Start taking a diary of what he says- what was said before? what was he reacting to? etc. Maybe you can unravel some of the mysteries. That's what we've had to do with my son, who has Asperger's/ HFA (high functioning autism). Could HFA be a possibilty as well? Has he been screened for Autism? (I just remember feeling like a lot of what my son said made absolutely no sense at all, it was totally irrelevant to what we were talking about, there were tantrums about seemingly nothing... it took a long time to figure out.)
MERLD is a long road, but it's not as long as you would think. DS#1 (7.5) has a diagnosis of MERLD. We started speech therapy last summer, and it has made a huge amount of difference for him. He still struggles, but it is getting better and better.
There isn't a lot of information out there for parents of kids with MERLD. The best information that I have found is on speech language pathology websites. There are some books available from Amazon that may help, and, as always, "The Mislabeled Child" has useful information.
There isn't a lot of information on long-term prognosis. Generally, what I've found is that kids with MERLD often respond well to speech therapy and many of their deficits remediate. However, they continue to show subtle deficits throughout their lives and into adulthood and it affects their functioning as adults. However, there is no reason to think that they won't be successful in careers or university or have families.
He needs speech therapy. Most programs are 1-2 hours per week. Daily practice at home will help a great deal.
(Those are two parts to the same study.)
However, considering he didn't talk till he was over 3, he is doing great. I have found "The Mislabeled Child" to be the best resource for MERLD.
my son (age 6) was diagnosed with merld just before turning 4 and is doing phenomenally. he is still below peer level in his receptive and expressive language but is definitely on track to "normalize" by age 8 (i.e. catch up). according to the clinicians who did my son's evaluation, once merld normalizes, there are no long term ill-effects aside of social immaturity (because the lack of language impairs early social learning) that also corrects itself with time. maybe there are different types. we saw clinicians at vanderbilt in nashville who are known experts in the field, who do differential diagnosis and have a high rate of accuracy in their diagnoses/prognoses (stephen and mary camarata). here is a good website that has been a tremendous help to us in our journey (a forum for parents of "natural late talkers"): http://www.naturallatetalkers.com/. feel free to email me with any questions (email@example.com).
Per Dr. Camarata: http://www.naturallatetalkers.com/delayed.php
My son has a MERLD diagnosis and I'd love to get together with other families who are struggling with this. My son would love more playdates with similar children. I live in the St. Louis, Missouri metropolitan area. Please feel free to PM me.
(RiverTam, I'm new here and I don't yet have the required minimum # of posts to be able to PM somebody, otherwise I'd PM you. I'd love to hear more about your experiences. We're really struggling with finding appropriate therapies and school placements and the like.)
Good luck to everybody who is working through MERLD or MERLD-like challenges!
Our son also has MERLD (and probably verbal apraxia as well).
I have found that the receptive delay is absolutely the most difficult part of this journey for me. When DS (4.5) can't really understand what is going on, he feels out of control and we are much more likely to have a bad time.
A few people mentioned the site naturallatetalkers.com which has been a life saver for me, it is specifically for kids with language disorders but not autism. That is a very small niche of kids whose needs are not the same as those on the spectrum. It can be a confusing road to travel, especially if you start looking into therapies and such.
For us, speech therapy has helped quite a bit. Play based, child led therapies tend to work best for kids with MERLD, and I would definitely seek a therapist who can work with your little one a few times a week. Also, the books "Play to Talk" and "It Takes Two to Talk" were GREAT resources. They both have specific strategies and games that you can play to encourage receptive and expressive development.
Many kids with MERLD "normalize" eventually. That doesn't mean they don't still have some difficulty processing auditory information, but usually they get to a point where no one else would really notice their delays.