Does this sound familiar?

[Azik's mom]

Just trying to figure this out.... it's so confusing.  My DS just turned 4.  I have been concerned about  his speech in the past but until recently was told it was normal development.  He goes through stages where he stutters really bad and then it seems to calm dow.

Besides the stuttering Im concerned that he may not be understanding everything thats said.  Sometimes he can follow directions other times he cant.  We have checked his hearing and they say he is ok.

He has a few friends but I notice he communicates mostly through giggling.  He has a rich vocab but seldom uses it only you talk to him one on one.  Ive observed him in group settings and he seems interested in the other kids but he doesnt know how to interact with them.  He has problems following their games and ends up on the sidelines playing by himself.

He is afraid to try new things but can be persuades after seeing it over and over again.  E.g. he refused to play in the sprinklers with the other kids but he enjoyed being around it.  By the time summer was almost over he began trying to go in too.  Sometimes when he sees his classmates outside of school its as though he doesnt know them but when I ask him if he knows their names he is able to tell me.

He barely talks to his teachers and when he talks he is barely heard because he talks so softly.  But he giggles and shouts non words quite loudly.  Ive noticed that in class when his teachers ask the kids to do something he looks to see what the other kids do before doing it.  Outside of class he has a lot to tell me.  He tells me about what happened during the day and when his dad comes from work he reports everything.

At my insistence we qualified for childhood special ed.  They are addressing speech fluency and a possible cognitive delay.  They will only see him a few times and Im not sure if they its enough to address the problem.

I hate to see him playing on the sidelines especially during the times when he seems interested in joining in.  Any advice?.... I know this is long.

[FarmerBeth]

The main thing standing out to me is that your son has a much easier  time one on one with you than in a social group.  It seems to me that what he needs along with the speech is help with social readiness.  Has he been seen by EI, yet?  Do you have resources for an assessment, like a thorough speech assessment?  If you aren't feeling confident that the few times he will be seen is enough to assess and treat his difficulties, then maybe it's time to pull in some additional help.

[Emmeline II]

Originally Posted by Azik's mom 

Just trying to figure this out.... it's so confusing.  My DS just turned 4.  I have been concerned about  his speech in the past but until recently was told it was normal development.  He goes through stages where he stutters really bad and then it seems to calm dow.

Besides the stuttering Im concerned that he may not be understanding everything thats said.  Sometimes he can follow directions other times he cant.  We have checked his hearing and they say he is ok.

His ability to hear may be fine, but there may be a problem with how he processes what he hears.

When my ds was evaluated by an SLP last February (at 6.5), he scored significantly lower in tests with a verbal component, which prompted a recommendation for the CAPD screening.

His difficulties with filtering out and ignoring unimportant auditory information in background-noise inhibit his ability to focus on the important aspect of speech and disregard everything else...difficulty completing tasks with a language component indicates that part of his difficulty is due to a receptive language disorder.

The audiologist recommended using a device similar to this one:

https://www.lightspeed-tek.com/391.aspx

The recommendation for the audiologist came from a private eval at a hospital clinic, which involved a developmental-behavioral pediatrician, a speech-language pathologist, a psychologist, and a social worker (ds already had an ADHD diagnosis, but there was a question of Asperger's and we wanted to make sure we were addressing all his issues).

Ds used to stutter fairly often but it has largely dissipated. Sometimes it was due to anxiety, and sometimes it seemed like he was trying to catch his racing thoughts and put them down a shoot to his mouth. He is also getting better about trying new things.

Another one of ds' issues is with social reciprocity and pragmatics -- I didn't know what to call it until with had the eval. One way we work on this (also, following rules and being a good winner/loser) at home is to play board games--not as easy with a 4yo but there are games for this age out there. We also use the "You Are a Social Detective!" video/game, and have a copy of the book--but these are for older children..

I can't say what exactly is going on with your ds, but the links below may give you some things to bring up with the school and with outside evaluators.

Social Language Use (Pragmatics)

This link automatically plays sound:

Pragmatics: The Social Aspects of Communication

Auditory Processing Disorder

Visual and Auditory Processing Disorders | LD Topics | LD OnLine

Hyperlexia Symptoms

[Linda on the move]

Another issue might be sensory issues. I don't think it's the whole answer to what is going on with him, but it can show up in conjunction with a lot of other dx's. The sprinkler thing, for example, or not quite wanting to get in the middle of what the other kids are doing.

You might check out "The Out of Sync Child" and see if it rings true.

I agree with Emmeline that it sounds like there might be some processing issues.

[Azik's mom]

Thanks so much for all the feedback.  We do have an eval coming up with a team of professionals (Developmental Ped, Audiologist, speech therapist, Psychologist and Physical Therapist) so hopefully they will be able to provide some answers.  I think we might have to end up also going to private speech too but I will see how it goes first through the services offered through the school district  Thanks again!

[Azik's mom]

Forgot to add.  At the district ISFP meeting I thought it strange that things that involve  processing was going to be undertaken by the Early child intervention specialist whereas fluency issues only were going to be addressed by the speech therapist.  Does that sound right?  I asked about it and they assured me that thats how its done; that the other stuff is a language issue.