Progress at home but the assessments at nursery are bringing me down a bit (receptive language delay, 3.2)

[lingle]

A SALT did a more formal assessment of DS2 at nursery and said she'd like to ask a more specialist SALT for a second opinion. She was concerned that DS2 appeared unable to follow her instructions and was also concerned that he did not appear to be initiating contact with other children and therefore had social communication difficulties separate from his language.

"Is he different from that with his brother at home?" she asked.

Well, just a bit. My father, a man of few words, says "It's wonderful that your boys are such a team". DS2 and his brother (5.11) adore each other. They have a variety of games they play together. DS1 loves playing with DS2 almost as much as DS2 loves playing with DS1. DS2 cries if he cannot go with DS1 where DS1 is going. DS1 missed DS2 too. If I need DS2 out of my way, I ask DS1 to start a chasing game with him. DS2 may be in the depths of his favourite activity, but the promise of playing with DS1 never fails. When DS1 gets home, DS2 bounces up to him to get him to start playing,usually saying "hello DS1" then starting to run, bounce, etc.

DS2 also had an evening with a little girl of 4.0 the other night. I had to oversee the play because of his speech but he was ecstatic throughout and she enjoyed playing with him. They did an awful lot of action songs and bouncing. She mothered him, and he responded to her as he does to DS1. At one point I said to her "DS2 is so happy that you're here because he's only just beginning to have friends" and she replied "but I'm his friend". nice kid.

DS2 has also started running up to children who are his peers in the playground and doing a bit of chasing. He ran up to a little girl who'd been friendly and said "hello" straight to her face then ran back to me and held my leg in a sweet shy way.

Anyway, the SALT can only report what she sees, but it does bring home to me that DS2 feels shy at nursery and hasn't got any friends there. The other boys whose parents I know are all at least 6 months older and very advanced for their age at that. I think it would be a big deal for any child with limited speech to intiate play indoor with older, bigger, more developed children. Or is nursery interaction more significant than sibling interaction? surely not, I think....

I think all interaction is important tbh.

A non-home environment can give a clearer indication when something is up as it tends to be more obvious. I work with children who are severely autistic and sometimes you find that children who cannot be tested at all in a clinical setting can interact almost normally at home or in a familiar schoo setting (just with less speech).

If you have faith in the nursery staff to understand the ins and outs of communication, I would double check with the nursery staff whether they agree with SALT assessment. When DS was 3.10 I had a spookily similar experience with a SALT who "didn't specialise in joint clinic cases" - she wrote a report telling me DS didn't speak to the other children at all, had no pretend play and she was so concerned about his receptive language that she wanted him to be assessed by ed psych for learning difficulties over and above language! The pretend play stuff was bollocks - she was concerned that Ds was lining up toy dinosaurs in twos - I told her he had a bit of a thing about Noah's Ark - somehow this translated to - parent agrees DS has no pretend play . This report really upset me until it all got unpicked in the next month or so by school staff, and ed psych assessment went well. DS also ended up being referred on to a more specialist SALT, which I was rather thankful for at this point.

So - a point to this ramble - yes DS has social communication difficulties (which have significantly improved as his speech has improved) and some comprehension difficulties, but an inexperienced SALT panicked me more than necessary. I think that receptive language delay isn't always something that SALT are used to tbh, particularly if it's a SALT who works more with pronunciation problems.

btw - DS wouldn't have initiated at 3.2 with other children - would have started to initiate at more like 4.2 IIRC.

Lingle

I received the same report from Ds2's preschool about a month ago (apart from the understanding part). Does not interact with peers, watches from a distance what they are doing. They felt that he wanted to participate, but did not know how.

At home, he plays with both DS1 and DS3. Chasing games, rough & tumble and board games. Actually, his current fave is balloon tennis .

Like your DS2, he always runs around with the other children when we go and pick DS1 up from school and I have seen him on many occassions go up to other pre-schoolers and say hello or tell them to 'go down yellow slide' .

His new Salt (not specialist, just new) has signed him up for a group to help with social communication. She feels that pre-school may be too big, noisy for a speech delayed child to make himself heard. She interacted with him fine and she understood everything he said.

