Language / speech delay - Please help/advise

[Pennybubbly]

First off, sorry for the long post: please bear with me!

I've noticed for a while that my DS (3.3) is behind his peers when it comes to speech. He has no problem with any of the sounds, can repeat words back to you (when he wants to), but he just doesn't talk much. He is being brought up in a bilingual setting: Japanese/English and Japanese is stronger than his English, which is not surprising as we live in Japan and he has been in full-time daycare since he was 15 months, and though I want him to speak English of course, it's more a priority that he speaks properly in ANY language. Even in Japanese though, he doesn't say much. His sentences are very short, very simple and though he seems to understand what his said to him, most of the time, he just doesn't bother answering. The same with English, though he's producing less English and hardly makes sentences at all, though he does understand.
Elsewhere, he has melt-downs quite frequently (maybe one or two a day- and I wonder if it's because he still can't express himself clearly, whether it's because he's only just 3, or whether it's something more sinister. My DH keeps saying "autism, autism" and really winding me up and upsetting me, but I've checked autism and apsergers sites and they no way match him and his personality. The only similar trait I could find was that he sometimes lines up cars etc, but I think most kids do that and his is usually during play, he doesn't insist on them staying that way or anything. The only thing that matched on the aspergers site was that he occasionally gets upset if a pattern is disrupted - so the other day, he was on his scooter and something happened (he fell off or DD (6) went in front of him or something) and he wanted to go back to where the 'thing' happened and start again from there. But incidents like that are maybe one a month, not any more often (in fact I can only think of one other time he did something similar!).
Quite often, I'll have to shout at him to get his attention. "ds go and wash your hands, ds go and wash your hands, ds go and wash your hands, DS GO AND WASH YOUR HANDS!!" and it ends up me dragging him to wash his hands. But then again it's to WASH HIS HANDS, not get a present and DD was/is particularly compliant in that area, so perhaps I am bad to compare (ie I've got extremes in both kids!).
He had his ears checked at his 3-year check-up and they were fine. Nor did they say anything about his development at the check-up, nor have his nursery said anything (but they are very cautious about 'diagnosing' in Japan anyway.
Compared to how he was one month ago, 6 months ago, a year ago too, he HAS improved, albeit slowly.

Physically he is way ahead of dd even now when it comes to kicking and throwing a football and she is 3 years older! He does say words, he is improving, and I wonder if I should just leave it. I wake up in the night and think about it till my stomach hurts and I'm in tears, then I get up and he comes for a cuddle and smiles and says "ohio (morning) mummy" "yakult (name of drink) please mummy" "Thank you mummy" and I think I'm just imagining it all. Then he has a melt-down (could just be hungry? we are being impatient? he's 3? DD never really gave us trouble, so he seems bad? We know he is really independent, really head-strong and really stubborn - is it just this?) and DH raises his eyebrows and looks at me as if he's just found yet more evidence that he's not 'normal'.

Anyway, sorry to go on and on. I just want some advice before I go to the professionals and make it all Official. A friend of mine had her son assessed a while ago in Japan by a non-bilingual specialist and he was diagnosed with autism - only to be told a few months later he wasn't autistic and I'm almost afraid to go to see anyone in case they label him with something that then marks him for the future.

Can anyone help?

Sorry - I just read that through and it reads as very stream-of-consciousness.
I guess my question is 'Do you think there is an issue to be addressed, or am I just dealing with a very headstrong 3-year-old who is behind with his speech, which will develop more over the next year or so?'
Thanks

Hi Penny. Didn't want your post unanswered.

I think there are lots of issues for you there and difficult as you in another country with another system (as am I). I think you should try and see a Developmental Paediatrician and a Speech therapist as a matter of course. There is no harm in it, and in most places anyway, very unusual to get a diagnosis and then for it to be taken away - so don't let that stop you. Much better for your boy to be getting appropriate help at a young age. All speech issues should be addressed at toddler level for best effect.

Secondly, I've been told that speech disorders, auditory processing difficulties etc. (different and more complicated than straightforward delay) can sometimes be identified at your DSs sort of age by their level of comprehension. My DS was non verbal at 2.5 and then very slow to pick up language and his understanding was very very poor. If your DS has good understanding then that's a great sign.

Your description of him not hearing you say 'wash your hands' rings bells for me.

Also the dual language thing can be a red herring and don't let it put you off getting a professional opinion. Lots of bilingual children are slower to talk and lots aren't - so really shouldn't come into the mix.

