Does ASD always come with language delay?

[Woodwork8]

DS is nearly 2 and I have some concerns around ASD. I’ve tried to keep this as short as possible so sorry if I’ve missed anything important.

He was a nightmare baby. A permanently screaming, breastfeeding, none-sleeping machine until about 4 months. Didn’t smile until about 16 weeks and even after then it was a rare event. The screaming turned into a constant fussing and whinging until he learnt to walk (never crawled or bum shuffled). Sleeps okay-ish now.

He is now a relatively okay toddler, but with a big proviso - his routine is sacred. If things don’t happen as expected he loses his mind. He is okay at toddler groups, but categorically won’t engage in any joint activities. While all the other kids are dancing under the bubbles he’s off examining the stack of chairs or the fire alarm in great detail. He doesn’t seem to have any particularly strong emotions towards me or DH. Really hurts to write this, but if he hurts himself he screams to be put down and seeks comfort in his ambulance toy or the TV. Has always despised being held - screamed blue murder in the sling right from birth, would only tolerate being held face outwards, at arms length. No obvious sensory issues now, but loud noises were a massive issue until relatively recently.

The only thing that goes against all this is that his language seems quite advanced. Spoke at 11 months, Hundred plus words at 15 months, talking in sentences by 18 months. Will only talk about what he is interested in though. Eye contact is limited. Pointed very early and still does, but only at things he wants, not things he thinks we might me interested in. Rarely claps and waves in context, usually just does these things sporadically.

I just can’t shake the feeling the something is amiss. I’ve tried contacting the HV (no reply) and the GP, who said she didn’t think there was anything to worry about at this stage due to his language being so good.

I’d really appreciate some advice on whether I should push harder or let this play out a bit longer?

This sounds similar in a lot of way to my DS, who has recently been diagnosed with ASD at age 5 (we suspected from about 2.5). His vocabulary as sentence structure has always been very good, and if you want a 20 minute monologue on the evolution of whales, or different species of lizards he's your man. Ask him what he wants for tea or where his shoes are and you may as well be talking Greek.

Our SaLT was actually really helpful as she can see and document how his good vocabulary is masking a lot of his communication difficulties. For instance he has no concept of body language or tone of voice, and doesn't know when it's his turn to talk in a conversation. So although he doesn't really need any help with his speech, it was the salt report that made other professionals take notice, as to a casual observer he appears to communicate well.

Thank you for your reply. That is so interesting to read. If I say ‘DS, let’s go out, go get your shoes’ he can tell me shoes go on his feet and that his shoes are blue, but the request bit gets completely missed. Likewise, if I say ‘DS do you want some more food’ he can tell me his plate is ‘empty and has dinosaurs on it’ but I don’t get a yes or no. It feels very subtle. I have to say if there wasn’t the backstory I would think potentially toddler selective hearing…but with everything else going on I do wonder. I spoke to the GP a wee while ago, but I ask now as DMil (who looks after him 2 days a week) thinks there is something a little different, compared to his cousins.

Im very interested in your experience with SALT - my limited googling suggested that might be the best route. I might research local private options, as I’m guessing the wait is pretty obscene, looking at other threads on here.

The thing is, if you’ve met one child with autism, you’ve met one child with autism.

My DS is hugely affectionate, loves being held and cuddled, would clap and wave…. however he is non-verbal and autistic.

What I’m trying to say is that there is such a broad set of parameters and behaviours for autism that trying to compare your child to others is never going to be an effective way to work things out.

It does sound like your child may have some neurodivergent tendencies so the best thing to do is to speak to your HV.

Thank you for your reply. I completely appreciate that. The last thing I wanted to do was pick bits of his personality and try and fit them into a box to fit a diagnosis that maybe isn’t even there. I shall certainly try the HVs again (I didn’t get a reply last time) but I think the previous posters suggestion of SALT is also good. I’m more than happy to be told to see how things progress if that’s what the professionals think, but I just don’t want to do him a disservice in the meantime.

I think there are a few online tools to see if it could be autism, I think one is called mchat. It does seem like higher functioning autism.

Hi, autism does not have to involve language delay, autism involves uneven development and so while some children are non verbal others might be very advanced at least in their vocabulary.

In my experience it's well worth getting a diagnosis before school if you can. In my area, getting an autism diagnosis below age 5 is much easier than getting one for a child over 5 as it's done through a different route, and the over 5 route has a waiting list that's over 3 years. I don't know if that's just my area, but I'd say it's worth pursuing your concerns as it could take a while to go through the assessment process.

No. Autism doesn't always come with a language delay. It's primarily a sensory/neurological/ pragmatic disorder. Hence, since communication isn't inspired in children with ASD this can affect language but more interns of how language is used.

Children with Autism can have an associated language disorder.