words, this will become background noise and he will tune it out.

You could get some little cards with pictures of the park, bed, bath, cookie, dinner etc and show him the card when that event is happening. You may find he communicates better non verbally.
Dont play with him if he doesnt want you to. Just relax and let him be him. You dont have to do homework with him.
When he is happy and calm he will learn most.

in the UK it's absolutely standard on the NHS for kids to have a hearing test before having speech therapy to rule it out as a cause of speech/language delay.

Please note that the baby hearing test can be clear / all fine and the baby can still go on to develop glue ear within months.

Exactly what happened to my DS.

Hearing difficulty can also lead to sensory delay and problems. It's perfectly normal.
Every OT and consultant we saw said the same thing.

@mamma536

I know you have loads of replies so may not see this! But just want to add that I have a v similar 2.5 year old! Not really talking, won't repeat things (he has started to repeat a few things the last few days), he chats away but it's not real words, he's very much non stop, always on the go, he's kind of crazy! I couldn't walk down the street with him because he just will drop to the floor and leg it, his physical and motor skills are excellent.

I had a health visitor app the other day and she was so great, I wonder what the health visitor system is like in your area? She referred him for hearing test but said she would wait a few months before referring him for speech therapy because she noticed that although not talking he actually was able to communicate well with his actions and made good eye contact (which apparently is a good thing) and thought that it wouldn't be long before speech started to develop. Are you able to stay in contact with your health visitor for advice?

@boymum9 I don’t want to worry you but we also got this advice from hv and we accepted it but it was false reassurance

Based on our experience my understanding from SALT was that poor speech at this age needs an immediate SALT referral. I would go to GP to ask for one and in some areas you can also self defer to a drop in

Turned out we hadn’t realised but ds was very dear so he was saying words as he heard them eg chair was ‘ha’

There were no signs he was deaf as he could hear some frequencies really well. We didn’t realise you can have hearing loss that mainly affects Hyman speech frequencies

Sorry Human speech frequencies

Very deaf

@Onceuponatimethen thank you for your reply! I do also echo your concerns. I didn't say but health visitor provided a list of the speech therapy sessions which will attend when they start back up for the new year, I'm really keen to do everything I can to make sure things are ok. I had a hearing aid as a child so hearing is a concern for me. Don't have one now but hearing is not great on one side!

@Onceuponatimethen hope your ds is doing well

He really is!! I would so strongly recommend that go to GP and say you think he isn’t hearing. The words which don’t sound like words is apparently a classic sign! I would get a referral straight to paed audiology

We also have a history of family hearing difficulties and my ENT specialist thinks in the end they will discover genetic links