Any 4 year olds with similar difficulties?

[Tiredmummy224]

Hi all
So I'm just hoping someone may have 4 year old who behaves/struggles with same things and tell me if they're diagnosed with anything?
I'm not really sure how to ask I guess what I mean, my 4 year old is not diagnosed with anything but yet he clearly cannot do stuff other children his age or younger can do and because I don't know what's causing it I have no idea how I can even begin to help him
He's meant to start school in September and it's really stressing me
I guess easiest is to just list some stuff he does/can't do and hope any of you deal with similar and maybe any advice?
-doesn't talk, he attempts to say few very basic easy single words eg cat buy can't say them properly, our 19 month old pronanunces words better and can say way more
-quite limited understanding on what others say to him, can understand most everyday commands but anything new and he's lost
-he rarely pays attention and very rarely will look at me when speaking to him
-when trying to get him to repeat words he usually just shouts random notices and doesn't even attempts to try
-he spends most of his day shouting different sounds on top of his voice, again completely random noises and if asked to stop eg because trying to get him to focus on what I'm trying to say he just carries on
-won't sit still, he's constantly on a move, it's a nightmare during for example speavh therapy appointments as atm they're online through video and he won't sit for a minute to try and do whatever they need him to he keeps running around or doing his own thing not paying any attention
-not potty train, doesn't understand the idea of potty training at all, doesn't even want to try. We keep trying but it's same thing, even if he wet himself he would just sit in it and make no attempt to try and show anything is wrong, if he poops, again won't even show any signs of discomfort or wanting his nappy changed
-can't do most basic things for himself eg 19 month old can take of his clothes himself, 4 year old can't do any of that and no matter how much I try to help him to learn it he just cries when I try, can't put on clothes by himself either, onyl things he can do is take off his socks or shoes as long as theyre simple to slip off, and will take off his coat if it's unzipped for him

• I am sure if I just let him walk off on his own somewhere he would walk into the road without paying attention where he's going and get hit by a car because he has no danger awerness either and relies on me to hold him back when getting near the road and despite every time trying to explain we must look first to see if it's safe he pays no attention

Now he can do stuff perfectly like walking climbing running throwing etc and can do stuff like puzzles and other similar games that require a bit of thinking for example on tablet but in normal everyday stuff he really struggles

I apologise for super long post, I'm hoping anyone has similar and can try and point me in what this could be or how to help him?

Does your DS go to pre school / nursery?

You mention speech therapy - what has the speech therapist said ?

Have you seen a paediatrician and/or occupational therapist?

Sorry for lots of questions but it sounds like your ds will need additional support for school and if you can get more input from professionals before they start it will be easier for him to get the additional support they need.

@lorisparkle

Thanks for your reply
Yes he goes nursery 2 mornings a week on the funded hours spread over the whole year he's been going since 2

Speech therapy hasn't said much in all honesty, just adviced there's some delays with his speech and recommended activities and stuff to do to help him learn talking/understanding
No haven't seen any, we've been in constant with health visitor and she's made further referral for an assessment but I'm not really sure yet how they're assessments work or what they can assess for I know they can make assessments for autism if needed but not sure what else they can assess or if there's some stuff I'd need a doctor?
either way due to the current situation I can imagine it will take a while his speach therapy took good few months to sort out

This sounds worrying . Has the nursery pushed for an assessment to see what support he will need in school? There are lots of reasons why children have learning needs or delay in their development including ASD and hopefully a paediatrician will get to the bottom of it.

I personally would look at getting a referral to the paediatrician and the occupational therapist. Your GP can do this if your health visitor hasn't.

I would also ask for the 'area SENCO' to be involved at his nursery.

It is really important to get early help.

Has anyone suggested using Makaton or pictures/symbols to help his understanding or communication?

We made a referral for my son to the paediatrician and have had both a phone consultation and in person consultation over the last year so hopefully the current restrictions won't cause too many problems.

In my experience you do need to keep asking and often trying different routes to get the help you need.

