22 month old with speech delay.

I have a 22 month old speech delayed son.  After looking up possibilities of why he might not be speaking (much) I noticed one cause was autism.  I have previous experience with working with adults with autism, Aspergers, etc., but am unsure how autism and autism spectrum disorders usually present themselves in toddlers.  Here's a brief summary of my son:

My son stays at home with me.  My husband works from home as well so there is always one of us attending to all his needs.  For the most part, he's a very happy, curious, independent little guy.  So far, he's met all his milestones on time if not early except for recently when it comes to speech. He typically gets his needs met by taking you to the area that he wants something and pointing at the object, getting it for himself, or at times he'll even point to a picture in a book for what he wants.  He has said 'mama' (rarely), 'dada', 'baba' (bottle - his most favorite word), 'up', his sister's name (rarely) and a few others.  What I have noticed that with the exception of bottle he may say a word and you'll never hear it again (for a long time or ever).  He will give eye contact, participate in joint attention (he'll look at the object that you are pointing at), and will typically respond to his name.  He does have good receptive skills - he can point to 5-6 body parts, many pictures in books, and simple commands (throw that in the trash, etc.)

He enjoys being out of the house and besides shopping, etc. I take him to a playgroup that meets every other week.  Most of the kids are the same age and I haven't noticed that he behaves any different than the other children - he doesn't shy away from them and will play next to them He does do some pretend play (like pretend food\kitchen, will put a toy phone up to his ear, move cars across the floor), but he doesn't make any sounds while playing.  He isn't rigid in his schedule.

Does this seem like an autism spectrum disorder or just a speech delayed child?

[Jason C Bourret, Ph.D., BCBA-D]

It sounds like you’re taking a great approach and the facts that your son makes eye contact, participates in join attention, and shows an interest in interacting with others are all excellent signs. I would recommend having your son assessed by a professional who has experience diagnosing young with autism. However, at that age, it can be difficult to tell if an autism diagnosis is appropriate. The most important thing right now is making sure that he’s receiving services to help in the particular areas that he’s having difficulty with and it sounds like you’re doing that. I would be surprised if your pediatrician hasn’t done this but I would also recommend having your son’s hearing checked. It isn’t uncommon for early speech delays to be correlated with difficulty hearing.

[sewinggal]

I should probably note that I had him 'screened' about his speech and he was referred for services last week.

[prncessme]

Honestly, it sounds like "just' a speech delay. Children with autism have problems with social skills. Most have sensory intergration disorder (SID/SPD). Many do have speech delays but not all. It's just one symptom in a list of many.

If you are concerned about autism though, or even other things, I would make sure that when you were looking for a speech therapist that they also had a occupational therapist there as well. That way they can refer you to them if need be (OT's deal with sid, autism and hypo and hypertonia)

[courtney563]

Oh my gosh you couldnt describe my son any more than you just did right there, hes exactly the same. He's so very bright in other ways and follows demands and sometimes makes eye contact, but the only thing he will say is "hot" and in the past at his younger months he would say "please", "I love you" ",momma","dadda"one time and i never heard it again. He plays with other kids sometimes, he has his favorites. i dont know im confused and scared so i was just wondering if u ever got that looked into and what kind of doctor you take them to.

[sewinggal]

Courtney,

I haven't taken my son anywhere yet - I'm waiting for a couple of speech\language places to call me back and\or schedule some appts.  I did call a few former coworkers (one a psychologist and another a SLP) to discuss his issues (they never physically saw him, we just talked about him).  The psychologist said basically the big indicators are pointing - in her experience autistic kids just don't typically point especially when it comes to pointing to things far off (my son will occasionally point to things of interest when we're in the car and make a noise like he's commenting) so what he's doing is sharing joint attention.  Given that fact and the fact he doesn't seem to have social issues and no stereotyped behaviors she wouldn't say he was in the spectrum.  

The SLP at first was concerned about him not using words he once did (like language regression), but after telling her more about what he does she thinks that he just doesn't view himself as 'having a voice' and that speaking can help him get what he wants - he just seems to think of himself as independent.  She recommended that I start picking just a few things each day that he has to try to say before he gets it.  She would also like for him to have an audiology appt. to make sure that he doesn't have ear issues that had gone undetected (just because he doesn't have a history of ear infections, doesn't mean that his ears wouldn't be plugged up and not hearing all the sounds).

I do know one option is to take your son to a developmental pediatrician for an evaluation and\or psychologist.  I'm going to look at this for the time being as a speech delay issue and then if someone sees something different then I'll take that route.  Hopefully I'll be able to make some changes to get him talking soon!