I hope you are alright. I've been through this all myself. My DS is 7 now and has been diagnosed Autistic (high functioning). But it took a long time for the traits to show and the speech delay was our primary concern for ages. That's not to say that your DS is on the spectrum, but just that its hard to pull apart the issues really and that's why you need a professional. I hope you are alright.

I dont know to be honest, my son was raised bilingually and was very verbal in one language from start and didn't speak other at all hardly until five or six. The wash your hands thing sounds completely normal - but I'm not expert.. Am slightly taken aback at dh apparent desire to find him autistic but maybe he genuinely thinks this.. I think I'd get him assesed if you trust assessors.. Hope things go well for you - he sounds lovely!

Thanks for your post Shells.
I suppose I've got myself into a bit of a panic recently, especially after spending time recently with a friend and her dd, who is the same age as my ds and same background (bilingual Eng/Jap), but who is streams ahead (in English at least).
That said, they've just returned from a month in the mum's home country plus spent a month there in January, so she's had way more exposure to English than my DS - we've not been in the UK for 18months.
Am I just making excuses?!

There is nothing in your description that sounds to me like a red flag for autism. In particular, is he good at nonverbal communication - pointing, showing you things, imitating etc? But do see a specialist if you are worried.

Oh he can make himself understood no problem, Parietal.
In fact, I think that's half of the problem. He'll point, moan, whine, (or go and get what he wants, regardless of whether we want him to have it or not!) and he's verbal enough to say 'xxx please mummy' (even if I do have to prompt him).
He constantly asks (usually in Japanese) what things are when we are out and about, or tells us to 'look' and points at stuff, (sometimes he knows the word, sometimes not). If I ask him to repeat a word, he can usually do it - yesterday he showd me an electricity pylon and it took him a few attempts to say 'pylon' (think he said plyon a couple of times to start with), but then said it ok.
I know this is not what you mean about imitating but his favourite 'trick' at the moment is pretending to be m-in-law's dog. We have to pat him, ask him for his paw etc - he finds it quite amusing. I guess I'm trying to say imagination is there...

Well, its a cliche, but a lot of girls do speak way earlier and much better than boys. So again, I wouldn't put too much store by it. If you're really worried, you should see a professional. For peace of mind if nothing else. I don't think the 'wait and see' approach has much to recommend it at all.

There are loads of experienced speech people on MNet in this section. I'm sure they'll come along in the morning there.

Ds at the same age was non verbal and grunted and was told he was maybe red flagging for Asd.But as he got older like your son he was trying to find ways to communicate pointing dragging you to things etc.

Now at 5 it is very clear that he is not got ASd or As and infact has a speech and language disorder and he is infact in a speech unit .The act he is intrested is a good sign and ye sif he is exposed to Japanese more then he will natrually be stronge rin that lanaguage and as for friends daughter having monthn in uk yes her English would have improved as she has been immeresed in the language .Same way the say you learn a language best if you live it

I would try maybe to get appointment with speech therapist .Ds can sometimes say a word correctley then cant repeat it has verbal dyspraxia and also oral where he just cant make the sounds and we do lot of fun excersises .blowing bubbles/whistles making shapes with his mouth sticking his tounge out this one he loves

Definitely see a speech therapist, ideally one with experience with bilingualism, to work at bringing his language on. And given your DH's concerns it's worth getting him checked over by a developmental paediatrician. Your DH I imagine is genuinely very concerned about your DS's development, try not to let it come between you, I know it's hard if someone suggests ASD and you think absolutely not, but listen to his concerns.

It's a good sign you think his comprehension is so good, but worth getting that double checked by the speech therapist, as he may be struggling to answer rather than be unwilling. Don't know about the Japanese system but in the UK doctors do not diagnose ASD lightly, IME if there's any doubt, they are happy to leave things up in the air for some time to wait and seem.