Hi OP,

He sounds a lot like my son who is 6 now, although mine had more speech and I potty trained him when he turned 4, he wasn't ready before that.

I got him a referral from our GP to the local Child Development Centre. In our area they have SALT, occupational therapists and paeds under one service so he's been referred to all 3. He has struggled in the classroom setting a lot, he's in mainstream Y1 and doing okay academically but struggles to understand things. We've got a private SALT working with us along with the school SENCO.

If he's at nursery they will also have contact with your local area SENCO so that could be another Avenue.

From what you've said though, he definitely needs intervention, the sooner the better. I can answer any other questions if you have any.

Here's what we did with my DS:
I took him to the GP and he was referred to paediatrics which is part of the child development centre in my area, similar to pinkgins description.
Audiology, SALT, OT, all of it's under one roof.

I'd suggest you put your little one in state nursery... every day. This really, really helped my youngest with his speech. Also, his nursery was attached to a state primary with an excellent SENCO lead. You really need a nursery/school with a decent SENCO lead/keyworker. DS's nursery was amazing and did group chats with the children who struggled with speech delay (whether it was just standard speech delay, ESL, or autism like my son, they would take a small group of 3-4 children into a room and just help them take turns chatting or playing a simple game, getting the children to take turns speaking and listening, engaging in dialogue. It was amazing. DS also did group SALT at the child development centre. Again, amazing results.

In the meantime at home, have you tried PECS cards?

@Sleepingdogs12

I will speak today to nursery see what can be arranged for when he starts school
If he gets the first choice school I know that school already has quite a bit of support available for students who need more help than others but theres no guarantee he will get into that one and won't find out until some point towards end of next month which school he got into

@lorisparkle

The speech therapy have suggested makaton
Waiting to receive booklet with information about using it
Although I can't say I'm certain it will help as like I said he barely bothers to look at me when speaking to him but we'll try it
Thank you I'll get in touch with health visitor see what else can be done

@pinkgin85
Thank you
Can I ask how yours is managing with sitting down for so long and coping with the different things expected of him in school?
Also any tips on how you potty trained yours?
How about any friends in school?
Does he need extra help outside of school to keep up?
Sorry for all the questions
I will get in touch with our health visitor and nursery and see what else can be done

@TheVanguardSix

I will see what other stuff/referrals can be provided for him
Sadly cannot afford to put him in nursery everyday otherwise we would of done so long ago
His keyworker does a lot of one on one with him when he's there and they discussed starting to do things in smaller groups to make him more comfortable trying to speak
I'm not sure what Pecs cards are? Are they different from regular flashcards?

I think you need to start being much more proactive, your son needs a lot more intervention and support now, not when he starts school.
Make an appointment with the GP and ask for him to be referred to a paediatrician. Look on the internet and find yourself an online Makaton course. Maybe look in your local area and see if there are any support groups for children with additional needs that you could contact for support.
The earlier you can get help in place the more effective it will be.

I can compare him to my now 5 yo (6 May) if it helps.
doesn'tt talk, he attempts to say few very basic easy single words the video of DS at 3.5 is all oh oh eh sounds. I know what he's singing because he's mine but it's just noise really. Speech therapy helped. When he started reception they struggled to understand him but nursery thought he'd really progressed. When he started yr1 they thought his speech was behind but reception though he'd come on amazing. It Def came in leaps. Lots of getting him to talk through what he's doing when he's playing helped and gentle corrections. "E oh im". "Yes, he got him" etc. He's stil under speech but he's mostly comprehensible to strangers.

quite limited understanding on what others say to him, yup. It's got better in the last few years and school Def helped because there was a routine and repitition to it. Slow and broken down instructions help

