I want to "assess" where DS2 is before the SALT assessment tomorrow

[lingle]

A SALT more specialised in receptive language delay (probably from an ASD unit? who knows) will come to assess DS2 (3.2) at nursery tomorrow. I know it will be more negative than how I think about him and that's ok - doing her job, etc.

Is there any accessible information that would help me find out what kind of place on the speech centile charts he would now be on if my "mum" assessment is right? I'll probably be a bit down after the assessment so want to think it through now.

This is how I would see DS2 in a "snapshot" right now, (sorry so long). If you remember my first posts you'll see how much things have changed....and I really do think that depriving him of recorded music has made part of the difference. It's like a drug for him!

receptive speech:
DS2 understands everything I say to him about our daily routine. He understands my 3-word sentences ("give a banana to DS1")in context. He can understand simple instructions from a different room ("DS2 come back to the kitchen and put your plate away please" REPLY "ok"). Have told DS1 he no longer needs to use 1 word at a time (DS1 did this instinctively to help) but can use sentences.

expressive speech:nearly 150 "real" words now (I said 200 on here in July - I was so wrong! I was just coaching him! but now it's qualitatively different). About 20 of them verbs with 20 other more "not quite consistent" verbs coming.

combining spontaneously into 2-word sentences with more fluency and variety every day (DH noticed a difference after being away for a week). These are increasingly natural-sounding eg "whatsthematter DS1" when DS1 burst into tears or "mummy got hurt" when I say "ow!" after being jumped on by DS1.

still uses a single word to represent the word he can't think of eg when tired he will use the word "open" instead of "cut". Many examples of this. Many overgeneralisations still. eg his water words are "water" "bath" "sea" "puddle" but all other bodies of water such as rivers, waterfalls, streams, etc are described as one of these or as "splishsploshsplash". So doesn't have a word for everything in his life yet (we live by a waterfall, stream, pond etc)

names family members spontaneously with ease ("hello daddy!"). Starting to do the same for other children. But if DH says "hello DS2" will still say "hello mummy" in reply (overgeneralising again - he used to just repeat and it was hard for him to learn to say my name instead of his own). Uses own name in sentences.

Echolalia fading - appears when tired or insecure or doesn't understand someone. Rare now with me but still uses assertive tone + repeat language instead of "yes". Starting to say "yes" before the assertive repeat but this is very much learned not natural to him.

Understands the basic "who" "where" and "what" questions. Just starting to understand answers to where questions that involve "school" "work" or other places that he can't see. Progressing fast here. Always answers "what can you see?" appropriately. Nearly there with "eat" "hold" and "wear" but still muddles them when tired.

No "why"or "when" questions yet. Progressing but not there yet with "shoes on first THEN park" and other two-event sequences. Understands "it's time to" but still doesn't always understand the description of where we're going next.

Just starting to get to grips with under/over on/off etc. Good with up/down.

Lastly, the grandma test: my mum says "this child talks just as you would expect a two-year old child to" (ie she found his speech pretty "normal" but a year or so behind other kids his age when we spent a week with her).

Other areas. Doesn't initiate socially with (new)nursery peers yet. Passive and quiet there. But joins in any physical game initiated by others (involving bouncing, falling, giggling, etc) with great skill, great care for others' space and excellent turn-taking. Visited "old" nursery friend and they trotted off together up to the bedroom after 10 minutes' hesitation (it was his first time in that house) and did about 10 minutes cooperatively on the train track.

Initiates socially with family and especially brother all the time.
When alone, "role-plays" conversations with brother (hardly sings now! poor thing! his cruel mother wanted him to talk instead! My psychotherapist neighbour thinks I'm terrible!)

Understands all my tones of voice and facial expressions. Understands when I'm joking, cross, playful, teasing, etc from either of these. Switched on and engaged with me at pretty much all times even if engrossed in trains or listening to music. There is no activity I can't join in. Not in a bubble. Not in "own world"

Not the most imaginative child but happy to play along with "doggy" going to sleep, waking up, etc. Pretends objects are other objects. Now pretends to be a "monsta" by holding out arms and making monster noise. Wants me and others to look scared and scream in response. It doesn't matter if we don't run away so he understands the meaning of the game is more than physical. When DS1 is a "monster", DS2 pretends to be scared and runs to me to pretend he needs protecting from DS1 but also laughing.

Fascinated by numbers, loves looking at the second hand on the clock, identifies speed limit signs and traffic light colours all the time. Since the days got shorter, adores turning the lights on and off. Lights on and off is the obsession. Does it about 50 times a day if nothing else is going on . Also flushes the loo about 20 times a day. Will pester to be allowed to do this at other people's houses.

Apologies and thanks to anyone who got this far....

Your first paragraph has made me laugh Kettle. First time. Thank you.
Yes. I'll get past it. We have a similar health visitor and I've worked out how to "work with" her. At the end of the day, sensitive bedside manner is desirable but not necessary.

