Would you be concerned (speech delay)

[RoadBuddy]

My DS is just turning 3 and aging out of Early Intervention. He was in therapy for a speech delay since 18 months, when he had no words. Now he seems to be on-track by many measures. His vocabulary is off the charts, sentence length good, he uses plurals, past and future tense, possessives, prepositions, he's happy and loving, etc. But there are still some quirks that I'm concerned about.

-he mixes up I/you like 99% of the time. "took your shoes off" to mean "I took my shoes off"
-Refers to himself by his name, not I or me. "A do it". "That's A's toy!" etc
-hesitant to answer questions, even when he knows the answer. This is progressing well right now, every day he answers more.
-still repeats himself and us a lot. There's plenty of spontaneous language as well, but more repeating than may be normal.
-he is obsessed with phones now and will sometimes ignore a question or statement and start describing phones "A has a broken flip phone upstairs". He seems to do this when he's bored or when he doesn't know what you're asking.

He's doing well in all other areas. I've looked into spectrum disorders and some things fit, but he's quite social with adults and has a good sense of humor which seems to rule a lot out (?)

We had an evaluation through the school district, but he refused to participate, so it's way off. He was sick, there was a new baby in the house, etc, so it's just not representative. I'm looking into a private re-evaluation, but wondered if other parents had similar issues? Maybe h has a problem or maybe he's just catching up after being a late talker?

I'm deciding on the public special-needs preschool vs. regular preschool+private therapy. It's hard because he's fine on so many measures but there are these less obvious concerns.

[BetsyNY]

The first things you mention sound normal to me, but the repetitive speech (echolalia) and unusual interests are red flags. My son has PDD-NOS and he also has a good sense of humor and is affectionate.

[SpottedFoxx]

You describe some of my DS's behavior. They suspect he has an auditory processing disorder (too young to test yet) and he has a pretty severe articulation disorder. He also has dyspraxia and sensory integration issues.

Have you had an outside speech therapy evaluation (outside meaning outside of the EI people)? I'd start there. EI told us that our son didn't have a speech problem but was too active to sit still and learn. After he aged out - we had a private evaluation done and he was more than a year delayed. I was furious. He has caught up substantially. He's in a public special education preschool and they have been beyond wonderful.

[sbgrace]

You're talking about speech pragmatics. Spectrum stuff is consistent with what you mention speech wise. His speech sounds amazingly like my son at three (down to the details except my son's obsession was trains)! All except the special interests worked itself out. I think in my son's case he was wanting to interact but he didn't quite know how and this stuff was his attempt to do it in a predictable way to him. I saw a lot more of what you describe when he was uncomfortable for some reason. At six I still see that taking conversation to his interests in social situations where he's uncomfortable but he does it in a much smoother way than he did at three! At three he would do it with us too at times. Again, he wanted to engage with us but he just wasn't sure how to do it well so he reverted to what he knew. Now that I think of it he still has some awkward ways of engaging at times "You like that train engine, right mommy?" but he can handle and navigate an unpredictable response (i.e. if I said "no" he would ask me why not now and he would have been "thrown" by that response a while back). At any rate, it's not awkward enough that most people notice or think anything of it.

My son is/was social with adults and well known to him kids. He's affectionate and responsive and all kinds of stuff I didn't think was autism. None of that really has anything to do with autism I found out. I think more telling will be things like your son's nonverbal communication skills (his own use and his awareness of and response to your facial expressions, gaze, nonverbals etc.)

These are my best "could it be autism" links, have you seen both?
http://www.childbrain.com/pddassess.html (this one is an online assessment to see if further evaluation might be warranted)
http://www.bbbautism.com/diagnostics_psychobabble.htm (real life language of the current (not upcoming) diagnostic criteria for pdd-nos.

My son's diagnosis is PDD-NOS...which means he fits enough for spectrum diagnosis but not quite right for an straight autism dx. I was told to bring him back for Aspie look at five or six. I actually think he's PDD-NOS more and it also doesn't matter for us in making therapy decisions and the like so we decided to go with what we've got.

[Linda on the move]

I think he sounds GREAT! I wish my DD had been talking so much at 3!

Originally Posted by RoadBuddy

He's doing well in all other areas. I've looked into spectrum disorders and some things fit, but he's quite social with adults and has a good sense of humor which seems to rule a lot out (?)

My DD has a spectrum disorder and a sense of humor, but she is unusal. (her dx was PDD-NOS and just switched to Aspie). Sense of humor isn't a litmis test, however, my DD has very little to no desire to interact with other humans. Some high functioning spectrum kids can't be dx'ed until they are older.

Does he have any sensory issues?

We had an evaluation through the school district, but he refused to participate, so it's way off... I'm looking into a private re-evaluation, but wondered if other parents had similar issues? Maybe h has a problem or maybe he's just catching up after being a late talker?

an eval is just a snap shot, and sometimes they aren't a very good likeness.

I'm deciding on the public special-needs preschool vs. regular preschool+private therapy. It's hard because he's fine on so many measures but there are these less obvious concerns.

I'd go for which program you like better and seems like overall the better fit rather than on the sn issue.

I think getting a private eval is a great idea. I'm all for evals.

In a few years, you'll want to do it again. The expectations for them as they grow up can bring up new issues, or sometimes things that they were delayed on they completely catch up on. So while I think it's great to do multiple evaluations now, I'd recommend not getting a feeling that it's all settled. It's possible that he has something minor going on with him that can't even be dx'ed until he is older.

[kme]

Your son is still very young. Both my NT sons reversed pronouns at that age. I can remember my older one saying "Hold you." all the time when he wanted to be picked up.

The repetitive speech and obsession are what would concern me the most. My son is also one who fits the spectrum disorders in some ways but not at all in others. He is diagnosed with SPD and mixed expressive/receptive language disorder. We were told he is "autistic-like" but not technically on the spectrum. His language problems are different than those of kids with ASD. He attended both public special-ed preschool and a regular private preschool when he was 3-4. He would go to the special ed school 3 days and the regular one 2 days. This gave him the help he needed but also gave him NT role-models to help him with his speech. It worked out pretty well - it was interesting - he did great in the special ed class. The teachers were always telling me how he was a role-model in the class and he was exceeding expectations. In the regular class, the teachers would tell me they were "concerned" about his language and the fact that he did not interact much with the other kids. He was teetering between the "two worlds" and didn't completely fit in with either one.

Good luck with whatever you decide!!