My amazing son is delayed

[Tina Dun]

My son is two (just turned 24 months), vibrant, curious, beyond happy, strong, a great eater and sleeper, fully of love, hugs and kisses and laughter, plays soccer with me, has a sense of humour.....

He has a speech delay. So we went on the waiting list and we are now seeing a speech therapist. (we live in Canada)

He doesn't communicate as well as he apparently should, he only "brings" toys to show me if he wants me to fix something or if he wants me to read him a book (which is often - he loves books the most)

He repeats what I say, but often doesn't know the meaning. He is starting to understand the meaning of many things, I can tell. The Speech Therapist said this is echolalia, and isn't a normal way to develop language. She said its a bad sign and we should see a developmental psychologist to be assessed for delays and autism. I have been looking on the net and found many articles on echolalia saying while this could be a sign of a bigger issue, it could also be normal for some toddlers at 24 months

I have read so much on autism and done the Mchat test online so many times, and always comes up the same - he is very "low risk" for autism

He has no autistic characteristics that I can see, no hand flapping, he makes great eye contact, smiles when smiled at, responds to his name, loves cuddling and hugging, he has no repetative movements, he has always babbled, he pretends to talk on the phone, pushes cars, builds with lego.

He like other kids (smiles) but doesn't interact with kids. The daycare said he has improved a great deal and continues to learn and improve, but they do say he is different from the other kids and he gets frustrated when they change activities. They say he only likes certain toys. They also said he is very happy and the most gentle child in the daycare

I am really really devastated that the Speech Therapist told us to seek an assesment by a Psychologist. We will do it, but I am still so sad (just as a side note, she doesn't remember his name - Max - she calls him Alex, and said we should stop him from lining up toys - he doesn't ever do that...)

 I feel in my heart that there is nothing "wrong" with my child. I am his mom, could a mom be so blind?

The only developmental delay I can find online is autism. Are there any other delays besides this? Nothing adds up with Autism with my little guy

Thank you for listening..... 

[McGucks]

It sure doesn't sound like anything on the Autism spectrum.  Frankly, kids develop at different rates.  I have a friend whose son barely spoke until he was three except for saying "What that?"  He has an IQ over 160 now (he's 12).

All two year old repeat what they hear.  It might be called echolalia.  It is also called "learning to talk" if you are just two!  You may have some rather ambitious therapists around.

My advice would be give him time.  Continue to enjoy him.  Honestly, he sounds fine.

If he has a pediatrician/GP, is that person concerned with his development?  I think you are on the right track in thinking the speech therapist is on the wrong track.

[Casha'sMommy]

Just chiming in, 17yo dd didn't speak until 3yo and started speaking in full sentences. She might have been on watch for her quirks in addition to her language but my gut didn't tell me anything was wrong so I didn't bother to look into it.

I think you should listen to your heart and your mama instincts. I don't think there's anything wrong with seeing the speech therapist provided the services match your methods of parenting. 5yo dd had speech services with multiple therapists and one wasn't a good match for our family, this led to some set backs in dd's language.

GL
 

[pbjmama]

There are many different kinds of developmental delays, for example ADD, ADHD, SPD (sensory processing disorder), several syndromes which are genetically based, learning disabilities, etc. You could google "names of developmental delays".

I think it is wise to follow the ST's advice and seek assessment but also to remember she is not trained to asses things beyond speech. She sees a problem and refers out beyond her specialty. Another option in the states would be a developmental pediatrician, not sure if that is an option for you. Things to consider - has he had his hearing and vision tested? Some delays are because a child isn't getting the input they need and it can be very difficult to determine that with out training/testing. Is his voice tone typical (similar to other children)? It isn't typical for a 24 month old to play with other children. Many 2 year olds, 4 year olds, heck even adults have difficulty with transitions. I don't think either of those is a big cause for concern.

He is communicating with you (very good sign) but he isn't using language.

Autism is a very broad spectrum. If your child does receive an dx of Autism he can be a happy wonderful vibrant child and adult. Of course you will mourn if it happens but from what you have said here I agree it is unlikely.

There are many many stories of happy healthy children who have speech and/or language delays, my son and dh included. I hope you get some answers for your ds soon.

