Verbal dyspraxia, a few questions please...

[genieinabottle]

Hi, we are waiting for my DS who is 4.4 to have his ADOS and ADI....hopefully in a couple of months.
DS has a severe language delay/disorder, his SAlt last year wrote on his report he had SLI with semantic/pragmatic difficulties. But no formal dx was made.
DS also has social interaction difficulties much more pronnonced with his peer group than with adults.
DS also has some mild sensory issues, with noises, lights, tactile defensiveness to some textures.
DS is easily overwhelmed by certains situations, he can be OTT with his reactions and is an anxious child on the whole.
He also has a few rituals and vocal stims, with occasional sensory seeking behaviours.

Now, when DS will have his ADOS, he will not be seen by a salt as part of the assesment as he currently is in a language unit and lang.unit have recently done a full evalution of his speech. No specific dx was given, but that he has significant delays/disorder.
So my understanding is if he 'fails his ADOS', he will not get any dx at all. It will be either ASD or nothing.
We have been told different things by different professionals:

1. DS has mild ASD.
2. DS could be borderline ASD.
3. he could just have a language disorder which impact on his social skills and interaction and his imaginative play. All these different opinions... depending on who saw him , where, and what they were doing at the time, it's all variable. And DS has good days and bad days.

I have been doing my homework for the past year, and have come to the conclusion that
Yes DS presents with a lot of ASD traits but i think there are not enough of them, my suspiscions are that he will fail the ADOS, and we'll be told he is borderline. I have a problem with that term 'borderline', my views are you have ASD or you don't.
Borderline means nothing, and DS will be left high and dry with no dx and likely no support in school.

Of course i have looked into speech and language disorders. And verbal dyspraxia has really pulled my attention. The symptoms in pre-schoolers are very similar to ASD.
I have checked the list of symptoms and it's like they are describing my DS.
I'm not a professional but i know my DS.
I am so surprised that none has ever thought of mentioning or looking into verbal dyspraxia as a very likely possible cause for all of my DS'problems. Becuase if DS is found not to have ASD then he definately has got something else! DS is not a typical 4 y.old, and we really want to have answers. We are fed up with this merry-go-round re:dx.

My questions are:
Who can usually diagnose Verbal dyspraxia?
Should i mention verbal dyspraxia to the salt at the lang.unit DS attends to see what her opinion is?
Should i mention it to his community paed at our next review in April?
Or should i do nothing and wait to see what happens when he does his ADOS?

Sorry long post , wanted to give a bit of background.
Thanks for reading.

Forgot to say: should i mention it to autism team at Cahms when they see him for his ADOS?
Thanks.

I think the truth is that the "professionals" in this country know f-all about verbal dyspraxia. This is in contrast with the US, where there seems a wealth of knowledge. So yes, I would mention it but expect them to waffle. The other thing I would be wary of is - are they all hedging their bets and not calling it ASD because that diagnosis has funding and extra help implications? You are right - there is no borderline, really, and an ADOS should sort it out. To be diagnosed as autistic a child needs to show problems in each of the triad of impairments (speech, social, obsessive/imaginative). HTH - nb my boy has verbal dyspraxia as well as Asd, and Verbal Behaviour (a form of ABA) has helped a great deal.

I know exactly where you are coming form. My DS (now 5) was diagnosed with moderate verbal dyspraxia aged 3 and a half and is now doing very well with S and L with a fab SALT. he also has motor difficulties and to me at least has definate motor dyspraxia. He also has some sensory issues (sensory seeks) though no problem with noises and not tactile defensive. He also has problems relating to peer group activities. He has excellent and broad imaginative play and plays appropraitely and reciprocally with his younger sibling. I am fairly convinced he is not autistic as is the SALT but we have had him put on the spectrum because his social and communication difficulties are impacting sufficiently on his quality of life at school. Paed convinced we will withdraw diagnosis in the future BUT I have come to the point battling school/senco etc etc that I couldnt give a toss WHAT he is as long as he gets some support-we are kind of treating symptoms rather than chasing a diagnosis.
So no real advice except verbal dyspraxia was diagnosed by our SALT and DS was clear case of this. Good luck. FWIW we are doing reflex inhibition with DS and this has had noticeable impact on speech/behaviour and sensory issues (he also gets sensory integration with OT)
HTH and best of luck

Sickofsocalledexperts, thanks for your reply. I just simply do not know who i should listen to anymore.
Paed and ASD team at Cahms both says ASD, but until ADOS is done and formal dx is given, everyone seems cautious.
On the other hand EP and SALT both says severe lang. delay and some 'ASD tendancies' commonly found in SLI ...

What the hell with 'tendancies' ot 'borderline'!!!
DH and i are soooo fed up with all this. They all seem to disagree with each other.

No one think about asking us our opinions on this. Afterall we may not be ASD or SALT experts but we know our DS better than all of these experts put together.
Deep down we think if DS has an ASD then it is likely a form of atypical autism, as it's true he does have difficulties with all of the 3 areas of the triad... but he doesn't fit neatly the criteria for HFA. I have checked it and re-checked it again and again... DS doesn't tick all the boxes.
For instance his use of non-verbal communication is now fairly good.
He can point, nod, look at people to and fro properly to communicate (when he feels relaxed and not worried about something), he can give good shared attention with an adult,... these skills will be an important part during his Ados and it's likely they'll say not ASD.

