Speech therapy for 22 month old suspect autism ... Pls help

[Rumaysa1]

Hiya all

My son is 22 months and since about 18 months I have felt something was wrong. He is in his own world , does not interact, cuddle, or kiss , does not point or gesture, does not respond to his name and I really don't think he understand what I say. I am going out of my mind reading and trying to get him support but without a diagnosis it's really hard.

I am thinking about getting him privately assessed as the nhs is saying 10-12 months waiting to be seen!

In the mean time I was thinking about starting some private speech and language therapy at home. I am in east london and wanted to ask if anyone would recommend any one they have used or think this is something that will benefit my son.

Also how much they charge,

He is not talking just really make sounds very rarely says dada.

Any advice will be much appreciated

Thank you

10-12 months is standard most places for an ASD assessment. However if you access NHS speech therapy you won't have to wait that long, you should be seen within weeks. It's always worth getting an NHS diagnosis even if you decide to get a private one as well as some area's are funny about private diagnoses.
Hopefully someone will be along to recommend a private speech therapist as i don't live in the south.

Speech therapy has changed our lives. Our son has had private speech therapy since he was 2 (he's now 4) and it has really helped him and us as a family. It helped us teach our son to point, wave, take turns, engage in pretend play and ultimately talk.

Go to: www.helpwithtalking.com/

This website lists certified independent speech therapists. Good luck!

www.teachmetotalk.com

Everything you need is know is on this site! Trust me.

Lotty. Is your son autistic, ? Thank you for sharing your experience.

It's just some ppl have said salt does not really help autistic children .

I have been in contact with local children's centres for sessions focusing in speech however they have not started but should this year once a week.

Thanks for all responses it's such a hard time

Hi Rumaysa,

I am a freshly graduated SLP. The lack of interaction at the age of 22 months really does sound like a problem. Does your son react to sound? Can he eye track an object he's interested in? How does he request for things he wanted?

Some quick tips I can give in the mean time would be keeping items that your son/s interested in far from his reach, and give them to your son until he vocalizes as a reinforcement (physically help him point to the object as he vocalizes).

Hope this can help

Also, what kind of toy is your son playing now? Can he play simple fruit cutting games or use other tools correctly (knife, phones, hammer, etc?)

Hi, it's great that you are being so proactive in helping your little boy. Have you mentioned your concerns to your GP / health visitor as it sounds like a referral to a paediatrician would be appropriate. That may open up other support, as others say please get on the waiting list for NHS therapy even if you go private in the meantime. In the meantime as Nivv says try to keep favoured toys out of reach so that you can support him to communicate in some way that he wants them. Hope you get some support soon

Also I would dispute that SLT doesn't not help children with autism, some may never speak which is what people may mean but the SLT will help with communication and encouraging interaction. Does your son show any sensory issues such as spinning / rocking, texture aversion? What is he like with food?

My daughter has autism and speech therapy does help her. Her speech therapist actually specialises with children with autism. In some areas you can self refer to speech therapy so that may be worth checking.

If you go on the ASLTIP website you can search for a SLT near you and each therapist lists their areas of expertise so you may want one that works with children with autism. I think you can expect to pay around £60ph but they should give you lots of advice and you can implement this yourself. You might also want to consider looking into ABA - there are loads of old threads about it if you do a search.

Hi Rumaysa1!

My son was diagnosed with autism at the age of 3. Speech therapy has helped him immensely. He is now talking in simple sentences, in 2 languages, and has lots of fun interacting with us. I have also read that some people say that speech therapy doesn't work for children with autism, but for us, I hate to think where we'd be without it. All I can say is, there are no quick fixes, you have to work hard with the therapy to get the results.

I've been reading the ABA 'Verbal behaviour book' by Dr Mary Lynch Barbera, and the only speech therapist that I know of who is quite similar to using Verbal/ABA type techniques is the speech therapist Laura Mize.

Though this could be because she Identifies EVERY skill in order to talk/communicate.