[fizgig]

There are MANY reasons a child can talk late.  Our son was also quirky and late talking.  He is 3.3 now but between 2 and 3 we weren't sure what was up.  The only way we finally determined what was up was taking him to a good developmental pediatrician.  PLEASE don't listen to speech therapists, occupational therapists, special education teachers, or really even child psychologists - none of them are qualified to differentiate between the many, many things that can resemble autism.  Our son was finally diagnosed with Mixed Expressive/Receptive Language Disorder after a number of "experts" told us he was likely on the spectrum. 

No matter what is going on, and even if you son turns out to be on the spectrum, he is the same amazing little boy and there is nothing wrong with getting such a dx.  BUT, based on our experience, if you do get an eval please make sure you go to a good dev ped!  It will save you a lot of time and confusion!

Incidentally, repeating things can be a normal way to learn language and is very common in late talkers.  I've posted below a comment written by Dr. Stephen Camarata (basically the world's expert on non-autistic late-talkers) about echolalia:
____________________________________________________________________

"Echolalia is the MEANINGLESS repetition of vocalizations produced by another. In autism, the children repeat, either immediately (immediate echolalia) or later (delayed echolalia) produced by someone else. The key qualitative aspect of this is that it sounds like parroting and the child does not appear to have any idea of the meaning or functional use of the words they echo. Like so many aspects of autism, after you have observed true echolalia, it is unmistakable. In contrast to echolalia are a) unprompted imitation, and b) scripting, which are both common in many late talkers AND ALSO in typically developing children. The key difference is that unprompted imitation and scripting both have a direct or indirect correspondence to the situation and the child will often show some degree of meaning in what they repeat. For example, my LT Vincent was a big fan of the movie, ³the little mermaid² (Disney version). When coming into the kitchen, he would often begin singing the song by the chef when he was trying to cook Sebastian the crab. This scripting has a functional relationship to the setting and should not be viewed as echolalia. Vincent both scripted and imitated for several years, but like most LTs using scripting and imitation, these strategies dropped out after he learned more language and social skills. There is no doubt in my mind that he would have been labeled autistic in today¹s environment. As it was, he was recommended for placement in a classroom for Cognitively impaired (mentally retarded) children. Time has proven that autism or mental retardation would be absurdly inaccurate diagnoses. That is one reason it is very important to know the difference between echolalia and scription or unprompted imitation.

Unfortunately, many clinicians seem to be unaware that unprompted imitation and scripting are normal aspects of development and should not be viewed as alarming at all. Indeed, if a child imitates and makes even a small change in the utterance, this is often a precursor to a language burst. So rather than being a behavior to get rid of, the imitation is actually very
positive.

Finally, I have seen some children who have essentially been taught to be echolalic. By this I mean that many LTs are mistakenly taught to speak using discrete trials, which also goes by the name ³Lovaas² or ³ABA.²In this
teaching technique, the child is forced to imitate what the adult says and is given a reward (usually food) when they do. If the child is clueless as to the meaning of the adult phrase, this is essentially teaching a child to be echolalic (ie, teaching them to display a symptom of autism). Although there are some children who will benefit from discrete trials (and we do recommend this approach for some children), there are many others who should not be treated using this technique. I just find it ironic that some LTs who are otherwise not autistic are taught to be echolalic by the clinician and the parents are then told that the echolalia is a symptom of autism (it does happen)."

Stephen Camarata

[transylvania_mom]

I'm no specialist but my dd had a very poor vocabulary at that age (still does). Her brother was the same, he wasn't speaking in full sentences at 3. Now he's 7 and speaks three languages fluently.

Children who are my dd's age form complete sentences, can answer questions etc. I'm not worried one bit, because I see how ds's vocabulary has developed.

I would seek the opinion of another specialist.
 

[fizgig]

I've been thinking about your post and I also wanted to add that I think you should get rid of that speech therapist asap.  She isn't even paying attention to your actual child and instead has a little checklist in her mind.  That she is telling you not to let your DS line up toys is terrible for 2 reasons.  1) It shows that she doesn't even see what your actual child is doing and 2) Even if he were lining up toys, that is called a "stim" (self stimulation) and most people working with kids on the spectrum now acknowledge that it is important to let kids stim unless wgat they are doing is dangerous. It is often a behavior that helps them calm down and feel safe so simply "not letting them" is downright cruel.  That says to me that she is NOT the right kind of person to help you or your DS!

