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....

Can I pick up again on this associative learning point?

Total said: "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. " And Jimjam has similar with "light"/"open window".
Has anyone else got or had similar?
We definitely went through a long phase of it. At 2, he would say "no buggy" and "you are a big boy" to mean "I can tell you're pleased with me, mummy!" because I'd said that often when he was learning to walk home from nursery. The call to my mum on his 3rd birthday where I reported him saying "birthday" led to him repeating "birthday" to me with a happy smile every time I was on the phone. Now, however, that seems so long ago. When the phone rings, he looks at me and says urgently "mummy, telephone".
A camera is a "smile" (cute) but I think many people learning their first language would trip up on that one.

I held back (a first?) on another thread a few months ago when one of us talked about building on the child singing twinkle twinkle little star by talking about stars. That might work for children less "interesting" than ours, but my instinct was, and is, that for some kids (definitely mine) that song is a purely auditory communication and not even a bridge to learning the word star. I think people in the "odd talking at 2/3" position aren't aware of this....it is communication but not the sort they think it is.

Our big problem in the "wrong word for wrong thing" area is a bit different. DS2 uses one word for itself and for its opposite. So he grasps "open" and always uses it correctly but often still uses it for "shut". Similarly up and down though that is now over. Similarly over and under. All very logical and binary - he's got a printed circuit board in there somewhere. DS1 used no for no and yes for literally years and as a result missed out on many treats.

Ds dropped a piece of food on the floor ages ago and I said 'Dont eat it, it's dirty' and put it in the bin. For a long time after that if he didn't like a particular food he would say 'it's dirty', presumably wanting it put in the bin.

thanks for that last post jimjam.

what you say is very close to what I'm trying and failing to communicate about DS2 (and would have said about DS1 had I known more). DH and I say to each other "he speaks boy". At the park, any spontaneous physical game, building a complex train track with 2 or 3 other well-behaved boys of varying ages as my brother (suspected aspergers) never did. Knowing how to roll around with two other strange boys for 40 minutes on a small bouncy castle at a strange house climbing over each other but just knowing the rules - knowing the personal boundaries . He just knows how to do it. His brother taught him of course - but he is a star pupil. His first playdate at around 18 months. He and the other boy were on best behaviour and kept handing each other things and saying "deryouare" - not cooperative play but instinctively imitating what the big boys do (as overheard from the next room) without being told to (he wouldn't have understood such an instruction anyway of course) He was stroppy and wilful and a cat that walks alone more at 2 - and we thought oh my goodness what direction is he heading in? DS1 had just whined and sulked - wasn't so wilful. But now he's settling back into more like what he was at 1. Fun-loving like all our kids - but - could this be close to the heart of it? - able to access that fun whenever language doesn't block him or distort his relationships. Whereas my loyal kindly aspergers? brother is blocked from fun despite having language because he can't be happy unless everyone else plays his way and so he needs formal rules (does cricket commentary, is an immigration officer) to apply to his communication - when he played out on the street with other boys ended up bullied and it was nothing to do with not being able to talk.

I realise none of this is that non-existent "not autism" trump card - and have learnt that that's not what it's about anyway - but hope I've communicated a bit better this time.

So what the heck is going on at nursery I just don't know . I'm worried. I think he's got bigger auditory processing problems than his brother perhaps. So his access to joining-in fun could be reduced if we can't solve that and keep the skills alive. Thank goodness I really do have faith in his teacher. And it so happens she has an autistic brother so at least I can feel she will have a more sophisticated understanding of the spectrum than I did with DS1 - not that that's saying much.

Right. Used to have a job once......wonder if I still have any clients? Do the rest of you manage to work whilst doing full-time speech therapy, etc?

I work full time (in autism research).

The interesting thing for me is that often the children I see with the most severe language deficits are more sociable that the children I see with more language. The children with the most severe language deficits are often very very god at using eye contact to communicate as well- which I find very interesting! I showed a rather well known autism researcher (not SBC!) a video of one of the children I work with at a conference and she commented on how natural the interaction was, and how 'easy'. If you're going to get a autism diagnosis when you have lots of language then I guess you have to be quite severely affected socially to tick the boxes, but to get an autism diagnosis with no or limited language is going to be easier (because with limited language you will tick all 3 boxes more easily). I guess it's 'different autisms' in some ways.