When trying to get him to repeat words he usually just shouts random notices and doesn't even attempts to try he is trying. Say Cat. Bla. Yes that's right, cat, good try. Repetition and positive praise. Yes it's frustrating

he spends most of his day shouting DS still makes a lot of noise, it's like he needs the sensory input. Random noise, noisy toys etc.
Can you try kneeling down, holding his hands still and him stop, listen? He's better if he's being physical.
won't sit still, he's constantly on a move it amazes me school get DS to be still. He never is and like your son, zoom therapy is done sitting on a million different positions, upside down, running around. A part of me thinks it helps but doing home learning with him upside down drove me potty. As above it seems he copes better of he's at least noisy or mobile.

not potty train firstly, you need to check for constipation. Secondly utter sympathy. DS has been in pants since Jan. Yes, this one. Some issues with undiagnosed constipation but also he just doesn't care. He'll sit in wet and soiled clothes, he'll smell. He doesn't understand why that isn't ok. No frigging advice. Except constipation was a game changer.

can't do most basic things for himself Answer honestly - do you just do it for him because it's easier given everything else going on? I think in part I did. School had less time so PE helped a lot. And doing half jobs. T-shirt over head, let him do his own arms etcm. He still struggles with zips, can't do buttons, often gets stuff back to front and will happily let me do it. Concentrate on getting him to do it when you're not time bound with school run etc.
I am sure if I just let him walk off on his own somewhere he would walk into the road I think there's an element of age but also it does tie into the other issues clearly. Not a problem we have I don't think as he is quote cautious about some stuff

At 4 DS was Def immature for his age. He'd been a bit early and v poorly and had a goat bit of mechanical ventilation so we'd always been told he'd have issues. However despite all that he is mostly a "normal" boy, a bit young for his age, average academically, some sensory issues. It's been hard to access help but a good school and an EHCP has made a difference.

If you get your school of choice, proactively speak to them about your concerns and how they can help you

Definitely agree with the comments above to push for a referral to paediatrician, audiology & area senco. It would be really useful for nursery to arrange with the senco a SOGS assessment which looks at all the areas of development and which stage they are at. Your son maybe eligible for funding which his nursery could use to help support his development.

Was your son delayed with any of his milestones like learning to crawl/walk etc?

My DS1 is 4, summer born, he is also very small for his age (my 2yr old is nearly the same size as him!), he started school last September. His delays were picked up at his 2yr check with the hv. He is delayed with speech and has been delayed across all areas & with all his key milestones from a baby. Like your DS he cannot tell us when he needs to go to the toilet or when he has been to the toilet either & will happily sit in wet/dirty nappy pants (or pants when we tried desperately to toilet train him before he started school). He also struggles with his independent dressing skills. He has been diagnosed with global developmental delay & he's about 2 years behind where he should be.

We were advised to try signalong with our DS and it made an amazing difference actually with his frustration levels when he was struggling to communicate his wants and needs, I would definitely recommend trying some signing and see if he takes to it. Our SALT used to teach him a new sign whenever she worked through a new concept with him (like on/under for example). It's so difficult though doing the SALT sessions via zoom & keeping them engaged! But it could be worth asking your therapist for some help with this & basic signs she would suggest you start with. Possibly things like; more, finished, drink, eat. A now & next board might help too as a visual prompt for daily tasks.

@Elisheva
I'm planning to reach out today to health visitor and nursery and see what can be done and if they cant put any further referrals then I'll speak to gp
I will look for a course

@SleepingStandingUp
He's definitely not consitpated

Honestly I constantly try to try and get him to do stuff but usually he's not having any of it
Eg if I pull top over his head and hold out sides for him he will put his arms through, if I just pull it over his head and let go so he can do the rest he won't do it, it always ends in tears and eventually I just do it for him
Sometimes which is rare he will be willing to try but for example will make half attempts at getting off his top and evne if I show him few times easiest way he really struggles and then gives up

Good luck. You might want to try posting your question on the SEN board here - they know all there is to know about supporting children!

