Case for concern?

[Paribus]

We have just met with our friends DS and I need the advice of someone experienced please. He is 2,3, almost non- verbal (3 languages- 2 at home plus English at nursery), lost his words at around 2 (had a few before that), now has around 15 words including sound imitations, no phrases obviously.

High pitched screams, lines up cars at home (as if he is parking them one after another), loves to look at the wheels. However he has eye contact (not great, but still does), follows simple instructions, imitates actions, cuddles and kisses.

Would you be concerned or am I imagining things? I told them that it's worthwhile to get him seen by SALT re speech regress.

A case for requesting a referral to a developmental paediatrician yes, but, Are THEY asking for Help?

Well, yes, otherwise why would I suggest they see SALT?

I have no idea Paribus. Just trying to get the full picture. Won't trouble myself any more.

Sorry didn't mean to sound rude at all, probably didn't express myself right!

i would be. Are your friends actually worried?

Okay. No problem.

Get a look at the MCHAT questionnaire, look up symptoms of dyspraxia and ADHD too. Get a long list of behaviours from them and write out the ones that apply to child. Next to each one, write a real life example of one or two of the behaviours.

Take this list to the GP. Be CERTAIN to mention the losing of skills. Hand the GP a copy of the list, dated, and request a referral to a developmental paed.

In the meantime, get a copy of the Hanen More than Words book and get to work.

Oh, just saw you reply, paribus.
We are also a trilingual household and dd's speech delay had been blamed by various professionals on the 3 languages. I never believed that but it was a red herring for us. We now have a dx for autism.

See, I am on the fence here- I don't want to scare them, but I don't want to just ignore the whole thing.
Starlight, it's not my DC, so can't really do all that you are suggesting. Do you think I should mention ASD to them? I just don't know, may be I am imagining things here. For example lining up- I always read about it as a red flag for ASD, but can it be just developmental stage that all boys have? He has eye contact, is it a reassuring sign?
Sorry, I am mumbling and asking all these questions, may be, it's none of my business at all, but they are very good friends and I don't want them to miss something important.

That's really why I asked about the SALT thing. How much of a green light you have to 'advise'.

It's a tough one and been discussed here many times. I know what I think as an outsider (that the child comes before adults sensibilities or friendships) but in truth I doubt I would act that way myself when faced with the dilemma.

Re dyspraxia- thought about it too, my DD had it (now re- dx as speech delay with dyspraxic elements, so am familiar with symptoms etc), but what scares me is speech regress and lining up of the things. Can it be developmental?

Lining up is a developmental stage for ALL children not just boys.

Sorry. Eye contact isn't a reassuring sign especially. Tbh, from your list I'd be concerned.

I guess what I'm really asking is what in the above mentioned behavior would set alarm bells ringing for you? What does lining up look like in real life- that certainly scared me when mum mentioned that he does it all the time(she said he does it as if he parks the cars one after another).

Starlight, would you be concerned about ASD?

Eyes, tbh I can't remember my DD lining things up- nor any other children I came across.

Can't link as on phone but it's part of the play schema in early years..

A Dx do ASD requires substantial investigation from experienced and trained professionals but from your post I woukd want him seen by them if he were my child

Yes, lining up is something most children do, but not obsessively and to the exclusion of everything else.

Loss of words / any regression is a massive red flag for ASD and age 2 is the classic age for regression in ASD. My DS regressed at that age. A lot of the other signs did not emerge for several months. The loss of words in itself is a huge red flag.

Agnesdipesto, thanks, that was my concern as well.

Paribus I think there is enough there of concern that they should go further.

BUT did they have any concerns themselves? And how did they react to the SaLT suggestion?
While you would want what's best for the child, if they are anything like I was, the thought that it could be ASD was too big to contemplate.
I'd suggest a softly softly and hope that if you leave the door open they will come for advice when they are ready for it?

Porridgelover, no, they were very grateful for SALT suggestion and asked me to check with our SALT when she can see them....

Although, I don't think they knew what I had in mind when I was asking about lining up- loss of words etc.

Tbh ds2 speech delay was his only really noticeable "symptom" he has good eye contact, is loving and affectionate, has fairly good imaginary play.

A SALT whilst useful will not be able to indicate if it is asd or not (in fact mine felt it wasn't asd) I think there is enough cause for concerns with the speech delay and loss of words

Catsdontcare- they can go to private paed, but in my experience paeds tend to dismiss concerns by repeating 'all kids develop differently' mantra- or is paed still better than salt?