DS1 aged 2 used to sing twinkle twinkle when he saw a star. That's what he meant by it- he would often pick up my hand and point in the book with it to a picture of a star at the same time.

Lingle - pure surmise, but could part of the problem with nursery be that you/they have only recently realised that he is behind with understanding of language - so he's not been given the simple language and visual cues to help him, so he's finding the nursery environment a struggle in that respect? DS was also good ?liberated by the running around games at 36 months ish - took the pressure off him language wise.

TBH I don't think being good at physical play can rule a child in or out of the spectrum because as jimjams says some kids on the spectrum are very sociable. But it's nice to see our kids getting along with other kids, don't undervalue that.

btw - SALT advice re:paired concepts - is to teach one of the pair at a time, not both, partly I think to avoid this sort of confusion. E.g. to teach soft/not soft, instead of soft/hard at the same time.

We waited for 5 years before our dd was finally diagnosed with AS. We were previously told it was just a language disorder and obviously wanted to believe the almost 10 (I kid you not!) professionals that saw dd and dismissed the AS.
For me it was the not knowing that was the hardest.
My dd is actually quite an enigma as she is in a language unit and when she first started was classed as having a severe language disorder and her receptive and expressive language were in the bottom 5% centile. Now at 9 she is in the top 5% for both which the speech therapist has never seen before. However I go along with the point that jj makes that although my dd has very good language skills her social skills are not as good as say a child in her unit with a severe langauge delay. Theses children do not have sensory problems (commonly attached to asd) and the subtle body language and eye contact difference is very obvious. As the person who diagnosed my daughter explained that does my dd communicate normally? Does she have the table tennis like conversations (back and forth) like my nt ds does?
The whole language delay/disorder/asd thing is a nightmare and I think a lot more research needs to be done. I cannot quite remember where I heard the saying along the lines of it would take the judgement of solomon if you lined up from 1 end mildly language delay children and severly autistic children at the end to decide where the language delay stops and the autism starts.

TC- the definition isn't really about imagination anyway- it's in flexibility of thought. You have to remember as well that the triad is based on behaviours not underlying problems. So for example under this part of the triad would come difficulties with generalisation- ds1 certainly has that, but it's nothing to do with a lack of imagination it's because lack of language and an associative memory means he has to store things differently iyswim. So when he accesses a memory he doesn't do it in the same way as us.

little Blossomhill sounds like an impressive young lady .

Thanks for the tip on pairs TC. So I should stick to "over" and then say "is it going over? no!!" for for when the train goes under the bridge. something like that?

I am coming so late to this thread, have been lurking, but just want to say how good it is to see all this being discussed... so much I can identify with...

So I should stick to "over" and then say "is it going over? no!!"

I think that's too complicated- it's a complicated sentence structure- and you're assuming a fully working understanding of 'no' which isn't always there. Push something over and say 'over' then push the train under and say 'under'. So he sees both at the same time.

TC_ it's really common for dh's and wider family to be resistant to the idea of anything wrong let alone autism. I used to have to hide my autism books (taken out secretly from the library) under my bed as I got such grief for reading them.

Have you had a paed assessment? The SALTs may well be right, but tbh I think lots of autistic children show flexibility of thought in some ways. For example when ds1 was assessed aged 3 the clinical psych asked if we had to take the same route to places etc and I said 'no' and she said 'oh yes I find that young children often aren't that bothered, it's as they get older that kicks in' and in ds1's case that is true. So someone being very black and white might have said that he had flexibility - because he wasn't fussed about routes (nor does he line things up or any of the other 'classics')- when in fact I think that when he was younger he had no concept that he had a choice in anything so he never really complained. It was only once he's understood choice that those behaviours kicked off.

None of which is to say that I think your son is autistic, but just to say if you retain doubts then don't be afraid to question- especially someone like a SALT who usually are not very experienced in a hands on way with autism. They've learned it from a book in the vast majority of cases and because of the way SALT now works will probably only ever have dealt with autism in a consultative role. If they have proper hands on one on one work with autism then I would trust their opinion more. But tbh I don't trust anyone without that now. They have too many stereotypes in their mind.

re over and under- the other thing you can do is make it active. Give a train 'push this OVER the bridge' advantage being you can prompt. Take photos of the train going over and under (and other objects as well it generalises). Then give a selection of pictures. Give me the train going over the bridge (you might need to simplify that sentence) but you would need to ensure your choice there showed trains doing various things or he could tune into 'train' and get the answer right.

oh there are some cards that SALTS use to teach all these things- they have a special name- Moondog will know- scrappy pencil drawings of dogs lying under buses etc etc.