I really do recommend you look on her site OP, like I mentioned.. www.teachmetotalk.com.

I personally think the most effective treatment, whatever you use, is to work, interact with your child all the time.

Nivv- he does react to sounds, if in another room will run in if he hears a cartoon he likes.
He had his hearing checked couple weeks ago he passed as part of the checks requests by HV after I pressured her to come and observe my son at home.

Gp been useless jus always fobbing me off saying my son is young and a typical boy!!

We are waiting for autism assessment and salt assessment.

He can tract toys with his eyes however cannot follow my finger when I point.

When he wants something, he initially moans, then cries then screams.

I have started putting a couple of things he likes further away will see how it goes.

He loves cars, plays with them appropriately , big cars and sisters scooter he flips and spins wheels.

I have wooden fruit and veg to cut he never does that just pulls th apart and gathers in a corner , he likes gathering things in corners.

Toy phones never puts to his ears. Hammer he bangs with as he likes banging things.

Llikessweetpeas- he likes really rough and really silky meterials.

He flaps his hands a lot when happy, excited or angry

Thanks every1 xx

In terms of the eye contact/responding to name what we did with our DS was to sit about a metre in front of him and call his name, every time he looked at us we would immediately reinforce with a sweet and say 'good looking'. When he was doing it at that distance fairly consistently we moved a little further away, then we started at one metre but at the side, then behind and eventually from a different room. You should always give social praise when delivering the reinforcer (sweet) so that your DC associates the praise with something nice and eventually the hope is that the praise on its own will be reinforcing enough. Also anytime he did make eye contact in any other situation we would try and remember to praise him.

It might be an idea to try working on basic imitation now as that is such a key skill. So sit in front of DC and clap your hands while saying 'do this' and then prompt him to do the same (hand over hand if necessary) and reward him for doing so. Eventually fade the prompt by say just touching the back of his hand or his elbows etc..

Also you might want to work on getting him to see others as fun, so play lots of games that need another, such as blowing bubbles or pushing him on a swing, jumping with him on a trampoline etc

If you want to encourage speech start with things that he really wants. So for example if he is on a swing say 'push' before you push him and then stop the swing and wait for him to say 'push' or 'puh' or any vocalisation if he can't say that, and then reward him by pushing the swing.
If there is a food that he particularly likes give him a little at a time and get him to vocalise for more. So it may be that he just says 'ba' for more banana.
You can do this with loads of things, tickles, bubbles, bounces etc.. Basically anything that he wants - he will be learning that communication gets him wha he wants.
And if he can imitate you then oral imitation is a great idea - so copying you sticking out your tongue, blowing raspberries, opening your mouth etc

My son is 22 months and has autism (he got diagnosed at 18 months). If I were you, I would do the following things:

1. Go to the GP and insist on (a) a referral to a developmental paediatrician (you are quite right that this can take a very long time and it's worth getting in the NHS queue now, even if you decide to go privately) and (b) getting his hearing checked (bad hearing/glue ear can often produce similar symptoms to ASD, and it's worth getting it checked out/ruled out as a possibility (unless you are sure there is nothing wrong with it)).

1. If you can afford it, find a really good autism specialist near you and pay for a private assessment. We saw Dr Daphne Keene in London (she has many, many recommendations on MN!) and she was brilliant - diagnosed DS without any hesitation and really helped us to get the right help from our local authority. Beware, there are often long waiting lists for the best private consultants (we had to wait two or three months to see Dr Keene and I know some people have had to wait much longer) and it is expensive (I think we paid about £800), but without that diagnosis I am quite sure we would have continued to be fobbed off by the NHS (the NHS consultant we saw only a couple of weeks before we got Dr Keene's diagnosis said that she thought he definitely didn't have autism ).

1. Look up Portage on the internet and see if it is provided in your local authority. They will give you some great ideas of how to help your DS interact.

1. Get a referral to your early years centre (ask your GP) - they may be able to offer some assistance even before you get the diagnosis.

