Advice on significant speech and lan delay/impairment

[Kurly]

Have been told by SALT that DS (34months) has significant speech and lang delay/impairment. She has also referred him to specialist play as his interaction with other children is very poor but in every conversation I have with her she stresses that his eye contact is good and he attempts to talk with adults. he has other issues like doesn't like changes to norm and covers his ears when stressed etc..he also struggles with emotions

We are seeing a pead on wednesday for a development review.

My question is could his other behaviours such as interaction be due to speech problem or should we expect some other dx from pead?

Yes the social problems could be due to the language delay. Language delay/impairment often shows the traits of ASD and at such an early age it can be hard to say if a child just has a language delay or ASD.

I wouldn't be expecting a dx at this stage but the pead may mention ASD.

I suppose they've checked hearing already? I think the professionals tend to talk about "speech problems" versus "language problems". "Speech problems" are to do with problems forming the words with your lips and tongue. "Language problems" are to do more with what's going on in your head - maybe you have trouble remembering what word to use, or trouble processing what other people say to you (my sons both have/had this). It can go even deeper than language into other kinds of communication problems. Sometimes you can have problems following complex gestures like when someone points to something. Or problems processing what facial expressions or body language mean.

If he covers his ears, he might be processing what he hears in an uneven way - even without being deaf. Some noises might seem really really loud or unpleasant to him (think nails on blackboard) but when people talk to him, that might just sound like a sort of melody - he might not be breaking it down and figuring out what it means.

let us know how you get on.

Think it is more of a lan problem because the words he uses are very clear even to people outside of the family. Hearing has been tested, all ok.

Just wondering if it is usual for the SALT to refer child to Pead and a multi-discplined panel to assess what DS needs are? Or is this all standard and I am reading too much into it?

good, so you already know it's a language problem not a speech problem, that he's got no articulation (speaking) problems and that his hearing is fine. You will already be able to get more out of your doctor and SALT by being clear about this.

If I were you, I'd treat my next challenge as figuring out whether he's also got a problem understanding language.

To do this:

• think of something you often ask him to do eg "put the bowl on the counter".

Now break the routine and ask him to put it on the floor instead (without pointing). If he really understands language, he'll turn to you surprised or even put it on the floor. But what's quite likely, if he has problems understanding language, is that he'll put it on the counter as usual. Do you see what I mean?

These next steps that you need to take are going to be the same whatever diagnosis you and your paed choose (often the parent has a lot to do with it - many of us, though not me, have fought hard for an ASD diagnosis because it sometimes means you get more help at school).

I know without trying that he would not understand that. He only understands very simple instructions in familiar situations

OK Kurly, so you know he has a problem understanding language. My DS2 couldn't do these things at that age either. They call this a "receptive" language problem (they use the term "expressive" language problem if you understand but can't find the right word to use in reply).

Your SALT will already have figured out that he has problems with understanding and that's will probably be why she referred him to the paediatrician.

Has he got problems at the gesturing level too? When he wants something and can't ask for it, or when he wants you to see something exciting that he's spotted (a train, for instance) does it occur to him to point at it and then look back at you to see if you've spotted it? If the SALT thinks he's got problems at this level, then that's another thing they will want to get to grips with.

Though be aware ds did not point at all till he was 4 and he has sli with a severe expressive problem and a receptive delay was and is still agreed that ds does not have asd just his language disorder prevents the socialising

He has recently started pointing at things he wants and will occassionally bring me a toy he likes. But he doesn't really show any emotions it is more matter of fact e.g. thats dog thats car and he does not seem interested in how we respond. If that makes sense?

Thanks for all your comments it is good to know others understand and have similar things going on. Most people just say he'll catch-up stop worrying etc..

Am sure I will have loads more questions after tomorrow!!

Ds was like that was a functional point when he learnt would never point. At things like ducks etc or trains
now at 4.9 he does point to share things he can see

good luck tomorrow

there are loads of things you can do to help. Come back when the dust has settled if you want to talk more.