I suppose the trouble with under is that it can be static (opposite of on) or moving (opposite of over) think that that can be tricky for children.

I was thinking of something simpler like "over" and "not over". At the point where I was doing the prepositions I did it pretty much like jj described - not had the advice at that point about only teaching one of a pair of concepts iyswim.

'not over' isn't necessarily going to be understood though. At first a child will just hear 'over' they're not going to hear the 'not' until they reach a certain stage (and it can be difficult to judge that- in context they always look to understand a lot more than they do if you strip the language bare).

One of the first things were were told was not to use negatives. So if a child is touching something you don't want them to touch rather than saying 'don't touch' (they'll just hear touch) you need to say something like 'come here'.

Wow - this thread moves on fast! I'm definitely saving it - so interesting. I'm supposed to be preparing for DS2's tutor and planting about 100 bulbs as well as washing, hoovering etc, but what am I doing....?

Going back a long way to your question about word confusion Lingle - DS2 I think muddles words both because of sound similarities and because of association. So we get the use of one word for its opposite - 'open' for 'open' and 'shut' but we also get confusion between 'open' and help' - both because of the 'p' sounds (which DS2 really emphasises in both words) and because if he's asking for help it's often to open something! We are tackling it like this (ABA-ish way)

Start with full prompt. So if he said 'open' I'd say
'Oh, you want HELP?' with great emphasis. He will usually then repeat 'help'. I then say 'What do you want?' and (with any luck) he says 'help'. (At this point in true ABA you should ask a couple of unrelated things as distractors but I don't do this in this case because he'd get too frustrated)

Then fade the prompt. So he says 'open' and I say 'Oh you want h...'
Next fade it more ' Open?' with a puzzled expression on face, shrugging shoulders etc
Then just progress to the raised eyebrows.

We're still getting the confusion but he's getting it right much more often now.

You may well know all this - in which case .

very interesting post Sphil - that's given me ideas about how to handle it when DS gets words wrong!

jimjams/lingle - I suppose that the "problem" when I try to give advice is that I have experience of my DS and not other kids with language problems - so I suppose I tend towards what worked with DS - DS was OK on the negatives/not etc by the time I was told to do it that way. so jimjams - do you think there is any value in the advice about teaching one of a pair of concepts at a time?

Yes I'm sure there is good reason to do that TC. Prepositions are way above ds1's level so I don't have any practical advice other than keep it as simple as possible and I would avoid negatives. We did do some work on prepositions 'put the car on the chair' 'put the car under the chair', but it was a bit above ds1 and he did tend to do either (probably would have been better teaching individually but the SALT told me it was to soon so we stopped completely).

I like sphils' way of prompting (which isn't surprising given we've worked with the same supervisor )

Another good general bit of advice is to comment rather than ask questions.

Ds1 has an imagination, but I think there are restrictions with it. He will call all the family by Night Garden characters, but doesn't take it further than that. He will get his Teletubby toys and take them through a five minute day at school (repeating back things the bus driver and teacher and assistants have said ) but he wouldn't change scenarios (mind you, that could well be typical). He is also very "plot driven", for want of a better word, he won't act out someone being upset or cross or feeling ill. It's about the events really.
Now myself, I have got a good imagination and for a while I thought I couldn't be Aspergers because of it. But whilst I can imagine myself in any number of different times and places (though to be honest all my daydreams hover round only a very limited number of scenarios) I can not envision a different role for myself , or imagine myself as another person. I'm always me, as I am, who happens to be somewhere different. When I write my stories I always imagine myself as one of the characters and then just change the name.

An aside -I found out yesterday that Growing Minds may be making a rare visit to the UK in 2009 or 10. Will keep everyone posted - well worth going on the course.

I think weve been very lucky in the dx process as both the SALT and paed have 20 years each experience in ASD. Ds has very subtle signs of asd and I don't think he would have been dx so quickly. I hear others here struggle to get a dx with much more obvious signs,even those who are being told language disorder.
Again it might be because of where we are (north east), but I wanted to pick up Tclangers point about few ASD children getting a statement. That just doesn't seem to be the case here. ASD dx seems the quickest route to statement and help (much more so than language delay etc.)