Does DD sound normal? Have concerns but HV/GP won't refer her

[cheapFlower]

hello,

wondered if I could get some feedback here. I have some concerns about DD (3.0yrs) and tried HV and GP to refer her to dev. paed but was told she is fine and hence they can't refer.

• she is speech delayed (we see SALT shortly after pushing for 1 year) - has about 300 words but can't combine - only one-word-sentences. she can follow simple instructions but nothing complex. however, she often refuses to do things on demand. she can and will say what she wants/need (e.g. if she wants a certain toy, or wants to eat and drink something); also pointing a lot (not leading by the hand). she can answer yes/no questions such as: do you want an apple?
• she is going to nursery and is fine with the other kids but does not play with them a lot. she seems to prefer doing her own thing / when we meet with friends and their kids, she needs a long time to warm up; doesn't like if they touch her either (starts screaming)
• generally she is IMO quite immature - her play/interaction is more like a 2 year old...
• horrible tantrums if things don't go her way all day long/ also many tantrums for no apparent reasons
• she doesn't have a concept of personal space
• not aware of danger, e.g. the road
• I can't leave the room without her having a meltdown
• she has very good motor skills (gross and fine); can even make very basic little drawings of people e.g.
• not interested in potty training
• she is a great eater. not fussy at all (she just can't stand textures with hard little pieces like crunchy peanut butter).
• she know the complete alphabet, colours, shapes...

was thinking of bothering the HV/GP again but start to feel a bit paranoid. does the above sound normal (apart from speech - we are seeing SALT anyways)? or do you think I should push for a referral for her? just wondered if it sounds a bit like ASD?

thanks for reading!

I'm no expert but in my view she does seem like she is ok,good with children sometimes,great motor skills,eats well just not bits ect and 300 words sounds like she is developing well,doent like touch or bits in good sounds a little sensory but still ok-ish for her age,but you are her mom you see her everyday so if you have concerns it's worth pushing a refferal.perhaps if you list more things she struggles with maybe we will get a clearer picture. Xx

yes - I think her language is way behind (also her receptive language). but I find it really odd - so many words and yet no sentences...

What does the SALT say? They can often ask gp's to refer on for further investigations.

Some of what you are describing sounds normal, some not so. Your instinct is saying something isn't right so it is worth pursuing.

have not seen the SALT yet - appointment next month...

Sorry, am reading on phone. I think I need sleep!

Good luck with the SALT, have these points written down so you can be sure you mention them. Hopefully they will point you in the right direction.

Hiya,I don't know but I just didn't see anything really wrong but as I said a few things do sound not so right,I think I misunderstood that she can Only say one word at a time,Now that is something to worry about sounds like a language delay,but as you said ASD I was thinking That she didn't sound that bad,but again I'm no expert and you see her everyday! I think the SALT will have a much better view of things than the Hv,and if she has a language prob she will most likely refer you to The pead to see if there is a reason why she is delayed and if/what Is The reason for it!

Nothing that you have posted sounds especially like ASD, but does not rule it out either.

Try looking on the NAS website and look up MCHAT. If you can list a number of 'symptoms' it would be worth writing them down and taking them to the GP with a second request.

She sounds like she has salt delay but I'm no expert in ASD, but she doesn't sound like either of my girls who both have ASD.
I would await speech appointment and see how it goes.

I'm not an ASD expert either but I will be hnest: it can take months and longer to assess teh difference between a child with an ASD and one with a langauge delay, especially as decent support foten reduces the ASD-like symptoms in a child not on the spectrum.

It may be she has a few sensory challenges but that can go hand in hand with a language issue such as verbal dyspraxia.

In some ways she sounds a lot like my ds4 although his langauge is OK- the screaming if I leave the room etc. As Mum to two with ASD I woudl say he doesn;t have ASD but a few traits: that is not uncommon. ANd ofren apsses in toddlers.

See SLT, and if you are still concerned speak to a charity such as BIBIC about a referal. Don;t get shyrugged off though- answers matter.

You are right to be concerned and the best thing will be to get your SLT baseline, then go from there.

She does sound significantly delayed, although there is a wide range of development.

I think rule-of-thumb is '3 words together by 3 and 4 words together by 4'.

Having said that, the range is huge. My 20 month old is saying 'It's cold outside' 'What are you doing?' 'Where are you going?' 'DD1 pinched me', etc.

My DD2 is 3.4, and very NT, but she wasn't word combining at DD3's age, and took a little while to get sentences, but now is talking well.

DD1 is very speech and language delayed, so her sentences are still atypical and she isn't clear.

How is she communicating? You see, when Ds1 was two and a half he could physically say a fair few words. As in he could recite (albeit rather garbled) a word perfect rendition of the three little pigs story). He'd get the intonation the same as he'd heard from me and all the words.
Pretty good, right?
And he could count, at least up to twenty and possibly more, but I can't remember.
And he could repeat whole other sections of things he'd heard from what people were saying, or what he'd heard on the tv, or what I had read to him.
But what he couldn't do was communicate to another person. See, to Ds1 the words he said were for his benefit, he'd never appear to direct them to anyone else. So he couldn't say he wanted a drink or something to eat. He couldn't point out something he'd seen, or look for another person's reaction to it. He couldn't call us, couldn't say "mummy" or let us know he wanted us.
Now he's 7.5 and he's come on a great deal and I can have a conversation with him, but it's a conversations with limitations far beyond what would be expected with a "typical" 7 year old. It has to take into account his significant receptive language difficulties, his echolalia, his lack of awareness of almost all abstract concepts, his hyperfocusing. If I had to give an analogy, I would say he is like someone who has done a summer's evening class course in a foreign language and then been picked up and deposited in the country and expected to understand all the slang, the jargon, the nuances, the different ways of talking, the to and fro banter of, say, an office workplace in that country.
Now Ds2 was less clear. A lot less clear. Because he was almost completely non verbal at the age of 2.5, but because he loved interactive games and would make eye contact with them and because he could pass his beaker to you to let you know he wanted a drink, or shout out or cry when he wanted you, I put him down to being "just" delayed.
Three years later he is still almost non verbal. Still can get his needs across, but communicates pretty much only for his needs, rather than, say, to share an experience. Scored 21 on the ADOS 3 months ago (cut off for autistic disorder being 12 or 13). So sometimes it's not always clear in the early years.

Ds was similar at this age re no of words, and did not end up with full asd dx. Agree with peachy about it being hard to tell sometimes between asd and receptive lang probs. Once you have seen salt i wld speak to nursery then try and get paed referral anyway tho as waiting lists can be so long its better to get in system

ask salt if your area runs hanen courses, www.hanen.org, they are courses run by salt to help you help your child communicate

try and encourage verbs at this point, as that is first step towardss combining, if u can show her fave toy doing various actions that can help