Delayed Speech

[Marie Lizzie]

My 3 1/2 year old was born with a cleft in his soft palate which was repaired successfully at one year. He is still not talking well and many people except for myself, grandparents, aunts etc find it difficult to understand what he is saying. He has started school and the teacher has complained about his behavior. He sucks his forefinger (this started soon after I stopped his bottle last July), takes his shoes and socks off in class (we do this at home or when entering another person's home), suddenly gets up and wanders off when the teacher is teaching, shows difficulty in writing and understanding what she says. She says that he is immature for a child his age and fondles her breast and wants to be carried sometimes. He used a pacifier for the 1st year and we had to discontinue it after the repair. That was when he started touching my breast for comfort. I have told him not to do it and he hardly does it now. He started Speech Therapy 2 weeks ago and has improved already. But because of his lack of coherent speech his classmates do not understand him so he has no best friend as such but he does play football and run around with them. The school counsellor says that he might be Autistic because of this. I think that's an unfair diagnosis because of his cleft palate. He knows his colours, numbers 1-50, sings, can read alphabets and match words, do puzzles well. He babbles but also speaks in sentences of up to 4 words. When I sit with him, he writes his standing and  sleeping lines well, joins the dots, colours nicely and is constantly asking for evaluation by saying, "Mama look, mama look."  His ENT and Pediatrician say that he appears normal and intelligent to them. He loves going to school and calls his teacher his best friend but I think that he is frustrated that people cannot understand him and behaves like that. Is he Autistic?

[hdcMom]

I also have a 4 1/2 year old that was born with submucous cleft palate.  He didnt really start talking till her was 4....but he has attended preschool since he was 3...he is just like the other kids, other than his speech.  

I think you should talk to you dr. and get some advice, he definatley needs some more help at school.

Hope all works out soon!

[Cleveland Mom]

There could be more than a language delay going on with this little boy but at his age and even older it can be quite difficult to determine if a child has ASD because this is such a wide range of development in young children.  The line between normal and abnormal behavior is quite fine.I am a clinical social worker.  I think mom should run her concerns by Dr. Kennedy, in the least.  I think that it would be prudent to have him eval. by the school district, he might benefit from an EI preschool and he may have a more positive experience there most importantly get the help he needs.  

[RockRose]

I agree with what Tired has said,  except the shoe issue.  Children who can't stand the feel of socks or shoes often have sensory issues.    They often can't wear socks at all,  or will insist on certain kinds of socks that don't have a tight elastic band or don't "bunch" under the foot,  and can't stand the feel of "hot" shoes on their feet.

I especially agree that almost none of these issues sound related to his cleft palate,  they sound like other issues he will have to deal with.

You may want to search the net on Sensory Integration Disorder.  Some of your answers may be there.

Best wishes.

[Cleveland Mom]

I have a 4.75 y/o son with a language delay.  He attends EI preschool so I have a good deal of experience with language problems bx issues and am quite well-read on Autism Spectrum Disorder (ASD).  In my opinion, only an opinion nothing that you say necessarily indicates that your son in on the so-called spectrum.  His language may very well be delayed and you have done the right thing to have him eval. for speech pathology services.  Its very typical for 3 year old children to have difficulty paying attention in circle time, after all all preschool aged children by their very nature have limited attention spans.  Your son demonstrates many abilities and strengths.  His counting ability is certainly advanced.  You said that he colors, this is a fine motor ability.  Very importantly you mentioned that he takes pride and shows you his work, sharing something of interest indicates that he has the ability to engage in joint attention, something that is often not typical of children with ASD.  Certainly, any delay in language or any delay in development in general can cause behavioral difficulities and social difficulties.  Many kiddos with language delays and speech problems are delayed in thier social abilities these same kids are not necessarily autistic.  It is possible to have a language delay and to be socially immature or delayed and not be autistic.

[anxiousmomtobe?]

I really think there is more going on here than a speech delay.  I have a 3.5 year old.  He goes to daycare with a 4 year old who has a speech delay.  Max (the four year old) rarely speaks.  However, he makes himself understood and he functions very well with children his own age and older kids.  He can sit at circle time and participates fully in all activities.  Even though he is almost completely nonverbal, he has friends and is accepted.

I think your son needs early intervention.  It is hard for us as parents to be objective.  We are supposed to think our kids are the best in the entire world.  It is hard to hear when they are not doing well out in the cold hard world.  The fact is you have a wonderful son and maybe he will need some help to make his way but with your loving support and the help of some professionals he will be fine.

[tiredbuthappy]

from my experience (working with 3 and 4 year olds everyday for over 5 years), they do not diagnose autism at this age yet. instead, they seem to diagnose and treat symptoms like low muscle tone, speech delays, cognitive delays, etc... i think this is due to the wide range of "normal" child development, and it would be unfair to diagnose a child as autistic unless he or she demonstrates such drastic symptoms  that would warrant it. that being said, honestly, if i were your child's teacher, i would be concerned as well, and it sounds as though they are communicating their concerns with you and preparing you for the possibility that your child may have special needs. he may turn around one day and catch up completely. what concerns me is:
~fondling the breast for comfort (a child of this age should be able to find other ways to comfort himself).
~difficulty comprehending what the teacher says (indicates that it is more a language processing difficulty than a speech problem)
- the babbling and use of short sentences also indicates language processing is a problem. normally developing 3 year olds may talk to themselves, but they do not babble

Many of the behaviors you describe normally would not sound warning bells, but since he demonstrates these symptoms along with the others you listed, they support the possibility that your child has special needs. These are:
~ takes his shoes and socks off in class- i have seen children do this, but it was for attention or because of behavioral difficulties. They knew what they were doing was wrong. I suspect your son may not comprehend why they must stay on his feet.
~wanders off while the teacher is teaching- i have seen this is well, but again it was children who were seeking attention and knew that they were expected to be seated.
~ difficulty in writing- common in children who have not developed small muscles in their hands. can also be common in children with low muscle tone. there are many fun activities you can do with your child to help strengthen the muscles in his hands- play dough, ripping paper, etc... BUT this can also be an indicator of special needs as well, as many children with autistic tendencies have low muscle tone

and i feel i must comment that just because the child is intelligent does not mean that she or he does not have special needs. most autistic children have remarkable memories, so things like letters, numbers, colors (things that are memorized) come exceptionally easily to them. it also does not mean that they cannot socialize either. i worked with one child who has since been diagnosed, and he was the absolute sweetest, most loving thing in the world. He wanted desperately to be accepted and be like his friends, so he would adapt by immitating their behaviors. The other children accepted him.

your son does show some signs of autism, and since his surgery was at 1 (before children generally begin to speak), i do not feel as though his behaviors can be attributed to his cleft pallate. But, you are actually quite fortunate because early intervention for these delays (be they normal delays or due to autism) helps tremendously. it sounds like your child's school is trying to get him the services he needs and deserves. also, if it turns out that he is autistic, it sounds to me as though he is highly functioning and would probably be mainstreamed in most school districts. "autism" is a scary word, but is also a very broad generalization for a very broad range of abilities. and lastly, i want to reiterate that i am not saying your child has autism. i am just trying to explain why his behaviors are concerning his teachers.