Just after some opinions...

[Weegle]

...and hoping you lovely ladies can help...

My DN is 20 months old. He's also profoudly deaf but I am starting to get a little concerned that there is more to it than "just" the hearing. But obviously it's hard to tell what is taking longer to develop because of the hearing and what might be something else.

He doesn't have any vocabulary or meaningful sounds (e.g. animal sounds)

He never responds to being told No, or Dangerous etc, but he does hear you (with his aids) because if you offer him food he comes running!

He repetitively does things like opening cupboards and you literally cannot leave him unattended in a room for a second as he will destroy it, unlike the other 2 toddlers in the family.

He puts EVERYTHING in his mouth. He crunches gravel/sand/mud. He also licks things - completely random objects.

His twin (hearing) has learnt the Makaton sign language being used in the home for him, but he doesn't sign.

He's very small and doesn't seem as physically adept as the other toddlers of the same age I know but he's extremely good at puzzles but isn't interested in anything for long (ok that's normal toddler behaviour).

My parents keep asking me if they think he's normal and I don't know what to answer because if I'm completely honest it doesn't seem 100% normal to me. But then I only have my son and his peers to compare him too and the hearing problems were always going to mean he takes longer to pick up speech.

What do you think? Do you think there might be more to it than just the hearing?

Hearing difficulties and autism are so often muddled up at this early stage; we actually had our poor DS given an operation for for grommets before we found out he's ASD. Does your DN point at things to "share attention" or does he have any other gestures like waving ??

No expert but I don't think it sounds too out of the ordinary, tbh. ds1, 2.7 and definitely NT, repetitively opens cupboards and puts things in his mouth.

Does he point? Understand instructions? Engage in pretend play (however long/short the attention span)?

He doesn't point or wave that I've noticed and no, he certainly doesn't understand instructions. Or pretend play come to think of it. All the kids were playing various imaginary games at xmas and he was always on the sidelines, literally in his own world. It made me feel really sad because if that's because of the hearing I feel like his aids are failing him. He just seems so isolated.

He was also not interested in any of the toys which were pretend play - he got give a farm and a rocket. All he played with were the puzzles. And he doesn't like being read to. But that could just be what interests/doesn't interest him couldn't it?

Ah, now that would concern me a little more, all other things being equal, but there is the added hearing issue. Maybe referral to a paed would be the best thing.

there is something called a Chat test, probably on internet if you google it, and that's pretty much what a GP would use to make an initial diagnosis of autism. The only thing I would say is that if he is ASD< and it could be just a shy toddler at this age, but if he is, the earlier you intervene the better. Perhaps you and others in family could start using the "play dumb" technique - eg if he very obviously wants juice, pretend you don't know, then prompt him to make a sound a little bit like juice, then gradually demand more clarity. This can take weeks and weeks, but in the end the bit of the brain governing speech starts to tick and you can use this technique for other sounds too. Good luck!

I don't know how to approach my sis about this though because she's obviously already distraught that he's deaf - it would break her heart if she thought I thought there was something more to it so I'm scared to suggest he sees a paed but I know that early help would be best.

that is very difficult, as you will be the bearer of bad tidings. could you make up a friend whose son at this age showed similar symptoms (you could use me) - my DS had no eye contact at this age, very repetitive behaviour and no interest in other kids or adults. He used to do the same thing over an over again, jump up and down manically while flapping his hands and saying "eeeeeeeeeeeeeeee". He was also hyperactive and had no speech, but none of the gestures a kid would use either if he had no speech but still had an urge to communicate - eg he wouldn't point at juick, or a plane in the sky.

you could just mention this and say that I wished upon wish that I had acted earlier , rather than waited till he was 3 1/2 to start all the interventions. We were told that every month before the age of 5 counts a great deal, because that's the window for devlopment of the speech area of teh brain. So I have felt it's a race in the last year and a half. She may find out it's nothing, but better to know. Good luck!

thank you so much for sharing that aquariusmum - it must be so hard for you. I will do as you suggest because at the end of the day, if this is a really important period for help with his development then really that is the most important thing. I'm happy to be the bearer of "bad" tidings for that. I really hope it turns out to be nothing just an over-worrying aunty and I can be blamed for that!

Have you posted on Parent Place too? Its the National Deaf Childrens Society's equivalent to mumsnet! Not to knock the advice given on here but you may get other opinions and advice on there.................. My ds is 11 and has dyspraxia and behavioural problems as well as being profoundly deaf.

Deaf children and autistic children often behave very similarly when little. I have heard stories of parents of autistic children approaching a child they've seen saying 'when was your child dxed with autism?' (er maybe a bit spectrummy themselves I wouldn;t do that! ) and getting the reply 'they're not, they're deaf'. Behaviours can be similar because both have such sensory difficulties.

I'd agree with lottiejenkins- seek out some support/advice from parents of deaf children- they'll know what's normal for children who are profoundly deaf and what isn't. The school for the deaf in Exeter has a website with lots of helpful information- not sure whether relevant for this age group but perhaps worth a browse.

Do you sign with him (BSL I mean? What are the long term plans - for sign or for implants etc? I don't know much about deafness but I can tell you that research has shown that deaf children learn signs much faster if they're given as the child is looking at something of their own choosing- (as opposed to breaking their attentiuon to try and get them to look at a sign). My supervisor has some published research in this area- I could send it to you if it would be helpful.

The other thing to be wary of is not allowing the DR's to blame everything on a childs existing diagnosis.
I have no experience with deaf children so maybe talking total rubbish & your dear nephews behaviour may be totally normal, BUT if your sister does have any concerns she must push for full assessment by the correct professionals.
I was naively fobbed off, I was told my ds2's behaviour was a result of developmental delays & CP, he was 4 before dx'd with ASD/OCD & didn't get any specific support until then.

I'm not suggesting for one minute that your dn has asd, all i'm trying to say (not very well)is that a child can have more than 1 dx & it is important that your sister is listened to.

ah misread- 'you' should be 'your sister'