Hi,
My son is 25 months old and has a speech delay. He started speech therapy at 24 months. I had him evaluated by a pediatric neurologist and they ruled out autism and said that he has a speech delay. He now has about 70 words and some two word combinations like "I see" or "Hello + name" and "Mama sit", "Where did it go?". Being that he has a limited vocabulary, how can I tell if what he says is scripted or spontaneous. Can you give me an example of what this means and how I could tell? He seems to say words in context. He is very social, loves children, great eye contact. I'm trying to figure out if the pediatric neurologist has missed something and this is solely a speech delay.
Autism is sometimes hard to diagnose or rule out at that age. My older daughter is not autistic and didn't speak at all until 3. My younger daughter is autistic (diagnosed just a few weeks after her 3rd birthday) and her scripting and echolalia are actually helping her move gradually to more spontaneous language skills.
So I would just embrace your child's communication style and revel in the fact that he is so social and happy and loving and not worry that it's something else.
If he can come up with spontaneous answers to questions or thoughts that isn't scripted language. So he sees a dog and points and says "dog" or "plane" whatever. Since he's limited in language look at his one word speech rather than combinations. Is his one word speech spontaneous? Is it accompanied by gestures--pointing, waving, head nods? That would point away from autism stuff.
Basically scripting is when child (or adult..we all do this to some extent) has memorized an answer or statement. It's said the same way every time.
Scripted:
How are you? Fine (we all do this one at some point, right?)
But perhaps the child memorized fine as an answer to how....you? type questions. He doesn't have spontaneous speech.
How old are you? Fine
How are you feeling? .......maybe he won't answer or maybe he's memorized or just answers fine for that one too.
In your case does your son point and say "dog" or "plane" or whatever to pont out things to you. That would be spontaneous speech. You mention "I see"..does he use that along with what he sees? If you ask if he wants an apple (or something preferred) or broccoli will he say apple?
All kids use scripts to some extent. Look at his language as a whole. Some of it should be spontaneous.
http://www.childbrain.com/pddassess.html This is an online "could it be autism spectrum" assessment if that might help give you some information. At least you can see what indicates autism by looking it over.
My big concern is that I don't want to miss any signs that could indicate that he needs therapy in other areas. I know how important therapy is at a young age. Right now he receives only Speech Therapy, but I always wonder if he should be receiving other therapies such as OT. He does seem to have some sensory issues, but other than being a "picky eater", I think they are very mild. Other than the picky eater, he will sometimes go on his toes when running and excited, but other than that I don't see anything. The pediatric neurologist didn't put much weight on those 2 things based on his interaction in her office. Maybe he's just a quicky kid, I just don't know.
Sbgrace-Thank you for you response. This makes it alot clearer. Yes, my son is very good at pointing things out and saying "Plane", "It's a ball" etc. When he is searching for a toy, he'll say "Where did it go?" and then when he finds it he'll say "I see". If I ask if he wants Juice or Water, he'll tell me which one.
The things that make him seem off are his very social nature. I guess I'm just not used to this. My oldest is a very serious child so he just didn't interact with people like my youngest does. For example we'll go to the store and we'll be at the cash and when we leave he'll wave and say "Bye" to the cashier. I read up on Aspbergers, but he has a speech delay, which seems to rule out that one.
I guess time will tell, but I don't want to miss any opportunity for therapy at this young age.
Originally Posted by Schnauzer
For example we'll go to the store and we'll be at the cash and when we leave he'll wave and say "Bye" to the cashier. I read up on Aspbergers, but he has a speech delay, which seems to rule out that one.
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A kiddo can have autism with a speech delay and, in fact, Aspergers isn't necessarily less "severe" than other forms of autism. It's just autism without a spoken speech delay. But waving and saying "bye" to the cashier and pointing out things sounds both not autistic and also spontaneous.
You can request an EI evaluation in OT for sensory issues. You can also get books at the library on sensory stuff. Maybe that will help you feel you've addressed all issues.
The push for therapy at young ages is based on faulty understanding about the brain. It doesn't slam shut and stop developing at 3 or 5 or whatever age. So there is no "too late" if you find something later. Sometimes we put a lot pressure on ourselves for no reason. There isn't a rush.
Does anyone have a child with aspergers that did have a speech delay? Is it ever possible? I've always wondered about that, and I personally believe it must be possible. With a speech delay, there is still speech, its just not as many words or as clear as other children of the same age?
Rebecca
My older DD hasn't been diagnosed with Asperger's but has many of the traits. She was a late talker but started talking way above her age level when she did start. Advanced vocabulary, perfect grammar, complex sentence structure, very animated. And talks waaaay more than any child I have ever known.
Being an SLP (Speech-Language Pathologist) I see kids with all sorts of diagnosis and delays. It is possible for anyone on the spectrum, no matter their severity, to have a delay in speech & language. You stating that you are unsure if your child is scripting or using spontaneous language is a common question I frequently get [dealing with 1-3 year olds daily]. An important thing to remember especially with a speech delay is that children always start their language by imitating. So even if they are using scripted speech right now or it seems as if they are - it doesn't necessarily mean they have Autism. Children learn by imitation. It looks different in older children with a speech delay then when it is developmentally appropriate. You can never rule out Autism but don't stress over it right now. Language delays can look like a multitude or problems or diagnoses.
I just wanted to chime in and say that your grocery store example sounds like it could very well just be a personality difference between your kids. Introvert vs. Extrovert. I'm not an expert, though.
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