confused, and reposted this here but originally posted in behaviour/development --nonetheless I'd really love your input.

[eandz]

So my DS has incredibly delayed speech. He is 29 months old. We were seeing a private speech therapist but nothing really progressed. We've finally seen an NHS SALT person and DS begins therapy with her in 3 weeks time (the waiting list in our area is long and oversubscribed).

We did makaton/play therapy/toddler groups/play dates. Some progress, but very little on a whole.

He does all non verbal communication. He has about 45 words now, and 2-4 phrases that are very infrequent but used in the right context. He is generally quite well behaved.

When we had our first SALT visit they suggested that we should put him in nursery as soon as we could.

She suggested one that had good SALT support and since this nursery does have a space open, I've decided I'll put DS in.

Will nursery really help him? Or will he be lost in the crowd? He has tonnes of allergies, of which are red fruits+eggs. I will definitely make the nursery aware of this, but whats the likelihood that they will remember? I'm having anxiety issues thinking of him trying to trade his approved snacks with someones strawberry.

Is there anything I can put on him (he refuses bracelets) that makes sure he doesn't eat certain things? He's non verbal so he can't really say 'no red fruits+eggs' and tbh he's been trying to eat tomatoes for almost a week. (I eat tomatoes in private--I eat them like apples).

He does love to play with other children and is generally sociableshares his snacks/holds handshugs. I'm afraid that I've started to hope he'll develop better speech when he goes, is it possible?

I've posted about his behavior before/started threads. He's had a long list allergies/terrible reflux.

just re-posting this is filling me with more dread. I think he might be somewhere on the Autistic spectrum. I'll post about that later.

Re:nursery, its not the magic bullet for language everyone suggests, particularly if they dont do focussed one to one or small group language work but expect him to improve just being around his peers. Is his understanding of language age appropriate? Can he make a full range of sounds eg singing, just wondering if there might be a physical problem making speech sounds? If you have concerns re autism there is never any harm getting on paed wait list and reading up on it yourself, a lot of techniqures for kids with autism re lang and play are relevant for lang delay in general

hi i found this medical alert site on its in AU but doesnt make a difference you can still buy from it it does sew on badges t shirts ect www.starallergyalerts.com.au/ HTH

Hi,
I sometimes work at a small playgroup that takes children from 24months. We only have about 6 children so not quite the same as a general nursery setting maybe, but in terms of the allergies we would be very careful to ensure that he was never given the 'wrong' foods - we have had children who have needed medication before eating etc so are set up to deal with that sort of thing.
DS2 had severe speech delays (currently being assessed for ASD)- at your DSs age he had max 10 words and no phrases at all, but he loved going to playgroup. I have no idea if that is what helped his speech along, but he did start talking - now aged 4 he speaks fine other than mixing up pronouns still.
We had a child at our playgroup with 'dx-ed' speech and language delay and their language appeared to come along whilst there. However, most of the children we have are only 2 and so don't like talking to strange adults. Some do, don't get me wrong, but lots we are lucky to get a nod or a shake of the head to questions, yet they come in chatting away to their parents.
Hope that eases your mind a bit!

A good nursery will have very careful procedures in place to ensure that children are not fed inappropriate foods. You should ask what the procedures are and don't be scared to question more deeply if you feel they aren't adequate. If they are not open to reflecting on their own procedures they may not be the right place for your child.

In terms of language development you need to think carefully about what your son needs from a group setting.

If he needs low pressure opportunities to express himself to other children as and when he feels like it then perhaps it would help.

If he needs intensive one to one therapy with someone making eye contact, listening to his speech and responding carefully then a nursery is not what he needs. He'd probably be better of with you at home.

Some research has shown that children's language development is supported better at home than in a busy pre-school setting.

I'm not a SaLT, but have been through this a little with a DS who has diagnosed speech disorder (dyspraxia) and who is at nursery.

Nursery first raised concerns about DS and were clearly angling at autism given his behaviour there was unsociable. His speech was also far worse at nursery than at home. SENCOs at nursery were supportive throughout, and in fact established path to NHS SaLT. They also asked about foods and communicated this to all his carers (our nursery in fact obsessive-we once mentioned he didn't like pineapples and he's never been given them there!). They have been very good at taking advice from SaLT, and about implementing help as appropriate. You should expect nothing less.

On the setting itself, though, you may find that issues arise, and need to be careful about judging abilities or problems as a result of nursery behaviour. DS is almost entirely different at nursery-and only in the last few weeks has he even talked about home at nursery or nursery at home. He is clearly less able to speak and get feedback, because in some situations others can get it first, but also much better at other things (toilet training and eating, for example) where language is less critical, and finds ways of involving himself which are less speech dependent (this in itself may be a useful skill since he is likely to be unclear for many years). And when he has a language spurt, his behaviour at nursery is amazing and consolidates it greatly because he has so many others to show off to and interact with in a new way.

Basically, a good nursery SENCO should move to accommodate his needs linguistically as well as his needs socially. If it can't, then think twice, or find another nursery.

If you are really uncomfortable about sending him to nursery, then don't. Just because a professional says you should, it doesn't mean you have to. Parent and toddler groups can provide socialisation with other children, on your terms.

There should be other routes in to pre-school support and you could wait until you see the NHS SALT. They may refer you to a SALT group, with other parents in a similar situation.

Your post hit a note with me, because my son starts school very early (4 and 4 days).

