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Autism vs hearing impairment lack of speech
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Autism vs hearing impairment lack of speech

My son is 11 y/o, i've been to different specialist for hearing/developmental doctors but nobody can really give me an answer why my son is non verbal they just keep on pointing to autism or his hearing impairment. His sensorineural bilateral hearing loss are questionable to me - BAER results were from normal to profound hearing from different hospitals we went through. I started prompt therapy a year ago and now slowly he would approximate some syllables in a word. I would really like to be directed on how i can help my son, what are therapies that are needed? is there a specialist that can really help me and not just give a diagnosis?  I live in NJ border of NY.  Any help is appreciated, thank you.

This discussion is related to Apraxia vs. speech delay.
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My understanding from your post is that your 11 year old is non-verbal and that he has no hearing loss?
Does he frequently appear deaf?  Eg. he doesn't respond when you call his name.  Does he appear to retreat into himself?
There are a couple of things I found with my son, which might be useful.  Although my son is verbal is frequently appeared deaf and would re-run DVDs he has seen in his head.  The appearing deaf is partly down to him placing all his attention and focus into something and effectively his incoming sensory receptors are shut down.  So he doesn't hear you and if you touched him he might jump or accuse you of hurting him.
If your son's other senses are extremely hyper sensitive he may infact shut down his hearing because it is too painful or over stimulating to keep it open for too long.
I had my son assessed for Irlen Syndrome (which is a visual perceptual difficulty and a recognised medical condition), my thoughts were that as the majority of sensory information comes in through sight, that as he was oversensitive to light that reducing that overstimulation might improve his other sensory reception, and it did.  I also bought him a pair of ear defenders from the local DIY store.  My reasoning was that if my son's hearing was oversensitive and he was shutting his ears off to protect himself, then these ear defenders might enable him to keep his hearing open, and it did.  The combination of the glasses and ear defenders allowed him to control over stimulation to some extent, and made him confident of going into different environments because he had strategies to protect himself.
If your son does have sensory integration difficulties it can affect any or all of the senses and it fluctuates day to day and throughout the day.  So his response to sensory stimulus with vary eg. my son can appear deaf, cover his ears, make lots of noise and go to his drum club all in the same day!
Do you feel your son is capable of formulating the letter sounds?  If not it might be oral dyspraxia (it has another name, but I cannot remember it now).  Where although they know what they want to say, they cannot formulate the words.  Could your son communciate his needs using pictures and symbols?
Do you feel he has difficulty getting letters and words ordered?  My son has disordered speech so when he talks the sentence is all jumbled up.  I presume that if that difficulty were more severe it would make it very difficult for him to be able to speak at all because it wouldn't make any sense.
Your son may also have Central Auditory Processing Disorder.  Google that to see what it is.  It would be hard to assess for as he is non-verbal, but basically if he is not hearing sound as we do (this is not hearing loss but auditory processing) then he may find it very hard to speak.  My son makes lots of mistakes with letter and word sounds. eg. volcano is bokano, finally is finacly, gloves is globes, map is nap, suppose is pose etc.  So he may have this difficulty.  He may need to be taught sounds accompanied with articulation gestures to show the true letter sound, a SALT can do this.
Does your son have typical cognitive function and does he understand what you say to him?  If so it might be worth looking into various computer programmes where your son would type in the word and the computer 'says the word'.  If you go onto YouTube, you can see a woman called Amanda Baggs using this type of system in her video called 'In My Language'.
It maybe that he simply is not motivated to communicate.  Do you feel he is interested in trying to communicate but something is holding him back?  For motivation always use his areas of interest ie. don't try to encourage speach with set programmes, they must be adapted so that they are relevant to what his interests and obsessions are.
My Occupational Therapist is going to start a programme with my son called Listening with the Whole Body.  My son has auditory processing and auditory memory problems which impact on his ability to understand and remember things said to him.  However he is also echolalic and can repeat hours of DVD dialogue, yet he cannot adapt that 'skill'.
Do you feel that in some way he is hearing things okay, but there is somekind of breakdown between the internal communication of hearing and speech?
If you think sensory stuff is relevant then I would recommend a book by Olga Bogdashina called Sensory and Perceptual Differences in Autism and Aspergers.  This has a questionnaire at the back which you can complete to get a sensory profile of your child.  Our autism outreach department uses this questionnaire, so I know it is reputable.  Olga also has another book about language, but I haven't read it yet, so I don't know if it covers non-verbal children/adults.  If you look at the Amanda Baggs video it becomes very clear that non-verbal does not equal lack of cognitive function or understanding.  
Please post back if you think any of the above is relevant.
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