Delay in social communication skills - how can I help my 2.6 year old?

[needhopeandluck]

My son is 2.6 and is visibly behind with his social communication skills (rarely waves bye, does not say hello, does not look people in the eyes when they speak to him)...
SALT diagnosed him with severe receptive language delay. He never answered when we called his name and at 2 he could not understand pretty much any instruction. Now he can understand a bit more but very far behind his peers, my guess is that he is at the level of a 18 month old, so a 1 year behind.
Paediatrician said he has a delay in social communication skills....not sure if it is a delay or disorder...it was an observation she made in the meeting not a diagnostic. I guess they want to wait until he is at least 3 before doing an assessment.
He can say a lot of words now (he started pointing at 2 and it all started then; actually he used to point at 13 months and at some point he stopped) but he did not figure out yet that he can use words to ask for things.
With regards to pointing, he uses it to show us things and rarely to ask for things. He mainly hand leads us to what he wants.
He was waving bye and shaking head no at 14 months then stopped, so he had a regression, which I understand it is something very concerning.
He learned to say and wave goodbye again at 2 after he started pointing again, did it for a while then he stopped again. Sometimes he did it out of context...
I spend a few hours a day with him at home trying to help him with his speech and he is making progress, literally adding words every week and even stringing 2 words together sometimes.
Looking to get SALT help too for professional support.

Nursery has been useless so far, SENCO still to advise on things and my expectations are low in terms of support he can get in the nursery setting.

What can I do to help him with his social communications skills?
Has anyone experienced this and tried certain things that worked well?

Do you have a portage worker? From what I remember ours did a lot of signing with action words to help with social communication and joint attention and copying and making choices between two objects
we used flash cards aswell to learn nouns and verbs
Sign language (mr tumble) and pecs were used abit aswell all forms of communication rather than just verbal

if you can afford it a formal assessment by a private salt would help you give more ideas on how to help
you can apply for an echp aswell yourself
perhaps a child minder with special needs experience or another nursery might be more suitable if the senco is useless

Speak to the nursery again. Follow up with an email so you have evidence. They need to be doing more. If they need more advice, they can request advice from the Area SENCO. If they need more funding, they could look at whether early years inclusion funding is available for 2 year olds in your LA. It is in some LAs, but in others it isn’t until 3.

Have you looked for any local SN groups? They can be helpful. Some special schools run play groups which can be brilliant.

I second requesting an EHCNA yourself now. On their website, IPSEA has a model letter you can use.

Also, apply for DLA if you haven’t already.

@4naanjeremy we do not have a portage worker...how can we get this sort of support? I am so lost...everybody is fobbing us off and the waiting times are sooo long :(

@KeepGoingThomas I am clueless...is it the nursery's obligation to help? They basically have reduced our hours and days saying my son is frustrated there and that they are short on staff. What would DLA funding be allocated for? I need to google all these acronyms, I am seriously clueless :/

SENCO = special educational needs coordinator
LA = local authority
SN = special needs
EHCNA = Education, health and care needs assessment (the assessment you first requesr before an education, health and care plan (EHCP) is issued or not. An EHCP is a legal document that sets out a child’s needs and the support they require.)
IPSEA = Independent Provider of Special Education Advice (a charity who supports parents of DC with SEN).

Portage isn’t available everywhere and in some areas isn’t available to DC attending nursery. If you google you should be able to find if your area’s offer.

Yes, the nursery should be providing more support. Even if that support is seeking more support from the LA.

DLA is for DC who require more care or supervision than typical peers. Have a look at the Cerebra (another charity) guide.

Sounds very similar to DD at that age. She basically only knew nouns, she never used functional language so would not ask for a drink or tell me she had a dirty nappy etc.
our SALT taught us games for turn taking - we started off with a toy pig where you post coins “mummy’s turn! Put it I ! Yay! Your turn!” And that taught her the basics of playing with someone else etc.
i second Mr Tumble and DD also loved Miss Rachel.
Narrate everything. When DD would hand lead we would vocalise for her “mummy up” or “mummy help”.
If you can afford private speech therapy I would do it. NHS wait times are long. SALT will also go j to nursery and do sessions there which the keyworker can then copy during the week.

@Badtrampoline how old is your daughter now? Has she had any formal assessment? How is she doing now? Did she manage to catch up?

Morning

she’s 3.5. We had our initial ASD assessment but have been told it’s a 18 month minimum wait now to get a formal diagnosis.
we are still on the NHS waitlist for speech therapy - we were first referred September 2022!
we had around 10 sessions of private speech therapy and will be picking it back uo again soon.
She hasn’t caught up but she’s not miles behind anymore - she’s very verbal with some ridgedness to her speech but it’s functional. She can’t answer open questions like “what did you do at nursery today” but if I said “did you play in the garden at nursery” she can say yes or no.
Whilst she has sensory issues with sound which can stop her wanting to be around children, when she’s calm and regulated she does put herself in amongst them. She likes to cuddle them but doesn’t speak to them.
Nursery are good but you do have to constantly keep at them.

@Badtrampoline thank you for sharing that! Really glad to hear your little one has been making progress. Fingers crossed for you both!
An occupational therapist will go see my son in nursery too as they have raised he might feel overwhelmed by the business of the place. To br fair, I think I have also noticed that at times at soft play.
Did your daughter ever have receptive language challenges? Or was it always just speech related?
Our son is I think about 1 year behind with understandinf as only now he started to understand some simple instructions. Although still not answering when we call his name.

Yes she didnt respond to her name or follow instructions until she was around 3 - she just ignored it or didnt acknowledge it completely.

