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Autism or just speech delay?
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Autism or just speech delay?

I have a girl who just turned 2.  She is scheduled for an evaluation through First Steps next week, and I am not sure if they can diagnose autistic behavior (not sure if she has it, but a concern).  Also wondering if the evaluation says that she doesn't have any problems other than language delays if I will need to get a second opinion and where I would get it.

My daughter loves to be the center of attention (not autistic behavior at all), loves to play with toys (though not role playing or with dolls which she will throw on the other side of the room).  She also will run up and give you a hug if you hold your arms out.  She will play games with people, but not with kids her own age.  

But the symptoms she does have are:
does not speak (used to say mama and dada but stopped doing that even a few months ago)
does not follow directions and doesn't seem to understand what you are saying
does not respond to her own name (she used to up to about 18 months but no longer does)
arm flapping
hand wringing
not much eye contact (she used to as a baby but no more not even when you talk to her)

Her pediatrician referred us to First Steps, a program in Indiana.  So I am just wondering what to ask them, what to tell them, and what they will do during the assessment.

Just wondering if anyone else has been through or is going through what I am going through at the moment.

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Avatar_f_tn
Hi there,
  This sounds so much like what we dealt with with our own daughter.  At 2 years we knew there was something going on, same things with speech, no receptive language (not understanding),not responding to her name, etc.  We did have her evaluated and she was diagnosed as beign on the mild-moderate end of the autism spectrum.  
  My daughter also loves to be, and did when she was first diagnosed, being the center of attention.  Lots of hand flapping, especially when excited.  She spoke quite early, single words, but then lost words.  Her eye contact was great as a baby, and stayed okay with me, but was very sporadic with others.  I would say this, even if she is on the spectrum it does sound like she is at the same area as my dauhter, mild to moderate.  
  What they typically do at a n evaluation is ask the parents a lot of questions, did she ever/does she ever do this, that and the other thing.  Some are to see if she does what typically developing children do, others are to see if she does what children on the spectrum do.  They may have you play with her while they observe, or attempt to engage and play with her themselves during the evaluation.  They will ask some questions of her, give her some simple directions, show pictures of objects and ask her to identify them.  My daughter was not able to do any of these things when she was evaluated, they did however bring out some puzzle type IQ tests where the evaluator would simply show her how to start doing something and then she was able to complete the task herself.  AFter they tally up all o fher scores they will let you know whether or not she is on the spectrum.  
   If she is dx as being on the spectrum, please let me know.  I would love to be of help to you.  My own daughter is now 3 1/2 years, and is in a mainstreamed preschool doing wonderfully.  Her verbal language is extensive, including sentences, she has a lot of friends, etc.  Don't get discouraged, there are so many things that you can do at home to help her get to where she needs to be.  Please let me know if I can be of any help.  My email is on my profile, feel free to use it.
Good luck!
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Avatar_n_tn
Had the evaluation today.  I have to wait 2 weeks to get the official evaluation back from First Steps, but the 2 evaluators (a speech therapist and an occupational therapist) said Anya was definitely in the autistic spectrum and that she had most if not all of the autism red flags and that they didn't diagnose autism (a pediatric neurologist has to diagnose it and they said to hold off on going to one until she is at least 3) but could recognize symptoms only and address symptoms through therapy.  They went over some things that I can do in the next 2 weeks with her, including recommending I teach her more baby sign language.  IIn 2 weeks I'm meeting with another therapist to go over the formal assessment and find out where she is developmentally.  They were tallying up numbers on a PDD assessment but wouldn't even show it to me since I have to wait 2 weeks to go over it with the therapist who goes over assessments and some other lady is coming with her so I can fill out more forms since Anya definitely qualifies for the First Steps program.  And that visit, I have to pick out the therapists that Anya will have and go over how many times per week she will need therapy.  All this waiting is making me nervous.  How long does it take before she even starts therapy?  If it's 2 more weeks after the going over the assessment thing, that puts us a month from now.  I guess you went through this stuff too.  It's just a little frightening and intimidating waiting and not being able to do too much and wondering if what you do decide to do is right or not.  At least I can look into the sign language thing.