Lots of speech and language disorders can mimic autism initially eg the play can be behind as they don't have the language for imaginative play; the meltdowns due to frustration etc. Often its only with professional input and therapy it becomes apparent if there is a speech problem and ASD or just a speech problem. The not listening is classic ASD as they don't tune in to conversation / often don't use language except to request, can be very content on their own. However it sounds as though your DS does use language typically at other times. You should get a speech therapy assessment. He could just be behind, my nephew had a speech delay but nothing else ever showed up. Having speech therapy isn't harmful and its better to give support where it turns out not to be needed that lose precious time not giving support. There are some books which lots of people find useful eg Hanen (its takes two to talk) has lots of ideas eg about supporting language with signing or visual symbols. Also a website www.teachmetotalk.com has some good ideas eg for toys which encourage speech. You can look at MCHAT to score for ASD symptoms. The to and fro of conversation is the key eg if you sang a song with him would he make eye contact, sing the next line, fill in the gaps etc would it be an interactive / two way experience? If he is communicating back and forth in a series of interactions - even just with gestures rather than speech - but staying with you and lots of to and fro thats a good sign its not ASD as the social desire for interaction is there even if the speech is not.

Thanks for the advice. Have been watching/talking/listening to him closely tonight and yes, he DOES interact. He's at the stage where he knows to distinguish between Eng/Jap for me/my DH and adjusts accordingly. His English being weaker, he resorts frequently back to Japanese with me, which is fine.
TBH, when Im WITH him and we are talking, I think he's fine. He understands, interacts, eye contact, jokes and he seems fine. It's just when I listen to his peers that I panic and think 'There's no way he could say that'...
I asked him what he had for lunch in English, he thought about it and answered in Japanese and answered in English to my other Qs about lunch. Trouble is, I cant find the montly menu from his daycare to heck if he gave me the right answer!
Have found a bilingual speech specialist nearby so think will book an appointment and see what she says.
Thank you al for your answers.

And apologies for the typos - I CAN spell - I blame this 'smart'phone..

I think comparing your dc to others is a fools game tbh, although as the mother of 2 late talking ds's I completely understand!

I think his "meltdowns" could well be because he cannot express himself verbally very well yet....did you do baby signing at all??

Ask yourself some questions;
Is he - mostly - a happy and alert child?
Does he understand verbal instructions and act on them reliably i.e. pass me a tissue? (can you tell I have a cold atm????!)
Can he "read" facial expressions? i.e. does he notice if you are sad, happy, cross etc?
Are his "meltdowns" occuring after he has been trying - and failing - to express himself/ask/tell you something?
Does he enjoy being with other children?
Have any of his nurseries/child carers expressed any concerns?
Does the fact he is being brought up bilingual have any effect on language development? (I dont know, sorry)

My ds1 is currently being assessed for dyspraxia/dyslexia and APD but ds2 - who was also a "late" talker - is showing none of ds1's issues as yet.

Hi. I raise my DC biligually and nothing in your posts raises a flag in my non-expert opinion. You could have described my DS 3.5 who is NT. Especially the hand-washing is what we go through three times a day :-) However, I absolutely second zzzz. If you think there might be something wrong, trust your instincts and follow it up. But from what you posted, I wouldn't be worried.
I agree to make sure the person you are seeing knows about bi-ligualism.
From what I understand it's important not to drop the second language because it would reduce the overall vocabulary. To my understanding this is even the case if there is a speech or language problem.

My NT DS1 was very late talking (3.5 before he ever put 2 words together) and my DS2 with ASD was also late talking! The main difference was that DS1 would point things out to me and use whatever words he had to comment on everything. 'Wall' meant building, castle, Lego, bricks, block paving etc. His speech was delayed but his social communication was fine. He wanted to communicate. Playing with friends he seemed very delayed, but it was only because he couldn't communicate verbally with them. At 5 he started school, made friends and despite finding reading difficult, made good progress and is now at 13 exceptional at Maths and average at English!

Now, if you or your DH has any doubts, get it checked out, because early intervention is really important. My DS2's speech delay due to his ASD didn't worry me for ages because of DS1's example. Without a very lovely SALT suggesting that DS2 should be assessed, I would have stayed in blissful denial for ages. The other posters above have given great advice.

Thanks to you all for your very helpful and informative advice.
Your words and shared experiences have really helped to calm my fears and put things into perspective.

Becaroooo, in answer to your questions:
Is he - mostly - a happy and alert child? yes, very

Does he understand verbal instructions and act on them reliably i.e. pass me a tissue? yes

Can he "read" facial expressions? i.e. does he notice if you are sad, happy, cross etc? yes

Are his "meltdowns" occuring after he has been trying - and failing - to express himself/ask/tell you something? notsure - I think sometimes they may be, but also when he's tired, gone for a few hours without a sanck/meal/drink, or (more frequently) when I'm 'forcing' him to do something he doesn't want to do - get dressed at that particular time, put on a certain pair of shoes, put on a coat, etc. I'm learning to 'pick my battles'!

