Dies this sound like language delay and possible hyposensitive SPD, or autism?

[OhdearOhdearOhdearIndeed]

DS is 2.5 and has a moderate to significant language delay, but there have been other signs that I'm worried about and think it is more than that. Just wondered if anyone had similar and if they are connected?

DS chews on everything - sleeves, paper, furniture! Anything! He doesn't seem to feel much pain either. He is very tactile and loves music and musical instruments, but isn't great at communicating his needs apart from bringing me what he wants or standing by something he can't reach and having tantrums. When we go out, if we don't walking in the direction he wants to go he has a meltdown. He is definitely full of life, but it's hard to gauge his learning without much speech, but he does know a few numbers when I count.

I have spoken to his nursery and they are aware of his speech being behind, but don't think there is an issue with social interaction, and myself and other people agree. They said he loves any messy play and musical activities. They seemed very surprised that he has behavioural issues at home!

He has had his first SLT assessment and the lady thought it was not autism, but SL delay and behaviour issues were related to communication, but this does not explain the other odd behaviours. He has had a couple of audiology appointments but they are still unsure if he isn't hearing properly.

Is it possible to get an SPD assessment? I have been referred to a paediatrician we which was offered as optional (and I accepted) as the wait is 6m to 1 year. Is this how you go about getting an assessment?

Anyone else noticed the chewing and hugh pain threshold with this diagnosis? I'm really pulling my hair out as I have no idea what is going on, but know he isn't developing typically.

Sorry about the typo in the title. Bloody phone!

Ideally he'd need a multi-disciplinary assessment by a Paed, Ed Psych, SLT and OT, that would pinpoint the areas he's having difficulty with and give a comprehensive diagnosis. As you've seen the waitlist is long, but do get a referral, you can always drop out later, but a place in the queue is worth having for now.

You can do that privately, but you'd need to make sure the team you saw also diagnoses for the NHS, then there's no questions raised afterwards about the standard of the diagnosis you were given.

Is it possible to get an SPD assessment?
Some, maybe most areas no longer have a sensory OT option.
Look for private Paediatric Sensory Occupational Therapists.

Google chewellery, it may save him chewing his sleeves

Thanks for your reply BlankTimes. Your second point is really valuable if I go down that route. My fear is that if SPD is not recognised he might be diagnosed incorrectly due to the language delay or we will miss addressing the real issue. I have spoken about his issues and a lot of people feel strongly that he doesn't have autism, but I think this is just based on social interaction and the fact he seems more under-stimulated than over stimulated by sensory input, but I know autism can manifest very differently in different cases. I think he might just have a GDD or a language delay with SPD.

The telling thing is that his nursery don't really see many issues, just the language delay. He participates in activities well at nursery and has no behavioural issues, but at a childminders he was problematic and stubborn. I think he just loves a lot of activity and busy environments. He is very stubborn and noisy.

I found a list online and my son does seem to fit the description for being under-sensitive to oral, tactile and auditory stimulation. So I will look for some tips to help him in this area. I might mention to HV too, but can't see them doing much. I think I will need to rule our hearing issues at his next audiology appointment and then raise at next SLT appointment.

I will keep the paediatrician appointment as I fear I'm going to need it! I'm just trying to look on the brighter side of things. He is a very cuddly and loving boy, and it's a very frustrating process, but at least I'm closer to getting some answers so I can help him reach his potential.

Have you done the mchat assessment?

Hi ChristmasCatBells. I did have a glance the other day and he seems to be in the possible range, most of the scores were to do with communicating and pointing (my other son scored low on this and wasn't really a pointer and he's not autistic). I've never understood the need to communicate with pointing, and why a lack of it means autism when there is communication in other ways, but hey ho.

I'm keen to wait to see if language develops in the next few months, before exploring autism as a possibility. My first son was quite a late talker too and is a typical child now, very good at communicating (but rubbish at sport ). I doubt I'll get an assessment for some months now, so it's the only option I have anyway.

The more I read about SPD, the more convinced I am that my son has this. He loves pushing and dragging things around too. I think it's just understanding that my son might not experience the world as other kids do that has helped. I can work with that and it has given me a bit of hope.

On the plus side, due to his high pain threshold and need for tactile stimulation, Rugby might be a good option for him

It’s not so much the lack of pointing, it’s what pointing signifies - it signifies ‘shared reference.’

So children who don’t point, wave etc aren’t communicating non verbally in a reciprocal or ‘shared’ way. That’s a really basic way of looking at human interaction, or what’s underneath it.

I see what you mean now. My son likes to sit on my lap and attempt to sing nursery rhymes and knows the actions (he will point during wind the bobbin up) and he's great with eye contact here, but not when I randomly point to something to get his attention or when he wants something. He tends to just sort of look at what he wants and moan. It's very hard to know what he wants sometimes.

Which could be ‘he is always on his own agenda’ or could be due to language delay.

It’s quite hard to tell in the circumstances. I’d get on the paeds list, as you’ve said. No harm.

Ours DS4 has a high pain threshold and delayed writing skills alongside social and communication delays. He also likes lifting, climbing and pushing. Recently he's been biting things when frustrated. But he is highly interactive with his favourite adults and does give a lot of reciprocal attention he'll point at things and explain what they are or doing. He wasn't doing this 6 months or so ago so things do change. He also struggles concentrating on anything he doesnt want to do. Ed Psych wasn't concerned too much about autism but paed said its likely.

He sounds a bit like DD2. It's taken a lot of unpicking to get to the bottom of things with her - we couldn't "see" her autistic traits until she acquired the language to explain them a bit to us (her ASD is very much more female-like in its manifestation and is in terms of rigidity, anxiety to follow rules etc).

The sensory stuff was pointed out to us by NHS OT as an aside but they're not commissioned to look into that fully - and to be honest, that's just something we've dealt with as we've gone along - she still chews anything when she's stressed - we just redirect it to something appropriate and she has her own stationery at school so she's not pissing off classmates chewing the shared pencil pot ones. One of the biggest sensory early indicators for us was that nursery mentioned she'd not noticed the hot water was hotter than you would have expected (not to the danger point but to the point you'd expect a child to be reluctant to use it).

It may well be how it has been for us - you get to the bottom of one aspect of development... and that opens the door for you to see something else that's not quite functioning typically - we spotted the coordination, sensory issues and speech delay first - once the speech was largely resolved (for a child with verbal dyspraxia she has amazing speech now) - we began to see much more of the ASD thinking... and as demands increase as she gets older - then we're seeing the language processing difficulties with higher level language skills, and ADHD clearly visible rather than her just being a happy little ditzy thing.

She's a lovely sociable little girl, with an amazing sense of humour - but it's been like unravelling a knotted ball of yarn, working away at each knot in turn and it's taken a good few years to begin to get a full picture of what's going on inside that head (apparently it's pink and purple and full of ballerinas)