SLT mentioned eye contact - autism

[Clare123]

My son (31 months) saw a SLT specialist last week (previously seen other SLT therapist, but she was a specialist in speech disorders). My ds obviously has a speech disorder and it has been mentioned it's probably verbal dyspraxia which makes sense to me.

Yet during last week's appointment the SLT said she felt from meeting ds today, that his eye contact was poor and he showed little interest in what others we're doing. Obviously she is suggesting autism and has referred him to a paediatrician.

I'm so upset, because in most ways I would say no - he points to what he wants, he's friendly, loves a cuddle, shows me things and plays with toys appropriately, I can call him and give him instructions which he follows, he gets excited to see people. BUT - he isn't good at rye contact - he does give it but it could be better, he also doesn't like me being part of his games - he wants me to join him, but when I join in he 'll take the car/train/animal from me.

I'm sat here worrying and no one can give me the answers but what do you think? Does this sound as if he has mild autism?

It's very hard to say.

I heard that you cannot get specific language disorder diagnosis and have ASD, it's either one or the other. So it could be your speech therapist reckons that it may not be a speech disorder, but rather autism.

My DS has a diagnosis of autism, he has no symptoms apart from a social communication delay. My DS uses loads of gestures, and I'm not talking about using my hand as a tool as he has never done that, but he uses loads of gestures, which are his own sign language in a way, even though he has a language delay. He uses joint attention, can respond and follow person's point, can understand facial expressions, plays with toys appropriately, non-verbal communication is his main strength, has friends etc, no routine issues or obsessive interests etc, shows me things.

But-
because he has a social communication delay and is a bit repetitive with pop-up toys, he got his diagnose and like you mentioned about your DS, he would not allow some people to join in his play, apart of social communication anyway.

I do not think the lack of eye contact is an issue. It's about HOW he uses his eye contact, that's the issue...does he use eye contact when playing with you? When he points, does he look at you, look at the object, then back at you? (joint attention) Then again, my DS does all these things and he still has a diagnosis.

It is very hard to know whether your DS has autism or not. They look at the whole picture.

But whether your DS has a diagnosis or not, he is still the boy you gave birth to. Do not spend your time researching what your DS may have, play with him, read to him, work on the things he finds difficult.

You'll be ok .

adrianna22 A very good friend of mine has a Dd with a diagnosis of Asd and severe language disorder!

Clare123 When we were trying to find out if Dd3 had Asd a SALT spotted and noted her lack of eye contact. It was one of the things that led to her getting the diagnosis! If the SALT has seen something that is worrying her, she is right to refer your Ds on, that is part of her job.
No one will diagnose your Ds with anything if he does show significant signs of it. Children are not diagnosed with Asd at the drop of a hat.

Take care be kind to your self and stick around on here for advice and support.

Good luck

Ineedmorepatience- That's strange, because when the autism clinic which diagnosed DS, said that a child cannot have a specific language disorder and have ASD, because a child who has ASD would have a language disorder anyway. Though it is not a specific language disorder.

As for eye contact, ASD is not the only diagnosis possible. I took my daughter for a speech therapy assessment at 2y 10m. The SLT said she had all the attention of a butterfly, she mainly spoke jargon because she thought that is what we all do; she did not pay attention long enough to learn the language anyway, and she had not realised what eye contact is for. Her diagnosis was (eventually) moderate receptive and profound expressive language disorder.

The SLT told me first of all to teach her eye contact by making sure I made it with her, every time I spoke to her and if necessary hold her chin in the right direction, so she was looking at my eyes. I also had to extend her attention by getting her to sit down and partake in table top activities for as long as possible.

My next door neighbour was formerly head of paediatric speech therapy and she talks to me regularly about children with ASD and a specific language disorder on top.

adrianna22 Dd3 has a diagnosis of Asd and she has specific language difficulties! Her difficulties are specific to her Asd!

I think you were fobbed off!

Ineedmorepatience Really??? The clinic where DS was assessed is a very good, and both the specialist speech therapist and the autism doctor said that no way can a child have a diagnosis of ASD and a specific language impairment. Maybe some clinics diagnose differently.