Nice to have such interesting posts on the thread - not that I don't value the "hug lingle" element!

Jimjam, sorry about muddling your history - will read your posts in detail later. But if I say that DS2 "wants to" even if it's not his own agenda, does that help explain my feelings? He was wilful at 2 but isn't any more. On the playdate yesterday the host child gave him a chocolate and he said "thank you" and was so thrilled and then came and stood next to the child and looked at me as if to say "look at me and my friend!!" That's his desire.

lingle- I can't really judge how your ds compares to autistic children because I haven't seen him. I do think however, that your idea of how children have to behave to be autistic is incorrect. It doesn't mean that I think your son is autistic it just means I think the comparison you're making is wrong.

For example I took ds1 to shiatsu on Saturday and we had to take a diversion which took us along a road near a cottage that some friends from London had stayed in in the summer. This included his first 'friend'- a boy the same age as him -I met his mum through antenatal - but we moved from London 6 and a half years ago so ds1 hasn't seen this boy regularly since he was 2. DS1 immediately started grinning from ear to ear and I had to tell him that we weren't going to be seeing our friends. We arrived home a few hours later and ds1 immediately ran up to his room and came down carrying a photo of him and his friend aged 2 then proceeded to show me and point out the door (he wanted to go and see him).

There's an idea that children with autism can't be sociable or have friends & it was this side that sent us off in the wrong direction with ds1 for so long. In reality children with autism can be affectionate and sociable and friendly and wanting to share attention etc, especially in familiar loving environments. So being able to do all of that doesn't really rule anything out. As cyberseraphim said it's the comparison to 'normal' in an unusual environment that is probably the most telling from a diagnostic point of view.

A functional assessment is definitely the way to go to set up intervention but unfortunately a diagnostic approach is still needed at some stage if you need to access services (even if that approach leads to autism being ruled out - it should signpost your child to more suitable services either way).

"Well one positive thing is that the SALT and I both feel he has a real problem with processing streams of verbal information. I feel this may or may not be reinforced by habit. So I can concentrate on that when I see the paed."

Yes, I feel that is very much DS's problem - in his instance he resorted to quoting tv programs out of context rather than music. You may want to look for information on auditory processing problems. When I've raised that suggestion with private SALT and NHS SALT they've both felt it was a valid suggestion but not known enough personally to follow up on it. One of the things on the seemingly endless to do list for me to read about.

A few suggestions made by various SALT about helping listening skills were along the lines of playing kiddie instruments under a blanket and getting Ds to tell me which one - oh and there is a game you can get with a CD of household sounds to identify. Oh and syllable clapping for words.

T"here's an idea that children with autism can't be sociable or have friends"

Ds1 yesterday:

"I talk to T" (same name, different lad) "on da bus!"
Me: "Did you? What did you say?"
Ds1: "I say 'I on da bus!' and I say 'we two T's'" .
He loves seeing his friend A who is about 18 months younger than him and if a stranger was to see them running round together they'd probably just conclude that his friend was the older one, as he's taller and tends to lead whilst Ds1 follows. He also has a friend at school who he loves to run round with. He still likes to play a lot of the time on his own, but does like other children more now.

sorry if it sounds like I'm trying to product a trump card and say "look! he did that! so he can't be autistic!!" I've learnt(from you guys) that it doesn't work like that. the SALT encounter - it's pushing me back into the reactive "he's not autistic because..." dialogue and I really thought I'd got beyond that..... This is why I'm cross with her.

Today at nursery the staff saw him playing a "pretend to be asleep" game with two other children (one of whom has limited speech - interesting). And then he said "hello Martha" to Martha. If she'd said "hello DS2" to him he'd have replied "hello mummy" and the encounter would have got stuck.....

total - would his confusion of "house" and "cows" go along with auditory processing or would that be inconsistent do you think?

re:house and cows - I don't know enough about the auditory processing stuff - but could definitely see how he's only taking in the "ow" sign so guessing at the rest of the word, thinking of familiar ones that he knows already.

lingle, have you read anything about semantic pragmatic disorder? It does now sit on the spectrum (but didn't used to) and is essentially a complex language disorder which can present with some milder autistic traits. I read a wonderful article which I'll try and find for you, but a lot of what you describe is sounding familiar. It's one of the things being considered for ds, along with auditory processing disorder, HFA and SLI. Deep breath!

Glad I made you laugh, had a brief worry you'd think I was being judgey, wouldn't have wanted to come across that way. I've managed to get myself a reputation among the professionals that we deal with for being one of those who reads up on everything. I've found it's now actually working in my favour, and when I meet new people they seem to have been told (or warned!) that I'm the type that will ask a lot of questions, and they're actually giving me a bit of off the record advice too, which has helped in many ways - choosing schools, accessing SALT programs, gaining funding for a one to one at preschool etc. It is definitely better to have them on side wherever possible.