@luckymagnoliatree
Thank you I'll speak to them about it

Honestly it's only started recently been more clear how behind he was

As a baby he was on targets and no if anything he was always ahead on motor skills like crawling and walking
When he was 2 still not speaking it looked more like just speach but been constantly told a lot don't start until around 3 so wasn't too worried I guess
Then when he turned 3 and still wasn't speaking we had few appointments with health visitor and we would be going through the milestones and lists and it would turn that he's massively behind on communication, a bit behind on fine motor skills, perfectly on track with motor skills and the rest grey and so speach therapy was put on place
And then only in last few month it really started becoming clear how late he is with some stuff as my 19 month old would be starting to do stuff and I'd be realising he should of been able to do it long ago

It honestly doesn't even look like he cares about trying to communicate
He does sometimes like pointing at things but other times he won't even bother and if you ask to show what he wants he will just start crying instead of even attemtpting to point

Some of what you describe could attributed to hearing difficulties, so get his hearing tested - in addition to, not instead of, following the other advice.

[quote Tiredmummy224]@SleepingStandingUp
He's definitely not consitpated

Honestly I constantly try to try and get him to do stuff but usually he's not having any of it
Eg if I pull top over his head and hold out sides for him he will put his arms through, if I just pull it over his head and let go so he can do the rest he won't do it, it always ends in tears and eventually I just do it for him
Sometimes which is rare he will be willing to try but for example will make half attempts at getting off his top and evne if I show him few times easiest way he really struggles and then gives up[/quote]
When you say Def not constipated do you mean has regular soft but firm stools, or he has lots of loose stools or he has enot they're just hard, lumpy man poo?

Cos I was adamant DS wasn't constipated. Pop's daily sometimes multiple timesm. Big nice solid man poo. Except he was and he was just clogged up so new poo pushed out old poo and we never noticed until a conversation about poo type

A few months after we fixed it he started feeling the need to wee. He still isn't continent for poo but we're being seen medically for it

Speech delay has a massive impact on everything, because if they can't get their point across, why bother. I know you're having speech and will investigate hearing, but don't underestimate the impact it has.

Yes it could be something else, which is why you need all the other stuff as well, but sometimes it just takes longer to come.

Makaton Def helped. Feeding is a trigger here so "enough / finished" and "more" was literally life changing

I’m really surprised that your DS hasn’t been referred to your Child Development Centre long before now.

And have nursery not asked for support from the LEA (in our area they’re called a Specialist Teacher rather than an area SENCo)? Nursery need to do this as a matter of urgency.

I am absolutely disgusted by this “nursery”.
This poor child should’ve been assessed long, long ago.
From what you describe he needs an assessment urgently. He sounds no where near ready for school and he should’ve been considered for either deferment or a special needs establishment.
Yes, he might be deaf, but also he could be a number of things that needs a lot of support (for both the child and yourself!)

We pushed really hard to get what I think is now called a 'My Plan' to be written before ds1 started school. In my experience if you wait til reception there will always be a period of observation/ assessment whereas if you get that all in place now they can start with the support needed.

Even then I do not think I pushed hard enough and we did not get a full diagnosis for ds1 until he was 8. I wish I had listened to my gut instinct and referred to a paediatrician much earlier.

It can, unfortunately, take lots of effort from the parents side but early intervention is vital.

If you search for 'singing hands' they have lots of very engaging and informative videos on YouTube - a great place to start encouraging signs. Start really slow with things your ds is interested

PECS and symbols are line drawings representing words. They can be used to show children what is happening and also be used by children to support them asking for things and in the future commenting on things.

The website www.hacw.nhs.uk/childrens-speech-and-language-resources/ has fantastic resources

I agree with others- I think it's astoundingly negligent of the nursery not to have flagged this up and referred him to be assessed especially as he is about to start school. He needs to have a section 23 and involvement from the early years SEN team at your local authority. Google "local offer for Sen " and then the name of your local authority and you should get a link which will take you to information about various services that are available for preschoolers with special needs ( at least that what happens in the area I work.) if the nursery seem reluctant to help then I would action this yourself as if he is assessed with special needs then the school he goes to will have more funding to help him.

One other thing- Has he had his hearing checked recently? This can have a huge impact on development of speech and understanding.