We encountered this a number of times when our DS was younger and it sent me into a very bad head space without reason.  We had our DS in a school with a speech and occupational therapist and they were both very young and had an "autism checklist" ingrained in their minds.  Since our DS wasn't talking at all then they both jumped to the same conclusion and began treating him as if he were on the spectrum.  Every time he picked up a truck or toy car they immediately forced him to put it on the floor and I couldn't understand why until I asked and the ST told me it was to stop his "stimming" on the wheels.  Um, he wasn't, in fact he was pretending they were rocket ships because we had been watching Buzz Lightyear.  They weren't paying any attention to my actual child and instead couldn't see past their own assumptions.  They did this with a whole list of things.  They told me we need to work on pretend play and eye contact.  Um, my DS is the king of pretend play and will gaze into people's eyes forever. 

I would highly, highly recommend that you find a play-based therapist who is tuned into your son and who welcomes you at their therapy sessions so you can learn some techniques to help your son develop his language skills.  No matter what is going on with your DS, a good play-based therapist can help him.  Anyone who isn't tuned in with your actual child's strengths and weaknesses is not going to be able to effectively help him. 

Your DS is VERY young and I am a firm believer that mommy gut feelings are usually right.  We didn't go ahead with a full eval of our son until he was almost 3 and I'm glad we waited.  At 2 it is virtually impossible for anyone to really be able to tell what is going on!  I would get some good therapy and get on the wait list for a good dev ped and then have fun with your amazing little guy!

[Peony]

I have a beautiful 3 year old son that is speech delayed. We are just pursuing other testing now because he is really quirky and his speech is not improving as much as it should. I will just second what everyone else said, do not listen to others, they are not qualified to diagnosis. I have been told everything to he is completely fine to he has mlld CP. Now what ever DS1 is, he is still my little amazing boy. 

[Hattie'sMama]

My daughter has Trisomy 21(Down Syndrome) and after 18 months of working with a variety of therapists, I'd suggest finding a new ST. She should be able to remember your son's name and actual behaviors!

I would like to say that getting a psych eval is not always a negative thing. At my daughter's last eval, the psych told us that her IQ was around 130-definately not mentally retarded, which most people expect from a kid with DS. Even if you get a diagnosis of some delay, keep your expectations high. It sounds like your son is very bright and wonderful, he might need some special techniques to help him learn how to speak, it doesn't have to mean anything more than that.

If your state has a children's hospital with a center for disabilities, find out if he can be evaluated there. The doctors and therapists are often much more professional and aware of a wider range of diagnoses than a local doctor might deal with.
 

[BensMomma]

I have to ask because we are going through the same thing with my 19 month old son. Have you had his hearing checked? My son says very few words and first thing they did was all the autism checks where he showed as low risk. He says very few words and tries a few others but they never sound right. We got his hearing checked after many requests to do so and found he has massive buildup behind his ears which they described his hearing like sticking both fingers in your ears as hard as you can and he hears like that.. Completely muffled. He is having surgery on Wednesday hoping it will help as they think it will. Definitely something to at least check if you haven't. It was actually an early steps worker (which is similar to the person that is working with your son) that suggested it may be the problem.. After the first time she met with him!

[anjsmama]

My DS barely knew 10 words at 24 months. He didn't say much of anything until 2.5. At 31 months, he started speaking in full sentences. He's 3 years 8 months now and he NEVER stops talking. . I did not go through with the SLP evaluations... I decided to wait until he was 3, and by that time it was not necessary. I did have his hearing checked, just in case, and it was fine. 

DS is also very social, happy, outgoing, makes great eye contact,  etc etc etc I was quite confident he was not on  the autism spectrum. And while I was right about that, he does do a lot of the playing with a certain toy, not wanting to change activities, and lining up his toys... because he does have some SPD (sensory processing disorder) which basically means that his senses are heightened and frequently in overdrive. It does cause certain "quirks" but he hasn't had any true delays other than being a late talker. 