A confusion such as house and cows can go with an associative style of learning. So if a child learns in a very associative way - they see something then something happens at the same time those words of phrases can become 'stuck'. DS1 seems to have the word 'light' meaning 'open window' which comes from me incorrectly saying 'oh yes light' once when he was pointing to show me an open window. Buggered if I can correct it- he's heard it once, it's stuck! He knows what light means as well though.

I would forget for the moment the diagnosis if you can. It doesn't really matter if he's getting help which box he fits best in - it probably won't alter the way they do things anyway and it's clearly making you unhappy, but do be aware that there may be some services you need to access for which you would need a diagnosis and therefore if he could get one (whatever it was) then it might make life easier for you all. As children get older and start at pre-school then school you find a diagnosis becomes necessary, whether that's GDD, ASD or some sort of specific language disorder. For some reason being highlighted as 'in need of some extra help' doesn't really work. I wouldn't be scared of having the pros consider an autism diagnosis though. It can be a useful signpost and tbh they really don't overdx in the UK. It's not just handed out- the child does have to fit.

right, here's one -www.mugsy.org/spd.htm
and another which I found fairly useful -
www.hyperlexia.org/sp1.html

that's very interesting - I didn't realise that it had a name (associative learning). At the moment we are in a pickle with the concepts wet = dirty and louder = faster. And when DS was younger, and the little lamb was sad in the teletubby's - DS thought that sad was the word for lamb.

again IME - I think my area is particularly dire - a diagnosis of language delay gets you bog all help other than being under NHS SALT, unless your child is a good candidate for a language nursery/language unit attached to mainstream.

You might find this interesting TC It extends the idea a bit. I love Olga Bogdashina's books!

hang on I read down so linked to the wrong page

Mentions using songs and commercials to respond if you read down.

You're right Jimjam, I will try to put diagnosis out of my mind for the time being - as you say, it doesn't work well for me.

Kettle: re advantages of reputation as parent who reads a lot. I found that useful when choosing a new boiler. The plumbers were most impressed!

btw Sphil - yes I want your therapist!!

thanks v much for the link v. useful, only had chance to skim it. adds Temple Grandin "Thinking in Pictures" to the endless reading list!

"What a fascinating thread, although I have to hold my hands up to being no closer to understanding autism and where the line is btween SLI and autism, to where I was a year ago!"

Probably because there is no clear line. Language disorders will affect every part of the triad. DS1's biggest problem is definitely language - there may be some underlying processing/sensory problem(s) that have caused the language issues, but in terms of his triad of impairments they stem from his very severe language problems. Other people with an autism diagnosis might have the triad of impairments for different reasons- there might be something else driving the difficulties in the 3 areas.

Sometimes I feel these threads are less like a thread and more like a learned symposium - interrupted periodically by lingle's noisy blubbing! It was all so much simpler when we had DS1. We fretted for about a day then DH said "nobody could be less autistic than DS1" Because we thought that autistic meant not emotional and not empathetic, etc.

I think you have to realise that it's not something rigid and that it changes as a child grows. DS1 can recognise feeling such as happy sad and angry - which surprised me as I wasn't sure he had the language for it. 'Impairment in imagination' is a strange one anyway as many of the people I know with AS have an almost over-active imagination so they have difficulty distinguishing fantasy and reality. DS1 will play with pretend bottles and pretend babies, and with play houses and train etc- like a much younger child- but he's trapped at that stage because he doesn't have the language to move forwards.

When he was little getting his 'mild language delay' diagnosis it I suppose seemed appropriate because young children don't talk anyway- so a 2 year old with no speech/limited language doesn't stand out that much and the play he could do etc was more appropriate to his age. He was and is sociable so his big areas of deficit (language) just wasn't so apparent in a 2 year old and was compensated for y his strengths. He's moved down the autism spectrum to severely autistic because in part his language hasn't kicked in. And however sociable you are that can't make up for severe language difficulties in a 9 year old. Of course if you don't develop language then your cognitive development will be different too (although there will be some chicken and egg in that).

Remember as well that autism is not one thing, not one condition. It is many different things- a bunch of behaviours. Underlying causes of those behaviours are going to be different.

I heard a better desciption of 'impairment of imagination' as being more a 'lack of flexibility of thought'.

Lingle Ds2 had some speech problems but I knew when he was 18 months that he wasn't autistic. The way I could tell was that we went into ds1's nursery for a meeting and the girls offered to take ds2 into a session so we could talk in peace. When I went to collect him he was in circle time (the littlest there - the nursery kids started at 2), he'd never been in circle time before but he knew exactly what to do because he instinctively knew that although he was unsure all he had to do was look at the other children and copy what they did. DS1 has only really worked that out recently (now 9) - and even then there are many things that will override that (interesting sink to look at in the corner of the room for example). At 18 months ds2 understood that when unsure he should base his behaviour on those around him. It was quite striking for me, having been used to seeing ds1 in nursery.