'm not sure what book to pick up on baby sign language.  Or if I should get a video.  I taught her "eat, milk, drink, bed, change me, book, dog, cat, lamp, and more (there are a few more we have been working on that she hasn't used consistently yet)" awhile back, but I had stopped thinking that it would hinder her learning language.  If I only knew keeping on going would teach her more words, I would have kept going.  Some of those I picked up from a friend and others in that list are in the Baby Einstein Baby Wordsworth video.  I don't know what sign language words are essential to communicate and what ones are easy for a toddler to sign.  Would you have any recommendations of what words to teach her next?

Many thanks for your last comments.  It's good to know that there are other people out there who are going through the same things or who have already been through them.  Knowing what to expect takes some of the fear out of waiting.


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Avatar_f_tn
I am sure this is a very frightening time for you.  I am an educator and I am in graduate school, and we are learning a lot about Autism Spectrum Disorders.

You need to push to get her appropriate intervention immediately.  Every week that goes by you are losing ground.  I suggest that you look into a program that uses Applied Behavioral Analysis.  ABA is a method for teaching students with Autism Spectrum Disorder that is based on rigorous scientific research.  You need to get on the web and the phone and find out where she can  go to receive this type of training.  You should also receive services that will train you to teach your daughter while she is at home with you.

I suggest that you read as much as you can to understand what is happening to your daughter.  Find the autism specialist in your school system and open up a dialog there.  While your daughter is undergoing evaluation, you need to educate herself and become a well-read advocate for her.

God bless you and your family.  Feel free to message me.
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Avatar_n_tn
I just want you to know that at your daughter's age developmental disorders are tough to diagnose with accuracy unless the symptoms are severe, prominent, and classic, and that I would not trust a speech therapist and an occupational therapist to make a definitive diagnosis at the age of 2.

Your daughter needs to be evaluated by a Developmental Pediatrician who is capable of doing a full neurological workup. Please proceed with therapy as if she is on the spectrum, but make certain she sees a Developmental Pediatrician.

My daughter was diagnosed as having a severe language delay at the age of 2 years, 2 months, and the speech therapist who did the evaluation suggested autism. We had to wait six months for the appointment with the Developmental Pediatrician, but when she saw him, he said that she was not on the Autistic spectrum. She had therapy for six months, and today, at the age of 2 years, 11 months, her receptive language is normal, her articulation is normal, and her expressive language is low/normal.

You can't say a lot of things with certainty about a 2 year old. Definitely get her help now, but keep in mind those little brains are highly malleable and develop at their own rate.
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Avatar_n_tn
With the right intervention and with everyone involved it is possible to fall off the spectrum, my son was diagnosed with mild pdd nos very mild end of the spectrum he's almost 2 yrs.  I'm not so sure thats what it is I feel its a speech dely but I'm taking all neccassary precautions now.  Also look in to Kaprillic acid and acidophuluss sometimes it can be yeast build up on the brain like the kind of foods the child is eating.  You can het this at a health food store.  I do this for my son and his eye contact has gotten better as well as his other symptoms.
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Avatar_n_tn
i am really glad i have found this post as my son is 17 months old he is now walking hes not talking he only says mama and dadda when you speak to him he doesnt sem to be listening to you he doesnt give you any eye contact hardly my husband has said he thinks he might have Autism we have a health visitor coming out on monday to see him
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325405_tn?1262293778
If you live in the US, just see if/when you can get him in to the Birth to 3 program your state has.  Usually they don't start kids in it for language/speech until 18 months or later.  24 months is when most kids start going in for speech.  The not giving eye contact and not hearing would be receptive language, and he may qualify for therapy.  If he has sensory issues you might be able to get an occupational therapist (OT).  OTs can help with the eye contact issue as well.  Just keep working with your son.  Our daughter didn't start therapy until 25 months.  She could have started earlier, but not sure if it would have helped too much.  Her developmental therapist said that only in the last few months has her receptive language part of her brain started developing.  And she's saying a lot more words now (though many times we have to prompt her to say them).  She's about 32 months old at this point.  She recently received a diagnosis of PDD from a developmental pediatrician.  He felt that she is too young to assess if she has autism or PDD-NOS at this point (he said it may be possible she outgrows some of the things, but he said many quirks she will have for the rest of her life but also pointed out that we as her parents had a lot of these same behavioral quirks).  