There is so much more to autism than lack of eye contact.
Try to keep an open mind and don't get too hung up on it, the paed might not agree with SALT anyway. Its not unusual for the professionals to disagree, i think most of us have experienced professionals not being on the same page!

Its good that he gets excited to see others and responds to you appropriately. It can take several attempts for my DS to engage with me and sometimes he doesn't even notice those around him. He is in a world of his own.

They don't hand out diagnoses of ASD unless they are absolutely sure so your DS won't be diagnosed just for the sake of it and certainly not just because of poor eye contact.

ASD is so complicated. My 3.7yo is currently being assessed and likely to get a diagnosis as he has severely disordered language (lots of delayed and immediate echolalic, pronouns all over the place, struggles to construct his own sentences), finds it very hard to interact with his peers and shows a strong need to be in control of things. He also has sensory issues and little sense of danger.

And yet, and yet...he has a strong desire to communicate (on his terms!), he's affectionate, he shares attention with trusted adults, he gives eye contact, he follows a point... None of these things preclude a diagnosis necessarily.

Adrianna, is there a confusion in the terminology - eg my ds has a speech disorder (ie he has no speech at all) but he also has a genetic condition, autistic traits and other issues. However I believe that the diagnosis of 'specific language impairment' is such that it is just that - specific, so not concurrent with any other diagnoses. see here

Hi Hazeyjane, that's exactly what I meant, specific language impairment.

It is certainly possible to have verbal dyspraxia and ASD diagnoses, my son has both. Verbal dyspraxia is a speech disorder in any case (I think specific language disorder refers to somethign different) - plenty of people with VD have no language problems at all, ie they understand everything, know what they want to say but can't make the precise mouth and tongue movements required to make the word productions they are aiming for.

Claire123, my son's limited eye contact was picked up at a similar age to yours and a few months later he got the ASD diagnosis (and the paed formally diagnosed verbal dyspraxia at the same time). As others have said they don't diagnose ASD at the drop of a hat and if your DS does get the diagnosis, it will open all sorts of doors to help and support. To be honest we feel our DS' ASD is mild (eg he's happy at his mainstream nursery and has age appropriate understanding of language) but it's good to be one step ahead in terms of understanding what issues he may have in the future and ensuring he has appropriate support for all his needs in place for when he starts school.

Anyway there's a good chance your DS won't get diagnosed, I gather some children with speech problems avoid eye contact because they know they cannot communicate verbally and want to avoid situations where they are expected to speak. in the meantime it's good all things are being explored, even though it does cause a lot of worry...

Good luck and keep coming to this board for help and advice

Thank you all for taking the time to reply. I guess we will wait to see the pead, but I've been told it's roughly a 2 month wait.

We have his private speech therapist next week and I will ask her too. He has been seeing her for a while and she has not mentioned any concerns.

Feeling sad and worried.

Thanks again for replying

Hi Claire, I feel for you having been in the same place.

The next paed appointment might not give you a definitive answer, we saw a community paed first who then referred DS onto the consultant paed and a multi disciplinary team to do the assessment for ASD.

Good luck

Hi all, Ds is now waiting for his first paed appointment. I am just wondering how long is the process from the initial assessment to having a Dx? I know it depends on the council, but would be great to know indicatively...

And what tests do the paeds & MDT use?

Hiya, we had to wait 3 weeks from referral to see the community paed and then 4 months from that date to see the consultant paed and MDT. We got the diagnosis on the day. We got there at 9.30 answered loads of questions from the paed while a SLT specialising in ASD played with DS (I'm sure there was method behind all the stuff they did with him but it was all quite relaxed and he actually really enjoyed it). Then we had to leave with DS for about 20 mins and were then called back in. Paed suggested the nice SLT took DS off for a walk while she broke the news to us. To be honest it went really well aside from the obviously painful outcome! Hope you don't have to wait too long....

another possible eye contact thing - if hearing isn't right then people can prefer to look at lips when someone is talking not eyes.