Where do I start?

[Throwaway0]

DS is 23 months and speech delayed. HV weren't interested as he hasn't done his 2 year development check yet so I've got him into private speech therapy which initially felt promising but is now showing diminishing returns. The speech therapist didn't think he showed signs of autism but I've just done the MCHAT autism screening after reading a few threads on here and he's scored 8, which I understand is high risk. Where do I start now and what do I do?

Op just pause

he is not even 2 and a professional has already said doesn’t see any signs

just wait for review in a few weeks and go from there

With respect, I have a non-verbal nearly two year old who doesn't point or consistently respond to his name. There is something wrong here, as evidenced by the high MCHAT score.

Advice still stands
just wait a few weeks for the review and go from there

The review isn't going to be a few weeks away - the two year review is very delayed in my area and we're going to have to wait a few months. But thanks for your help.

I would speak to the HV again. I wouldn’t wait until the 2 year check because some don’t happen for several months after the second birthday.

In some areas, you can self refer to SALT &/or they have drop in sessions. If you can’t and the HV won’t see you soon, you could speak to the GP.

It might help you to look at the ages and stages questionnaires.

The reason I mention an NHS SALT referral is because they can then fight your corner for a referral to paeds. In some cases, they can even refer directly.

Hi OP. I have a 6yr old boy with ASD, he was also non verbal and not pointing at 2, scored high on MCHAT, too. Despite what previous posters may think, these are all red flags at 24mo and actually, a speech therapist told me that she didn’t think my son was on the spectrum. He is very much an autistic little boy. Regarding what to do next, in all honesty, nothing happened for L until he started pre-school at 3. It was there that they called in the professionals, educational psychologist, speech therapist, referral to the paed, etc. He was diagnosed in October at 5yrs 9mo. The good news is that my son is now verbal, not conversational yet but can make his needs and wants known and I’m sure he will get there in time. He’s a very different child to the non responsive 2yo that he once was. I now feel a part of his world and he’s holding his own in mainstream, with a lot of support. Funnily enough, as much as folk preach early intervention, I don’t think any of it did much. Time and love was key for us, and most of his speech he learnt from the television! 🙈 Best of luck, it’s a tough time that I remember well. X

How is your son’s receptive language? One thing that I did do with my son to try and bring on his speech is something called pivotal response therapy. There is lots of info online about it. X

Thank you so much, and you've hit the nail on the head around the 2 year check being delayed. I honestly feel that we're being passed around at the moment, the GP passed us over to the HV, the HV won't see us until he fails his 2 year check, and we can't self refer to SALT, which is how we've ended up paying privately. I've had a look at the ages and stages questionnaire and he seems broadly on track apart from communication, where he's obviously very behind.

This is a really good question - some times I think he understands and is just refusing to follow instructions, other times I question whether he understands at all. I will look into pivotal response therapy, thank you.

Whether he understands and can follow commands is more important than his actual speech at this age. Would he understand, “go and get your shoes” etc? They are less likely to be concerned if his understanding is age appropriate. At 2 my son had 0 receptive language. X

So he is 50-50 on actually following through with actions - he would sometimes get the shoes, sometimes he wouldn't.

One thing I would say that is really important is to focus more on trying to get him to understand language/follow commands before trying to get him to say words. They need to understand speech before they talk. I wasted so much time on flash cards and getting my son to try and repeat stuff when his receptive language was at a 0 and it was fruitless. The Book Hansen More Than Words was extremely useful and will explain all this better than I can and it is a book that professionals recommend. It isn’t cheap but def worth it. X

Hannen, not Hansen. That is really positive if he is understanding the command even half of the time. My son didn’t understand “go and get your shoes” until he was 4. Sounds like you’re off to a good start. X

Thank you so much for the book recommendation - would you mind if I PM'd you?

Go ahead 😊 x

Hi
I've been curious and just done this test from my memory, of my son at age 2.6 and he got scored 8!!!
My son at age 2-2.8 was non verbal rarely react to his name, never pointed on things,didnt like play with other kids, lining up toys(this one i specifically put here for those who like internet red flag bs symptoms),and many other "red flags" from internet autism gurus.
I was so convinced that my son have autism that when we went to developmental pediatrician and he told us there is nothing to worry about i thought DP is an idiot and dont know anything because he never went to internet to see "autism red flags" videos( which is of course the best source of knowledge)

Now the MCHAT itself: highly generalized, accuracy of results because of that far from actual possible diagnosis(Please see accuracy of MCHAT)
But one thing for sure this MCHAT is great: is for misleading and bringing mental health damage to parents.

Please wait for Health Professional opinion
And in the meantime :book SALT and OP if needed.
Makaton also helped to jumpstart my sons speech.

Oh forgot to say: My son end up NOT having autism ,he is at school at year 1 , doing just great.

Odd that the speech therapist said no signs given all you receive here op

She said he had good social skills, good joint attention and good eye contact, and he wasn't presenting as classically autistic. I agree with all that but there has to be something holding back his speech.

Age.

no one could understand me aside from my mother until I was 4

i am not ND!

With receptive language, how does he do with instructions he is very likely to want to follow? The challenge with something like 'get your shoes' is that sometimes he may be excited to go out, and sometime he may want to keep playing with his toys. How is he if you suggest his favourite things, at moments when he's not engrossed in something else?

In some areas the two year check is deliberately delayed a few months (in mine it's a 27 month check) because they found at 24 months they were referring a lot of children for speech delays who had caught up by the time they saw a specialist. By doing the check slightly later, they actually saw the children who needed help sooner.

That said, that's really for expressive language only. If his receptive language is behind, I completely understand not wanting to watch and wait. Has he had a hearing test? Glue ear is really common in toddlers and can make it hard to hear speech sounds properly, even they can hear a crisp packet being opened from the other end of the house.

Another idea would be to maybe go back to the health visitor with a focus on receptive language, and ideally get dad to come and do a fair bit of the talking. Sometimes that works to make people take things more seriously – it shouldn't, obviously, but needs must.