1. Buy "More Than Words" by Hanen. It's expensive (about £80) but it shows you very clearly all the best things you can do to help your DS engage. In the words of our ABA consultant - pretty much everything they suggest you do in ABA is in the book. The Teach Me To Talk website recommended in one of the posts above also has similar content and is definitely worth looking at.

1. I think it may well be worth looking into speech and language therapists but please try to find one who specialises in ASD and do your research - there is a real mixed bag out there and whilst some are excellent, some (including the ones we saw) were a waste of money. But remember that the key things you need to do to encourage communication are not rocket science (they are all set out in the Hanen book), and even if you can't afford the speech and language therapy, or if it would be a struggle to do so, you can do a LOT at home yourself (and it's putting in the hours at home day in, day out which is what will really make a difference).

1. If you do get the diagnosis, look into setting up an ABA programme if you can possibly afford it.

Please bear in mind the absolute KEY is early intervention. Well done for noticing something is amiss (and, to be honest, there are some red flags in your description) and please do everything you can to get an assessment ASAP and, starting now, work with your DS yourself at home to encourage communication.

Finally, I hope you're OK - I know what a horrible, worrying time this is. Please look after yourself and reach out for support if you need it. Feel free to PM me if I can answer any questions or if you just want to chat.

Speech therapy would never have got ds1 talking. Now that he IS talking, SALT is helpful in improving his articulation etc.

In our case, ds1 had zero motivation to speak, and the LEA SALT had no strategies whatsoever to deal with this obstacle, as she didn't have any knowledge of behavioural techniques which he needed in order to be motivated to use language in the first place.

Hedger- thank you so much for your advice.

I am on the waiting list for him to be assessed on nhs.

I have looked at different specialists to get a private assessment: dr Margaret o Driscoll, dr Keene however she is away till late November and has ppl waiting to see her, then I tried dr Diane smyth who no longer takes new patients apparently and recommended consultant paediatrician dr Stefan Studnik he works for the nhs as well at st marys hospital in paddington

Sorry message sent too early lol

He has over 10 yrs experience in autism and early diagnosis. I have an app booked with him and a speech therapist to do a joint assessment. However I have not heard from anyone's experience with him.

I have just received my copy of More than words and have my first home visit from portage next week 17th. They said they will work with him for one year but not when in pre school do you recommend I get h into pre school early or stick with portage as it's 1 to 1, there is no autistic specialist pre school near me.

If anyone could recommend a speech therapist I would be so relieved as some say they have x experience but how do I know it's 100% true.

I will pm you just to pick your brains as I'm already thinking about the EHCP .
Thank you sooo much x

Veragrant- what did you use to start then?

That's great - sounds like you are really on top of things already!

We actually saw Margaret O'Driscoll when my DS was 15 months old, when I first started having concerns. I thought she was lovely - very kind and very switched-on. She said that there were red flags but that he was too young to diagnose at that age (which I think is what any paediatrician would say) and that she would like to see him again when he was 18 months old. We ended up going to Daphne Keene in the end though simply because I had read so many positive reviews of her on here. But I would have been happy to go back to Dr O'Driscoll too.

I haven't heard of Stefan Studnik but it's always a good thing if they do NHS work as well as private, as I have heard some local authorities can be funny about accepting diagnoses from purely private doctors.

Re pre-schools I am not sure - Daphne Keen thought it would be good for our DS to go to a specialist pre-school, but now that we have the ABA in place I think we will hold off for another year because I think the ABA programme will be more effective. Also, our ABA consultant thinks it's best if our DS attends a mainstream pre-school/school (with an assistant if necessary) rather than a specialist school - her view is that children who are severely autistic need a specialist school but if there are no real behavioural problems and communication problems are not too severe then children can really benefit from being in an NT environment. So we are going to sit tight for a year and then see whereabouts on the spectrum DS is looking like being and make a decision from there.

Our DS also goes to our local early years centre which has two two-hour small group sessions for children with autism/other delays - a bit like a special nursery, but the parent/carer stays - so you could see if yours does the same thing?