[LynnS6]

Two thoughts:

First, you might post over in the special needs board -- there are a lot of parents (and some Canadian ones) who've been through the assessment process and might be able to give you a better idea of what to expect.

Second, no one can diagnose your son over the internet. A 24 month old who's having a lot of trouble understanding language is a matter for concern and warrants further evaluation. It might well not be autism, it could be. Without an evaluation, you won't have any idea. A good evaluation will give you an idea of his areas of strength and weakness so that you can help him flourish. 

(I'm assuming he's had his hearing checked, yes? That's the first thing that should have been done (even a mild hearing loss can really affect language development and they often go undetected).)

For every child who "didn't talk until they were three and then started speaking in sentences" there are more who didn't talk until 3 and still aren't doing very well at age 5. Speech-language is one of those things that do benefit greatly from early intervention. Kids who are behind are chasing a moving target. Children with comprehension delays are at particular risk. Having a fuller picture of what you're dealing with won't change who your son is, but it can help  you and your son move forward.

[JudiAU]

There are many reasons for a toddler speech delay and it is great that you are seeking assistance for your little one. It doesn't sound that he is autistic but there could be some other reason for the speech delay/speech acquisition. I think it makes sense to follow up on her recommendation.

But really...don't panic. Searching on the internet with a single key word is likely to make you distressed and paranoid. Enjoy your little person as his language expands.

[Tina Dun]

Thank you. I didn't know there were so many reasons! I kept googling speech delay and autism came up, making me thing its the only reason!

[Tina Dun]

Originally Posted by LynnS6 

Two thoughts:

First, you might post over in the special needs board -- there are a lot of parents (and some Canadian ones) who've been through the assessment process and might be able to give you a better idea of what to expect.

Second, no one can diagnose your son over the internet. A 24 month old who's having a lot of trouble understanding language is a matter for concern and warrants further evaluation. It might well not be autism, it could be. Without an evaluation, you won't have any idea. A good evaluation will give you an idea of his areas of strength and weakness so that you can help him flourish. 

(I'm assuming he's had his hearing checked, yes? That's the first thing that should have been done (even a mild hearing loss can really affect language development and they often go undetected).)

For every child who "didn't talk until they were three and then started speaking in sentences" there are more who didn't talk until 3 and still aren't doing very well at age 5. Speech-language is one of those things that do benefit greatly from early intervention. Kids who are behind are chasing a moving target. Children with comprehension delays are at particular risk. Having a fuller picture of what you're dealing with won't change who your son is, but it can help  you and your son move forward.

I actually know that there is no way to find a diagnosis over the internet.

If you had read my post to the end, you would have read my question, it was clear - are there other reasons besides autism to have speech delays? I think its an okay question. And it looks like, from the answers, that there ARE other things that could happen. I wasn't asking for a diagnosis. 

I wouldn't have my son going to speech therapy, taking the time off work to take him and work with him, and I wouldn't be posting on the internet UNLESS I thought there was SOME cause for concern. 

I have had his hearing checked - twice

"Change who my son is"? What?

"

[jmarroq]

My son did a lot of echolalia before he could talk. People would come up to him and say "oh what a beautiful young man....what is your name?" and he would say "where the moon go?" It was something he heard me say once and it stuck. Even after he learned to talk, he would repeat what they were saying on the TV right after they said it....he would mumble the whole time he was watching TV...a split second behind what they were saying. He still did echolalia after he could speak, mixed in with his regular conversations, but it got better with time. 

Today my son is a healthy 9 year old boy. We've been through a lot of doctors and different therapies. I won't even go into how many diagnosis he has had over the years! We never did medicate for what is thought to be ADD, so school is a challenge. His IEP just focuses on some of his weaknesses, without specifically naming any impairment. He has some tics, and he struggles with visual motor integration and fine motor skills processing, etc. so handwriting, and some math concepts are a challenge. He gets some extra help at school and has a private tutor. 