Could your SALT maybe put your DS2 forward for a similar group and see how he fares?

Also wanted to add the DS2 pre-school have an IEP for him to build up social communication with his peers. They have already seen progress in a few weeks.

Is an IEP an option?

Differences in how the child behaves/interacts/talks at nursery and at home are very common. I have experienced this with both DSs - one ASD and one not. Can they give you an example of an instruction he did not follow at nursery ? Can you ask for an assessment to be done in the home envirionment?

I do agree though that non home assessments have to be factored in too as children have to cope in all environments esp as they get older . My ASD son plays well with his brother but not with any other child.

I do think that if an assessment is being carried out with the aim of deciding what help to make available or for drawing up a program of some sort it is essential that there is some understanding of how a child acts at home (video can be really useful for this- I take video to meetings and show the pros). When ds1 was little he was refused speech therapy because "he's not capable of anything is he?' Well no, not in a strange room, with someone he has never met with a sink in the corner, but he was more than able to crack on with things at home.

I think it doesn't matter so much for diagnostic purposes where it can actually be helpful to see the child at their 'worst' because a diagnosis is always based on a deficit model. So a child being able to do something sometimes is not that helpful to see. It's the gaps you want to see, when they can't do something.

This is in the Floortime approach- when you assess you assess the range of functioning then pitch intervention at both ends.

I almost regretted starting this thread but, as ever, your responses are great.

Jimjam, yes, that must be right, in some ways I want them to see him at his "worst" so we tailor the pre-scool curriculum to him as much as possible (lingle has now decided firmly that she does not use the "intervention" word because it makes her feel as though someone was stepping in between her and her child and that he wasn't going in the wrong direction anyway, just going in a bit of a zigzag way)

Tclanger: yes, it's easier with younger or older ones. At a party yesterday he was going down the big slide delightedly with a 3.5 girl from nursery but then she said "I'm going down with Rosie now" and there's now way he can compete with the "Rosies" for friendship just now!

Total, very interesting. At least this SALT was open enough to admit that she wanted someone more specialist which I appreciate. I told nursery that the report had got me down. Teacher (lovely) reminded me that I'm the expert on DS2 and that she feels he is making progress. Teacher also said that she knows the more specialist SALT and is delighted that this person is becoming involved as "she will give us the best ideas for practical activities, which is after all what we want these people for isn't it?". I think the staff have realised that I will accept all help but will not tolerate any labelling and they're with me on that.

Poshpaws, haven't "spoken" directly with you much before but had a quick look at your other messages - I think our little lads are going to do great! Thanks for your support. Yes, he has an IEP but maybe we should add building up social interaction to it....he would love that I think. And it might save me a few begged playdates....

Cyber, yes, maybe I should try it at home. The video camera idea is great in principle but I don't want to let this late understander/talker stuff invade our happy home life too much.....at the moment, DS2 and I have fun with the Hanen speech techniques and it's a fine line....

In conclusion, I read testimony after testimony on MN from people who "just know there's something wrong". And I just don't have that feeling about DS2. I know he's a late understander but DS1 was very similar as many of you know. I look at the ASD criteria, I look at DS1 and end up with the absurd result that I probably could have had him diagnosed with ASD at this age, especially if we'd been in the States.

DS1 cried today and DS2 ran up saying "it's alright DS1" and I thought "dammit, why do I have to think "ooh good that's empathy" rather than just being glad they have a lovely relationship.

Thanks again everyone - the post was a bit self-indulgent as this stuff goes with the territory once you start to accept help.....

"it's a fine line"

totally with you on this, lingle.

we had salt assessment last week and she gave us some good games to try to work on ds's "own agenda". i was sure he could do them but was really disappointed when he became resistant. i found myself wondering if i was "allowed" to then play ds's games, or whether this would just reinforce ds's "own agenda".

i had to stop myself and think, hold on a minute, this is my lovely ds who is not even 3 years old and i'm wondering how i should be playing with him properly. i know this is not what the salt intended and she emphasised that the games should be fun, but i find it hard when these games throw into sharp relief exactly what it is ds can't do.

