First appt (long)

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I have been reading this board but not really posted much yet, as I had suspicions about my DD (2.6) but had not had them confirmed.

She has hypotonia and hypermobility and the physio had referred her to the community paediatrican for that, so she could have help at nursery.

Her appt was today, and I also brought up some major concerns I have about her communication.

I have noticed big differences with other children since she started at (non SN) playgroup.

She has only recently started to give some eye contact (to us only) and only sometimes responds to us speaking to her. She is often in a world of her own singing songs, and will never engage in conversation at all, just parroting phrases. Her vocabulary and memory are fantastic and she knows all her letters and lots of words though.
Her speech is clear and she can, and does get her needs across. She is affectionate and cuddly (only recently). She doesn't need routine and rarely has tantrums. She has only JUST started showing us things and pointing.

She is not interested in other children/people at all except to look at their jewellery etc, although she now looks at them a bit.

The paediatrician basically agreed she has some ASD traits but says it could also be just a delay in her expressive language, as perhaps she wants to communicate but cannot, so ignores etc. She said she could not say which at this time, as it is a complex case.

She says she also has lots of NT traits and that it is a good sign that things are improving too. She is now much more affectionate and runs to me saying "hello mummy".

Anyway I just wondered if this rings a bell for anyone. Does it sound like ASD or merely a language delay?

What can we expect with appts etc? She has been referred for SALT.

Is it bad that things have been picked up so early? Bad as in it must be severe to be noticeable at age 2??

I just don't know what to think or where to start. I had suspicions but poor DH is in denial somewhat.

sorry if thats woolly, am just a bit shell shocked..had to come straight to work too!!

cheeky bump

Thanks

Will try not to worry!

I'm sure that is a lot of the reason for the delay, but she has some very unusual behaviours too!

Anyway at least she is getting help, I suppose, and she hasn't suddenly changed since this morning! Thanks for answering

Hi, it must have been a difficult appointment for you today and certainly takes me back to when I initially raised concerns about my DS1. It wouldn't be right for me to speculate whether your DD has a language delay or ASD; the key thing being you have identified she is having difficulties with communication you and want to help address them.

I would ring the SALT department to find out how long the waiting list is (you can refer as a parent refer your DD, you don't need a professional to do it). If you're happy for the Paediatricians referral to go through I would chase in a week or so to make sure it's been received.

I'm not sure on the set up of playgroup, do you stay with your DD there or is more like a preschool/nursery where she is dropped-off? Do they have a SENCo etc?

It's just a standard playgroup. I do leave her. It has actually brought on quite an improvement in her communication and she is very happy there. There is no SENCO, but one of the workers also works with children with SN and has informally taken her under her wing, which is very fortunate.

sounds a bit like my DS at 3. He was only ever dxed with language delay, not ASD. It's good things have been picked up so early - it's v common to be fobbed off with language till kids are 3 plus with the "there's such a wide range of normal argument", I wouldn't read too much into getting a referral, but think that your DD has been seen by professionals who know what they are doing!

with appointments - each area has their own way of doing things. I would phone up SALT and ask what the usual wait is for kids who have been referred by community paed (you never know, it may be quicker than being referred by GP/HV). You may find it's a while on the waiting list before much happens.

I would also look for a hearing test (just to rule out this as a physical cause of any language problem) and at whether your DD has any receptive language problems (problems with understanding language). SALT should look at this area.

Thanks.

I just don't know, sometimes I try to talk to her and feel like she is just "not there", so I think ASD..but increasingly, recently, I feel like she IS listening to me but just not understanding. Did you feel like this with your son?

It just gets quite wearing and lonely getting nothing back from them, doesn't it.

how is your son now?

Did the SALT help?

Thanks again for replying.

DS's language and social communication is much imnproved - such that he has very recently been signed off by SALT . I still have some concerns around his receptive language, but he is speaking fluently in sentences and can initiate play/conversation reasonably appropriately, so has come on vastly in just over 2 years. I found that private SALT helped more than NHS SALT (first NHS SALT wasn't that great, and took 8 months just to see her!). In terms of receptive language - I simplified my language (caveman type sentences - mummy get cup! eat cake!) etc, and backed up by lots of gestures/photos etc. If you can get on any sort of Hanen course, (SALT departments and Surestart sometimes run versions, SALT department is better but you may have to wait till DD has been seen by SALT for that one).

www.hanen.org, www.teachmetotalk.com, www.ican.org.uk are all useful. the nas website (www.nas.org.uk) has some useful ideas to encourage communication as well, that IME apply to language delay as well as ASD

Thanks..

Am confused today, I saw my friend who is a health visitor (a dirty word round here but I respect her and we have been friends for over 30 years) and she was quite astonished that the Dr had mentioned having to go to a nursery with a special language unit, as she has always been impressed by DDs speech. She feels the SALT is a good idea to assist with communication though. She feels perhaps the Dr saw my DD when she wasn't at her best and so didn't get an accurate picture, although we were asked lots of questions.

Today I gave my DD an open cup and she said "no, put lid on it", then when we were going out she brought my coat and said "put it on"..which surprised me.

She still has the odd traits though.

I suppose the SALT will be able to get a clearer picture of her language abilities, and the paed did say that she couldn't make any kind of diagnosis without spending much more time with DD.

I know with DS, sometimes he would recite sentences in the right place, but it was more a memory exercise than understanding the words iyswim. Some kids with delays do learn useful language that way, but with DS I found that these sort of learnt sentences wouldn't stick for more than a month or two. Does sounds like she's picking things up from your daily routines, by talking about putting lids and coats on. I'ld try and expand things a bit - talk about putting other garments on, see if that influences her to use other combinations with the word put.

That's exactly it, she has quite a repertoire of sentences but they are all learned sentences and not her using her own words!!!

If you can do go to a nursery with a special language unit. You would be very lucky to get in one and then if she is under their wing she will be looked after. You can always take her out and put her in MS nursery if you feel it's not right. Also it's not how much language children have but how they use it. My friend had a daughter with AS and she couldn't see it at first because she was so proud at how well her daughter talked. I wish I had a SN nursery offered for my ASD daughter it would have helped a great deal.

I don't think the paeds know that much at such an early age if there is some language but not much and tend to keep all options open. It's actually harder to diagnose in children with poor speech as it could be a language delay where as children with excellent speech it's quite obvious if they are an Aspie.

I agree with getting a private SALT I waited for ages for my daughter only to end up with four sessions with a very poor therapist. Eventually found an amazing private SALT who has followed us through our problems for four years and is now being funded by LEA.

Have a look on the NAS website as its always good to be armed with information. Adders forum was a good one to look for me as my daughter was diagnosed with ADD. Good luck.

Thanks, that has given me a lot to think about.