Basically, one of the terrors of the situation is not knowing how or when the speech delay might change, and how this affects my attitude to nursery. If I knew that withdrawing him from nursery would mean that he entered a school environment able to speak clearly and distinctly, I would do it. But I don't want him to go to school still unable to speak clearly, and not to have developed the skills necessary to interact with other pupils and adults in a less DC-centred environment. I don't have much choice but to work but, if I did, I think the fears about the latter would probably shave it for me-I can't know if his speech will ever improve or when, but I do know that he will go to school and when.

In other words, he is a person with a speech problem, and I would wish to treat him as such and think through his needs in coping with that, as well as in helping it to vanish. In your case that might mean thinking on a timeframe, perhaps not sending him to nursery yet, but deciding that there is a point when it would be necessary whatever is happening with his speech?

Does that make any sense?

I'm still incredibly confused with regards to whats best for him. I always thought I was best for my child. I suppose Nursery could help. I'm just not convinced.

I'll visit tomorrow and figure things out and re-post. So far though, your input is helpful and supportive.

his

flicking

spinning

choreographed dance sequences for his three favorite songs on repeat.

hates artificial light--he freaks out at night if we have the lights on

refuses all foods if they don't either come out of a green pringles can OR out of a pizza hut chicken wing box--even his milk bottle has to come out of one of either containers

those are reasons why we think he might be on the spectrum, but it's all just hunches so far.

what else could it be? (please, i really would like to know what other possibilities i'm supposed to be looking at)

it's just so horrible not knowing what difficulties my poor ds is living with right in front of me and i have to wait for someone else to tell me.

Get him assessed. If it is ASD you'll need advice on the best ways to develop his speech and social skills generally. Unfortunately it's not as simple as with a neuro typical (NT) child. An ordinary nursery, unless experienced in helping children with speech problems, won't be of much benefit except to give you a break, which is beneficial on its own. A refreshed mum can read up on the best ways to help him and implement them all the rest of the day. Try the Hanen book, It takes two to talk, or even better More than words which is like it takes 2 but for ASD children. Nothing in those fantastic books will harm a NT child but will give you so many ideas to use at home. Quite expensive but worth it.

But get him assessed, get your GP or HV to refer him to a developmental paed. It might open lots more doors to help and support than just SALT.

we're waiting on a referral for the developmental paed. It was supposed to be here at the end of last week, so I've left two voice mails and sent an email.

i'll print out the email today and take it to the gp.

i've never heard of a neuro typical child...will look that up now.

thanks for the book reccs, I'll go order them too.

Hi Eandz. The books are either/or not both. Just to save you money! NT just a nicer way to say normal or not on autistic spectrum. Our ASD children are not neuro typical but they are normal to us!

Good luck with it all. It was 8 years ago for me but it's a really raw time when you start to realise there may be problems with your darling child. Just remember they haven't changed and their own personalities shine through any DX.

Off to visit my mum now with 3 lively DSs. Oh joy!

:) 3 lively DSs! I hope you have a good day with your lovely family.

i'll try to figure out which book i want more before i order it.

We had our second SALT visit (yesterday) and N will start weekly sessions + start nursery on the 21st.

She only gave me one task; which is to simplify my sentences to two words at most at a time/repeat/praise.

She wants to do the next session at a playgroup to see how he interacts with other children.

she thinks N exhibits a few classic autism characteristics and feels like I should hear the word 'Autism' from her so that when we are being seen by the developmental pediatrician I won't be in for a shock. However, she thinks it's more likely a speech impairment--but it's not her job to diagnose it, and I can't hold her to it so we just have to wait to see what the pediatrician says.

she submitted the referral and I should be hearing back in three weeks.

she said she chose to put N on the Social Communication track --I asked what that meant, and the difference between the other route and she did explain it, but I forget. I was changing a diaper in the middle of this particular part.

would really love to know what you think?

Social communication track sound like looking at asd type language problems, but bear in mind that delayed language, whatever the cause, can impact on imaginative play and social skills, so sometimes only time and the experts can unpick whether what is going on is asd, or possibly bur not definitely asd. Given you have weekly salt, just getting that one task doesnt sound that bad but obv it mus feel v slow going. I found simplifying language crucial with ds as he had an eighteen month receptive language delay at three.

how is your son now Totalchaos ?

eandz

People do seem to trot out the old "put ds in nursery then he will come on in leaps and bounds" when children have speech delay.

My ds1 had speech delay (which seems incredible to me now as he never shuts up!) and I sent him to nursery before he was ready and I deeply regret it.

I am not saying not to send your ds btw if you think he is ready and would benefit from it, but its not the panacea that some people think it is so dont be disappointed if your ds doesnt suddenly "click".

Could you go private for the paed referral? I only ask as you know my situation with ds1 atm and I rang up this afternoon and have an appt on 14th March!

Its quite a long wait here for community paed appts. but obviously by going private its going to cost us money.

hugs to you x

Ds made huge leaps between four and a half and five, salt discharged him at five and a half for testing within normal range. He has made a lot of progress, still immature socially and quirky and sometimes struggles to get a point across but doing well at a small caring school without any support other than general good staffing ratios. He is good at reading and maths, mediocre at writing. He may end up with some sort of asd dx in coming years, hes not nt iyswim but manages well for now in mainstream

Becaroo

I've been trying to contact private paeds but no one is calling me back.

I've left messages with three different doctors. Two at the porland and one with daphne keen...perhaps there is a conference they are all at together?

How do I know if DS is ready for nursery?

our new private health insurance is crap. :( it only covers cancer. i'm quite livid about this development.