No words at all at 4yo

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This is my friend's 4yo. She's obviously desperately worried, he's had loads of tests and no "cause" has been found. Hearing is apparently fine.

He has never said a single word, not even mama etc.

For a long time, whilst supporting her efforts to get a diagnosis, I tried(unhelpfully I suspect) to be reassuring, saying meaningless things like I'm sure it'll all be OK in the end. If he's never spoken at 4yo, what chance is there really that everything will be "OK"?

I'm not going to pass any of this onto her, but I am very interested if anyone can help.

Oh dear. I have absolutely no experience of this bur didn't want to read and run.

If he hasn't spoken at all he should be under some sort of language therapist/consultant? They can't just fob your friend off with 'he's fine', he clearly isn't.

Is she perhaps in a position to go private? Health insurance maybe?

This child needs an immediate S&L assessment.

Has your friend asked for a SALT assessment?

I cannot remember the name of this man, but he has autism and is very well known in the subject by professionals etc. He never said a word until he was 8 when he started babbling and then it progressed from there. He now gives lectures on autism to professionals. I'm not suggesting your friend's little boy is autistic, but maybe there is a bit of hope, so in answer to your question, I wouldn't give up just yet.

What are his other behaviours like? Anything to be concerned about? Does he interact emotionally? Laugh or smile? Ever cry or scream if hurt? Or is he totally mute?

For you, it must be difficult to know what to say to your friend.

Does he communicate ?
Take your hand and pull you over to things?
Bring something to you he's stuck with?
Nod / Shake head?
Join in actions of songs / rhymes?
Babble, or 'chatter' away in own language ?
Make noises - animals or car engine noises when playing?

What about understanding?
Does he understand simple instructions / requests?

Can he make choices?

Turn take ?

Does he make a noise when he laughs and cries?