What to Do?

My son is 3 1/2 years old and has a speech delay, but we are concerned that there may be something else wrong besides.

I am American, his mother French. He has two normal older siblings who are both bilingual and in school. Both languages are spoken in the home. One year ago, we moved to a German-speaking country.

My son speaks only a few words, not very distinctly. He says "No, no, no" and shakes his head, but "Yes" often sounds like "Laaay". When he has to go to the bathroom, he will say "Peh-peh." Juice sounds like "Juuu!" But more normally he points and holds out his hand. He will execute commands in both English and French. He shakes hands with new people and says "Bah-bah" when leaving. He knows the parts of the body and sometimes repeats the words.

He loves TV. One disturbing thing is that when watching certain programs he gets so excited that he will jump up and down in front of the TV -- for ages, I don't know how long it would go on if we didn't stop him. We are trying to break him of this habit by putting the movie on pause.

He tends to play by himself, although he likes to sit with his sisters, and he has one male friend of his age he likes to climb and run with. He loves to be hugged and 'taps' people strongly but affectionately.

When we are in public or in a school -- especially in a new environment -- he will often lie down on the floor, or climb up and stand on a table. This has caused problems because here kids are extremely well-behaved in public.

His hearing OK and EEG normal. A child psychologist who spent almost two hours with him in her office said he was within the normal range and had a good memory. He is good at puzzles and focues for long periods. We read to him, but he focuses longer with his mom than with his dad.

He often has bowl movement accidents.

Almost the worst thing is since he was 2 years old, we have had people make vague comments like "Your son isn't completely normal," or "he behaves strangely." Anyone from pediatricians to pre-school teachers. But when when we go to the experts, they can make no diagnosis.

He goes to an orthophonist who is supposed to help him with his speech. He stays 10 minutes in her office, playing with toys and ignoring her, and then tries to leave.

His mom often worries that he appears to be ignoring her. He often seems to be "dreamy" or "in his own world". He will cross a street without looking either way. When he is scolded or doesn't get his own way, he lets out a long, loud, strangled kind of screech.

His mom doesn't feel like she can leave him alone with other people. She says we are not admitting he has something extremely wrong with him, maybe a kind of autism. She wonders if he may have a sensory problem and need ergotherapy. She doesn't feel she can put him in school (she stays at home). Personally, I can't form a conclusion. This has put a great strain on an otherwise normal family. We talk constantly about the problem.

What can we do?

[Kevin Kennedy, Ph.D.]

Based solely on your description, your son undoubtedly displays some developmental lags (speech/language, social, emotional). It would be prudent to have him evaluated by a team of developmental specialists (e.g., developmental pediatrician, developmental psychologist, speech/language pathologist, pediatric occupational therapist). It's possible that, in a brief office-based evaluation with a single clinician (such as occurred with the psychologist), he can appear to fall within the normal spectrum, but your description certainly indicates otherwsie.

[Synove]

Have you had him evaluated for an Autism spectrum disorder?  Also check out the possibility of an auditory processing problem.