Can I ask is your OT private? DD also struggles with noise which def affects how much she wants to join in or take instruction.

@Badtrampoline yes private. The waiting times for everything with the NHS are just ridiculous!
How did you cope with not following instructions? Our son just runs off when we are out, literally running towards the cars. He does not understand no or stop (he knows what it means but just ignores it). I see other children his age walking next to their parents on the street and I just get depressed...

I find it doubly hard at this age because toddlers arent really known for being compliant so I never know if its developmentally normal or not!

Sounds like DS is an eloper...a super common ASD trait - they run without sense of danger, without looking back to see where you are.
IS DS any good with games? DD loved a video on super simple songs called 'Red light green light' and we started trying to play it indoors first, green light GO! RUN! Red light...STOP!'

SALT and OT are another reason to request an EHCNA. Both can be part of an EHCP without the need to sit on the normal waiting lists and in excess of what would otherwise typically be available on the NHS.

For leaving the house, do you have reins?

@KeepGoingThomas yes, we have reins but it just becomes a struggle...so embarrasing really..so we normally keep him in the pram when we are on the street.

@Badtrampoline I will check the song out, thanks. He recently started to turn his head while running to see if I am still behind him but he just ignores me when I scream STOP. He checks I am still there but keeps on running, so problem not solved :/
When you finally get an assessment and assuming you get a diagnosis for ASD (but not classic autism) what would that mean for you in terms of support you can access? Would it change anything?

As far as I am aware it doesnt change anything - you can still have an EHCP, or apply for DLA etc.

Hi, I'm just reading through this old thread and wondering how your little boy is getting on now? Mine just turned 3 past month and he is an eloper, must be kept on reins or in a pram although he's getting too big for a pram now...the wheel literally broke on mine because he's too big 😅 He doesn't say words or babble directly to anyone. He can copy some melodies and makes the odd sound that sounds like a word. He hand pulls if he wants something. Only started turning when we say his name a few months ago. Doesn't understand instruction and has be led and helped to do absolutely everything. He's starting preschool in a couple of weeks where they have a speech and language therapist. And he was referred to SALT 18 months ago still nothing...and his health visitor wants to refer him to Paediatrics but can't until he's had his first SALT assessment!

If you still need a buggy but DS is too big for a typical baby/toddler pushchair, look at an SN buggy.

@JojoVee there is barely any support offered unfortunately. My advice to you is to read about Floortime DIR and do 4 hours of intensive inreraction at home every day, if possible. The book More than words from Hanen is also very good and I recommend it. And also look into Laura Mize and the skills that a child needs to master before words emerge.

My son has made a lot of progress. He answers his name, his understanding has been improving and he follows some instructions. He speaks in 3-4 words sentences, can answer some questions and his imaginative play has been improving a lot.
I now have concerns about his social skills as he is 38 months and does not play with other children yet. Also there is more progress he needs to make on collaboration skills, although he has been making progress.

Do not wait for help to come from outside because anything offered does not even scratch the surface. We have done weekly private SLT but 45min a week definitely does not move the needle.

Also, be kind to yourself and keep in mind that we can focus on our children all day long, but ultimately their brains needs to develop so they can make progress. Without that, any therapy we may pay for does not change much.

Have patience and faith in your son and focus on helping him at home every day.

@needhopeandluck Hello, some update after 3m? :) and you wrote no receptive language at 2y. So if you told him "throw it at trash" or "bring me the ball" he do not understand? and what age became more verbal? Thank you for answer.

@Needer8954 His receptive language and his speech have improved a lot. At almost 3 and a half, he understands now most basic things (time to wash your hands, lets go to the playground, we are going to the airport etc.) and he can say 3-4 word sentences (I want a cookie, I want you to pick me up, It is dark outside, the plane is landing etc.). He has a very good vocabulary (telescope, engine, chassis, etc. all basic things you would expect him to know at his age). He is not yet fully conversational though. So he can answer yes and no questions, some simple questions (what is that? who is that? what colour is that? what shape is that?), but we do not yet have a longer back and forth exchange. There is a difference between understanding what you are asking him to do and him actually doing that. So even if he understands when I ask him something, he will not follow instructions unless it is in his interest (he will bring me a book only if he wants me to read him in that moment; he will open the door only if he wants to go outside, not only because I ask him to do so). And I think that is connected to his social skills where he is very far behind compared to his peers. Although he knows his name, if people outside of our family call him by his name, he will most likely not turn to look at them. His social communication skills are very far behind. In conclusion: just because he knows a lot of words, it does not mean he will use them to have a conversation. He ignores most people when they talk to him (unless they know how to approach him, such as SLTs) and he does not yet actively play with his peers, but alongside them still. He is lovely with us parents however: very affectionate, very loving, very interested in spending time with us, great eye contact, loves to tell us the new words he is learning and describe his play to us.

@needhopeandluck Thanks for answer and when he was 2y? receptive part and expressive part?

@Needer8954 age 2 he understood and could say almost nothing. Shortly before age 2 he started pointing and that is when he started adding literally 1 word/day. Age 2 and a half he started putting 2 words together. Receptive language has improved slowly together with his speech. He understood his name when he was 2 and 9 montha. Basically he can understand what he can say. Instead of understanding much more than he can say like other children.

Hi lovely to hear that your is improving .. do you get an assessment going private ? ☺️

@Claire123ee we have a referral in place. Not in a rush to get a diagnosis. My niece was diagnosed age 3 (no words, no joint attention). Age 6 she did not qualify for a diagnosis anymore. So things can change over time.