Does he enjoy being with other children? yes he loves being with his sister and will sigh and say "xx to asobitai neee.." (translation: it'd be nice to play with xxx..) about a friend he's not seen for a while. He will ask about friends he hasn't seen and if I ask him who he is going to play with at nursery, he'll mention 3 or 4 regular names, that I often see him with when I go and pick him up. His teachers at childcare will often write in his book that he played with x, y or z-child, so I know he's not playing alone. That said, he is quite content to play alone at home at times, but will often ask me to play with him (usually with some plastic fighting-hero figurines who like to ride on dd's unicorn / barbie horse (much to her horror) before crashing and falling off, repeat ad infinitum, until I 'remember' the 'important' job I have to do..

Have any of his nurseries/child carers expressed any concerns? no I've asked them about a couple of related-things, but they always tell me his behaviour is normal for his age. They've only mentioned his speech in a positive way (ie to tell me he's improving) but I think that may be deliberate. Although they don't speak English at his day care, they are all happy to 'have a go' when he says "see you tomorrow" - to the extent that he's now 'taught' the rest of his class the phrase. That said, I've heard that Japanese are very reticent about labelling children at an early age and I wonder if they would bring it up with us if they thought there was an issue - a non-Japanese friend here thinks they definitely would, I'm not so sure...

Does the fact he is being brought up bilingual have any effect on language development? notsure Many experts say no, but others say possibly. It's out of the question for me to stop speaking English to him - for a number of reasons, and the fact that we are living in Japan also means it's impossible for him to avoid Japanese, so we are a bilingual family by default, like it or not!

I've come to the conclusion that I will contact the bilingual Eng/Jap language specialist here and have an initial consultation and take things from there. Because of the bilingualism aspect, specialism sessions here are extraordinarily expensive, but I want to be sure I'm doing the right thing by my precious little man .

Thank you again for all your posts.

Well, nothing you have said in answer to my questions is worrying me HOWEVER you are his mother and IME I worry if a mother is worried....if a mother and granny are worried I really worry!!!!!

Get him checked out...it cant hurt can it? (he sounds lovely btw!)

Good luck x

oops, dont know why that all went bold then! Sorry!

Sorry haven't read all the messages in detail, but would get assessed asap.
I do know a bilingual lad moved to our primary school this year and wouldn't talk to anyone for ages in English. He has German parents. I will ask my neighbours for you tomorrow about the impact of bilingual. They moved to England with daughter aged 4, from France. Dad French, Mum English. Was slower to take off with English I think. Think like everything bilingual impact depends on child.

pennybubbly, my DD has a s&l delay (well, probably a disorder and most likely some other underlying issues). she is speaking far less than your DS. DD grows up with 3 languages. I have seen two SALTs and also the dev paed - all agreed that these kind of speech and language problems usually have nothing to do with the multilingual upbringing and strongly advised against dropping any of her languages. i have also read books and articles and the general consensus seems to be that bi/multilingual upbringing doesn't cause speech delay etc.
Salt and dev paed say that DD is a child who has language problems and just happens to grow up with more than one language.

Thanks for the updates

Auditory Processing Disorder (APD) is a listening disability, not being able to process what you hear. This can cause speech delay, problems following conversations, and following verbal instructions.
APD is a relatively recently recognised diagnosis in the UK , since 2004, but they have known about APD in the USA for over 30 years. The UK Medical Research Council has been developing a new Universal Battery of APD diagnostic tests based on Sound frequency, to replace the old language based tests. And have been party to establishing an international definition of APD.

Only an audiologist can diagnose APD, and should ideally be be part of a multi = discipline (multi profession) assessment to assess any speech and language and psychological issues that living with APD may cause.

Thank you for your post dolfrog - I think.
I am not sure if you are posting because you think the description of my son fits this disability?
My DS can follow instructions when he wants to . The washing-hands incidents, are as others have said, fairly typical it would seem. If I asked him to go and get his shoes, chances are he would.
He have a 2-way conversation. The length of his sentences are limited albeit, but for example yesterday, I said 1,2,3 to my DD (out-of-context here, but it had meaning then!), then he chipped in with 4, I said 5 and so on, backwards and forwards upto 10. As I wrote in a post above, I asked him what he had for lunch that day and he answered, giving specific examples (ie he didn't say "lunch" or "table").

Sorry about the appalling italics there....