IME - I initially felt private SALT was being too negative in focusing on what DS couldn't do - but I realised that there were some basic gaps in his vocabulary that needed filling - - e.g. just because he could make it clear verbally he wanted me to do something again (in this instance a man going up and down a ladder) still meant I had to teach him the word/concept "again!" - rather than let him get away with "man up ladder!".

Unfortunately the process of seeking help does inevitably focus on the negatives and all the problem areas, rather than celebrate our kids' achievements. I felt awful after first few SALT appointments/reports. But you get more used to the situation, and when you see your kid benefiting from the advice given you start to reconcile yourself to it all.

I know you're right Total....

Ragged, what sort of games is she suggesting? Did that "a"-word crop up as you expected? I managed to kill your rookie thread!

Can't log off without sharing the fact that DS2 now consistently calls me "mummy". So instead of "hello DS2" "hello DS2" it's "hello DS2" "hello mummy".

And if I say "I love you" he says "I love you too".

And that yesterday for the first time he said "DS2's a monster" and did a monster impression so DS1 I could pretend to be scared (he's learnt this from DS1 who learnt it from DH).

And that when crying about DS1 going out without him, he seemed to be getting a little understanding of "DS1's in a car" and "daddy's in a plane" (ie maybe just starting to understand language that's about things he can't see right now).

If anyone's feeling charitable enough to respond, a simple "yeah" will suffice. God, I'll be making you all hear my dreams next....

this all sounds very positive indeed, he sounds to have made a lot of progress in the last few months from the "life is an opera" phase.

at your monstrous dh

yes, halfway through the meeting, the salt said, "have you had any thoughts as to what might be behind this" and i said that i felt at the last meeting (with a different salt) that the elephant in the room was autism.

salt said "i'm glad you brought up autism, it's one of the things that we'd be considering, along with language disorder." she didn't think it would be possible to decide which at this point.

total chaos - i know that the problem is really my perception of the games at the moment; i need to chill out a bit and just try to incorporate them into our day. ds probably picks up on me changing into "teacher" mode and decides that i can get lost!

lingle: we've been starting out with really basic stuff, using animal flashcards and asking which one says moo, etc. he knows all the answers, but hates this kind of 'formal' turn taking stuff. i adapted it a little to use toy animals and a slide so he had to send the one that says moo down a slide, and he preferred that.

we've been doing some "simon says" type games which worked reasonably well for a couple of minutes (maybe just one!) and another game the salt suggested was getting ds to copy number of beats to a drum, which i'm going to try this week. she says the language aspect isn't important at the moment, it's the element of getting ds "to play the teacher's game". the non-comformist in me balked a bit at this, but i know that if he can't "play the game" he'll probably struggle to learn at school.

Sounds like you handled the meeting with aplomb Ragged. I'm sure it wasn't easy. It can only be good for your little one that the SALT feels you are "open" as a parent. I can't remember where you stand on the whole "Einstein Syndrome" thing but the "Einstein Syndrome" book is full of parents' testimonies about children with their own agenda - "he's not a performing seal" is my favourite quote. There are many stories about children reacting in the same way as your little one. Whilst the author's "theory" doesn't hold a whole lot of water (someone on here pointed out that arguably he's saying these children have ASD traits but he's in denial about it), it is perhaps worth mentioning that those testimonies are full of happy endings.....children who in later life are rugged individualists but seem to be finding their place in their own way....

I do believe you are right to want to strike a balance. I also suspect your little one might react against this more with you than with a reception teacher....and he'll be so much older then....is he generally good company and enjoyable to live with just as he is?

thanks lingle - i'm a little when i read over these threads about other people's lo's and i end up going on about mine. i wonder where ds gets his "own agenda" issues from?!

haven't read the einstein syndrome; i do find the title a little offputting. but it's always interesting to read that what might seem like a problem can be turned into a strength. i'll check out the library for a copy.

You can talk about your little one on my threads any time Ragged