I'm just annoyed that professional have gone down the ASD route all the while very cautiously.
And as we are told by SALT at his lang.unit that her opinion is all of his issues are down to his severe language delays then why can't they be more specific about his language issues and give it a name once and for all.
I mean my DS1 who is now 16y old, had speech delay when little, and his issues were simple it was easy to see it was 'pure' language issues, very different to DS2 which are complex.

We don't buy the speech delay alone anymore, it's got to have a reason behind it.
ASD? Verbal Dyspraxia? SLI? is it wrong of us to demand a precise dx?

Sorry for rant. Had a parent/techer meeting yesterday (teacher is Senco) and we feel they disaprouve of us trying to get a 'label' for DS.

I have ds with severe verbal dyspraxia as well as oral dyspraxia but to be honest he would and does not prsent as a child with add or asd. Traits

ask the salt what she thinks ds got his diagnosis at about 3.6 And it's the salt that Diagnoses not the paed

but yes I agree there's very little support available and I have found that what there is is aimed at the milder end even afasic was at lost on how to advise

Oddgirl, sorry cross-posted, didn't see your reply. Thanks for your answers.
My DS has delays with his imaginative play, he is very concrete in his way of playing and at times his play is very sensory orientated.
I mean he will stare quite close up at a toy lorry when pushing it back and forth, or he will get shoe laces or any bit of string and flap them or twirl them for ages... EP said DS'play was sometimes like that of a baby who is at the sensory explorative stage.

'I have ds with severe verbal dyspraxia as well as oral dyspraxia but to be honest he would and does not prsent as a child with add or asd. Traits'

Phoenix, do you mean your DS has verbal dyspraxia but defo no ASD traits?

I think the trouble is with my DS he has got a severe lang. delay, and communication area of the triad is by far the most obvious and severe of his 'traits', the 2 other areas such as the social imagination, the repetitive behaviours, the sensory issues,... he has too but it is much more milder. I mean it really isn't obvious straight away and not clear-cut iyswim.

Yep he has no sensory or repetive play problems enjoys imaginatve play with trains cars playmobil

Plays well with dd but his social problems are down to lack of language put him with compent and confident singers and other non verbal communication lot differnt

all his pronlems center around his pd or his language disorders

But know there's whole other issues some kids prsent with and some have more language than ds intact a lot do

ds test below 1%. For verbal communication bug non Verbal is lot higher.though he also has oral dyspraxia to

trounlewithtalk be along soon hopefully

your ds presents many ASD traits, and I would say HFA. They do not like to dx HFA/aspies early as the condition does present itself mildly but as life gets more complicated so many issues can arise (usually around 6-7y), hence the extra support.

It was mentioned in an earlier post I think by debs40 that ADOS is not always appropriate as are not sensitive to the more subtle characteristic, this is clearly the case, as it is so individual (yes always the triad of impairments, but presents itself in so many different ways).

I think they fob parents off as much as possible, I think that fact they even mention it is enough, as you would not say that lightly. Just for interest, our paed said 10% of the population is asd, but only 1% needed additional help, that's alot!

Does your DS seem to have difficuly in producing the sounds he wants, can he copy sounds you make? With a child with verbal dyspraxia I think it is normally obvious that they are trying to say something but can't physically make the sound.
It is probably worth asking the SLT at the S & L unit but TBH if they thought this was the issue I would be surprised if they hadn't mentioned it yet.
For a VD diagnosis you certainly need a SLT rather than paediatrician ( although to be fair it was the commuinity paed who first suggested VD for DD1 when she was presenting with loads of ASD traits)
I am so sorry you are driving yourself mad with this - I do empathise

Yes DS has difficulty making the sounds he wants, most of his consonants came out as 'n' but he has improved recently and his speech is a bit clearer. DS isn't good at making sounds or blowing bubbles or drinking from a cup for that matter. H
He also had difficulty with finding the right words to make sentences, althougfh he has a good single vocabulary he seems to have lots of 'blanks' like he cannot decide or remember what word he should use, so he still relies a lot on a single word repeated several times when he wants to say something that he can't iyswim?
Thanks for replies anyway ladies.

About this issue 'It is probably worth asking the SLT at the S & L unit but TBH if they thought this was the issue I would be surprised if they hadn't mentioned it yet.'

We have tried telling SALT well if you think it's not ASD and it's a language thing, what is it then? And we were told it is best to concentrate on working on his targets than giving him a label!
If the system was perfect we'd be happy to do that of course but we were just lucky to get this place in the lang.unit until this july coming. After that it will be back to next to nothing speech therapy. And DS will be at MS reception, so his needs being met in september and in the future is a big maybe... it will be at the willingness of the school.
If he has no dx at all to back him up, he 'll get other sorts of labels ...'lazy, naughty, over dependant,...'

I don't know why SLTs are so reluctant to diagnose. IME noone wanted to 'label'anything until we got to the specialist SLT, which was once dd1 had been in the system for over a year.
And yes,some the therapy would be the same regardless of diagnosis, but in this situation they must see that you want to know.
Sorry not really any help

Thanks Bubble, it is so frustrating. DS has been under SALT since aged 2, he is now 4. And at his recemt evaluation, it was concluded that he was significantly delayed across the board for speech and lang.(especially his understanding where he has a 2 years delay), but despite the evidence they are not wanting to give his language issues a name. Grrr....

Like i said before his placement in the unit he had hardly any salt sessions...sorry waiting lists are long we were told. And this is likely what will be happening again after the summer.
In fact the salt he was under has taken an extended parental leave last october, and we have not being told of anyone replacing her yet!