He has a unique way of speaking and is very creative. He is quite witty and comes up with the most incredible sayings. People always think he is trying to be funny, especially adults and they will laugh. Until he was like 7, he would get very upset by this and couldn't understand why people were laughing. I think it still effects him, but he learns to hold it in. He is always complimented on his vocabulary and his way with words. His writing teacher made a point to come up to us to tell us that he never had a student quite like him and he was very impressed with the way he spoke. His art teacher did the same thing recenlty. He used a huge word at the pediatricians office one day when he was like 6 and she started cracking up and said "and to think this is the same kid we were worried about speech delays with!".

Honestly, I was worried he might never be able to communicate...and look at him now! He is just one of those kids that can't get things...and one day it just clicks! He jumped earlier than most, and walked right at 12 months, but he couldn't walk down a flight of stairs with alternating the steps until he was 8...which is probably 4 years later than average! 

Of course an evaluation can't hurt since there may be something else going on like auditory processing or something but it really doesn't sound like autism to me either. 

I managed to stay away from an autism diagnosis and my son had lots of autistic like behaviors along with echolalia and speech delays (toe walking, head banging, pica, humming, hand flapping and jumping, poor eye contact, fine and gross motor delays, playing with toys inappropriately, would turn his back for hugs, hitting children instead of playing with them, etc...).

The fact that the ST called him by a different name and told you to stop him from lining up cars when he doesn't, makes me think she was thinking of a different patient. Could you see a different speech therapist for a second opinion and maybe go to a developmental pediatrician as well?

[LynnS6]

Originally Posted by Tina Dun 

I actually know that there is no way to find a diagnosis over the internet.

If you had read my post to the end, you would have read my question, it was clear - are there other reasons besides autism to have speech delays? I think its an okay question. And it looks like, from the answers, that there ARE other things that could happen. I wasn't asking for a diagnosis. 

I wouldn't have my son going to speech therapy, taking the time off work to take him and work with him, and I wouldn't be posting on the internet UNLESS I thought there was SOME cause for concern. 

I have had his hearing checked - twice

"Change who my son is"? What?

It wasn't so much you that I was addressing as the other people who said "Of course he can't have autism." There are lots of reasons a child can have language delay -- from hearing, to general cognitive delay, to apraxia to specific language impairment and probably a dozen other things.

[Tina Dun]

Thanks to everyone for your amazing and insightful answers

My son had speech therapy this morning. We woke up, the sun was shining, we dropped by the park on the way, kicked the soccer ball back and forth, went on the swing, and then off to Speech Therapy

He sat down at the little table like an eager boy...and then he lost total interest in speech therapy games after 15 minutes (my mom says "what exactly did you expect from a 24 month old")

I am at the point where I find it hard to watch my 24 month old son be scrutinized in such detail.

I told the Speech therapist about how responsive my son is at home, but she said he should be that way everywhere.

I put him on the waiting list for the Developmental Pediatrician (in my original post I was talking about psychologists, but I meant Pediatrician)

His spot should come up in about 5 months

In the meantime, we will finish the speech therapy sessions (we have four more, practice what she has taught us, but otherwise, I think we will take the summer "off" from specialitsts. I don't want to sound like an irresponsible parent, but IF my gut is right, then maybe giving him a few months to grow, play outside, go swimming, play soccer......

Let him grow. It feels right.

[mamandedeux]

I'm not sure if what I have to add will help or not, but it has been my experience that there's often a HUGE developmental leap between 24-30 months. My DS2 also had a speech delay and our experience with SLP was frustrating. He would lose interest or just say no to whatever she was asking him to do. She would force him, he'd cry, I'd feel bad. Rinse, repeat. We stopped going. He's 31 months and talking in 4-5 word sentences now, but it's very recent, and it happened almost overnight. He's also different than most toddlers in that he's quiet and very ''relaxed'', he's not super active and all over the place, but that doesn't mean he's not exploring his environment and learning. Give it time, and enjoy him! 

[Tina Dun]

Thanks Maman!. My experience is the same, very forceful, with him not interested, only difference is my boy is VERY active.  Jumping, throwing, kicking, climbing, running, the park is his mecca. Its like the daycare worker said "Max feels confined within four walls"

Max says "no" to the Speech therapis too. He says no in Greek, English and Polish to her, which I find hilarious (but I keep respectfully composed