Will the SALT notice my ds' subtle asd behaviours... Can salt miss the signs? (Long post)

[mysonben]

It seems the paed and the salt have 2 differents views of my ds. The paed relying on reports and questions said ds has mild asd. The salt lady who did ds' initial assessment over 18 months ago said he was very speech delayed but that it was too early to talk about asd. Now the salt has started again, ds is in a small group (2 other kids) and they play games with turn taking, and liking words and using verbs. I could see the salt is checking how well they all listen and their eye contact.

My ds is quite placid and played along to the salt games, waited for his turn nicely, got some things right and some wrong, but he didn't vocalise very much but the little he said was appropriate.
I noticed that he was making a lot of sounds but not overly loud and that he was a bit fidgety with his feet, and he put his hand by his face near his eye and mouth quite a lot. HE often does this when he is asked questions or is solicited to do some activities.
At the end, the salt lady said she had noticed that my ds' speech wasn't very clear (not sounding consonants well)so she 'll keep an eye on that, and she said with a smile that he was quiet and shy. But that's all. And since ds didn't do any echolalia ,repetition or anything asd like , i'm worried that she will miss the signs again and disagree with the paed. And that ds will not get all the help he should when he starts school. KWIM?

What do you think? Thanks for reading.

Shall i be upfront with the salt lady and tell her what it is that is odd with ds 'speech. Because i don't think she will see that during the simple games they do. It is a more noticeable when he is asked specific questions that require him to make a sentence using menory such as where did he go this afternoon? what did he do at nursery? What's happening in this story book? ... He simply cannot extract the info or use words that he does know to give us an answer. Plus he repeats the same questions or same phrases while commenting about his interest of vehicles or noises.

I don't wnat to look like the neurotic mother here ,but i don't reckon she will get to see his oddities with his speech during games .

What are your dc like during speech theraty?

Hello mysonben

I think (I am sure someone will correct me if I am wrong) that it's only a medical professional i.e. paed who can actually diagnose ASD. A SALT or OT makes a valuable input into the diagnosis but cannot actually formally diagnose if that makes sense. My guess is that on that basis any help he gets will be based on the paed's diagnosis so if the paed has formally confirmed ASD then that is what they will go with?

Remind me how old he is and has he had formal diagnosis confirmed?

have you got anything in writing from paed saying mild ASD? as the paed is the one who can make DXs, not SALT, so I wouldn't worry too much what SALT thinks, particularly as when you last spoke about ASD was so long ago.

My DS (supposedly not ASD just language delay) was similar to your lad in the groups, in that he's good in structured situations, but would struggle with conversation. I think that as long as whatever you say is reasonably polite, say what you think - if she thinks you are neurotic then so bloody what, I see it as a mother's job to be protective of my child's interests, professionals just aren't going to have the same personal interest.

In the area I live in the pead gets a report from a salt and an ed psych and then determines a dx from there, so it is not the salt alone that say yes or no. My salt didn't say alot to me about ds but her report to paed was a diffrent story. Try not to worry to much about it as long as she can see a problem then you are half way there. I would have thought the salt would need to see ou ds a few times in different situations before making here report to your paed.

Sorry, posts crossed over!

I don't think you are being neurotic at all. It's definitely worth having a word with her to outline your concerns - after all, you know him best, and his speech issues clearly concern you, and you're right, those sort of games won't really 'challenge' him in the way that would show up the conversational language issues he does have.

Sorry, posts crossed over!

I don't think you are being neurotic at all. It's definitely worth having a word with her to outline your concerns - after all, you know him best, and his speech issues clearly concern you, and you're right, those sort of games won't really 'challenge' him in the way that would show up the conversational language issues he does have.

ds is 3 years 7 m, he had a verbal dx followed by a written report with a mention of asd and reviewing the need for autistic assessment in a few months by the paed.

Yes i will compile a little report of my own to highlight all my concerns and the difficulties ds has with every day conversation, how he can get stuck on repeating the same phrases 4-5 times in a row day day out,...

Never mind if she thinks i'm a pain in the backside ! I have worries about how ds' speech is developing and as his speech therapist she should know about it.

OOOPS i meant to say 'in a row day in day out'...

I would say that unless it's a SALT with specialist knowledge of communication disorder then chances are she will fail to spot subtle asd signs.
In my experience SALT failed to see moderate to severe autism assuring me I was over anxious because of sibling with autism.
Luckily paed knew me and knew if I was concerned I was right to be concerned and Lucy was referred to specialist SALT and got autism diagnosis three months after SALT had dismissed my concerns.
Write it all down and if she still fails to spot difficulties discuss them with paed and ask for a referral to an experienced SALT. Good luck

Er, all salts should have specialist knowledge of communication disorders.That's the whole point!

Not around here they don't we have community SALTs and SALTs specialising in communication disorder didn't realise it was different elsewhere sorry