I do think one-on-one teaching is quite important, especially at this age - but whether or not this will be possible for you (and whether pre-school would be better) will I guess depend a lot on your current childcare arrangements and what position you are in financially. Do you look after your DS in the week? If so, you could really throw yourself into learning the ABA/More than Words/SALT techniques and make a tremendous difference just doing that. Or you could put a proper ABA programme in place (but this is enormously expensive).

What we are doing is having an experienced ABA supervisor come and work with DS and train our nanny for 10 hours per week and then our nanny is doing the rest (me and DH are also learning so we can do it on weekends). We're also making lots of time for playgroups, playdates and activities and things as well so that he does get some interaction with other children.

I think adrianna22 hit the nail on the head when she said that it is not so much about just having an hour's SALT or an hour's Portage or whatever per week - it is about you and whoever else looks after your DS completely immersing themselves in the techniques and doing them all the time, day in, day out.

In terms of SALTs, the one we saw privately was dreadful (the NHS one was better, although we only got one hour every six weeks ?) but I remember reading a glowing review on here by the mother of an autistic child for The Children's Place on Harley Street so you might Google them? The key is to find one who specialises/has lots of experience in autism - because VeraGrant's post is unfortunately reflective of the experience quite a few parents have (including us).

Ooh, in fact, my ABA supervisor mentioned that she knows an excellent SALT in London looking for more work - apparently he is free on Saturday mornings. I can find out details for you if you like? I think she said he was about £50 per hour.

PS - The name of the SALT at The Children's Place who was recommended on here is Nicole - if you look at her profile on their website you can see her bio includes lots of experience with autistic children.

Oh wow thank you sooo much, pls do email me the private salt details has he any aba experience? My email is [email protected]

My financial situation is not good really but I will put all I have into this and get help from family .

I have read aba costs £45,000 per year ! Is this right?

I have been looking into peach , due to my finances.

I take my son to childrens centre twice a week one generic session stay and play and the other is for children with developmental delays.

Feel so guilty to be honest that I can't just set up an aba programme but I suppose that I'm in the majority.

Really appreciate all your advice, feel like I'm going crazy with info overload and its me doing all the research and making contact his father is in total denial.

Will do.

I think a full-blown ABA programme does cost that much, yes . But as your DS is very little, if he is diagnosed and ABA is advised, you would only need about 20-25 hours per week for the first year or so (rather than the 40 hours which is usually recommended) and the thing to remember is that you can do it, you parents can do it, if you currently have a nanny they can do it, etc. (with some training from a supervisor) - so there are ways to incorporate it even if you can't afford a full-blown programme. And of course, once you have a diagnosis, you can apply to your LA for funding (although that's often not a straight-forward process...). There are some charities that can make contributions too, like Cauldwell. I think there is even a new charity that is making huge contributions for anyone with an income of less than 45k pa, although I can't remember the name.

But in any event please don't feel guilty about not being able to set up a full ABA programme - I don't know who can really, you'd need to be very rich indeed to be able to fund a full programme independently. The only reason we manage with our quasi-programme is because of help from parents.

I had the same denial thing from my DH, it's hard isn't it. If your DS does get diagnosed, I am sure he will gradually come to accept it.

You're doing so well to have found out so much about it all and organising all these different ways to help your little boy. He is very lucky to have you .

Very useful advice here

In our case salt worked after aba taught her imitation

Aba can cost as less if you do it yourself ( consultant at £800/day 4 times a year and supervisor at £50/hour 2 times a month) and lots if you hire tutors. We hire tutors but the more I am learning the better it is getting

What I have seen with aba is that there are two aspects mainly - general behaviour like grumbling in our case lately and the 'table top discreet trials' . The general behaviour all his carers will have to tackle. It's the table top teaching that we need tutors even today (20 months into aba) that I struggle with. The natural environment teaching is again something that most carers can/should do throughout their day.

But I know a few parents who do far better aba than tutors themselves.

If a local family is happy for you to go and watch their aba session pls do so. Most aba these days is very play based.