Anyways, I guess the point is that don't worry too much, but stay on top of things and ask the pediatrician lots of questions and try to get referred to get a free evaluation by a team of therapists.  Never hurts to get a free assessment.  When our daughter was 18 months old, we had concerns, but we decided to wait 6 months because of a family history of late talkers, sensory issues, people with OCD and other neurological disorders (myself and my husband included among those).  I don't think our daughter would have started talking any sooner, but she may have been better off with an occupational therapist dealing with some of her sensory issues.  Sometimes sensory processing can affect receptive language.  Part of it is also just when that part of the brain develops, as well.

The most important thing I think is to encourage your son in developmental areas and things he's good at, congratulate him a lot, and give him lots of praise about things.  Our daughter is good at so many things, and we've continued to encourage her in those areas rather than obsessing primarily on all the things she can't do, like all the language stuff.

If you want to PM me if you have questions, you are welcome to.  
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470168_tn?1237474845
If you go to the autism forum you can click on the Health Page link.  I've posted the diagnostic criteria for autism and some people have posted examples of their own children's behaviour to give examples.  You might find that helpful.
If you think your child has any sensory issues I would recommend you google the name Olga Bogdashina and read an article by her in Autism Today.  If that sounds relevant you can buy her book Sensory and Perceptual Differences in Autism and Aspergers.  This book has a questionnaire at the back which parents can complete to get a sensory profile of their child.  This woman is reputable and her questionnaire is used by the autism department in our city.  She was also invited to speak to professionals and parents in our city.
If she has problems with speech these are usually pragmatic.  You can view a goog explanation of semantic/pragmatic speech disorder on http:// www.hyperlexia. org/sp1.html (but take out the spaces).
I would recommend you get in touch with a parent support group because you find out alot of information through them.  Some of these groups also organise social activities for the children which is good.
I would also get in touch with a parents advocacy service so that you can find out what your rights are and what your child is legally entitled to.  Unfortunately budgets tend to run most things, and supports are usually provided to the basic minimum level.  If you get clued up you will have a better idea of what you can ask for and what should be provided.
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762323_tn?1281404599
Hi! I know its been more than a year since you posted your message, but I would like to know how your daughter is doing right now? I have my 1 year and 10n month old son see a Behavioral/Developmental Pedia  a week ago. My son also shows some signs that you mentioned on your message last October 2007; speech delay, not responding to his own name and seem to be deaf but can perfectly hear well (He had his ABR test a few days ago, so we ruled out hearing impairment)He used to line up his pairs of shoes before, but now he doesn't do that anymore. He also has limited eye contact and inconsistent with following directions (sometimes he does but most of the time he doesn't).But he seem to be enthusiastic to see and play with other kids and plays with toys the proper way. His Behavioral Ped said that it's kinda early to tell if he has PDD or Autism at this age, and we have to wait until he reaches 36 months for his diagnose to be finalized. But we need to take actions right now to help my son by Occupational and Speech therapy and temporarily enrol him in a  SPED school for socialization. I must admit that I'm kinda apprehensive of enrolling him in SPED with worries that my son might asimulate the behavior of his classmates if they are of severe cases. I was thinking of having him enrolled in a playschool instead, but the Ped said that teachers in a mainstream playschool are not equipped nor trained in handling such cases as my son's. However, the Ped assured me that  he will be joined to a class with 2 students with the same problem (speech delay) and age bracket, and the class will be handled and managed by an experienced SPED teacher. Once my son improves, he can be pulled out in SPED and have him enrolled  in a mainstream play school in a few months. Of course this will all depend on how my son progresses. Anyway, I'll be glad to know about your daughter's at this point coz it's encouraging to hear from other parents who have or still currently experiencing the same challenge with their chidren right now. I wish Anya the best and to you as well..God bless.
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Avatar_f_tn
Hi, may I please get your email address? I have a 28th month old son. He knows a lot of words, knows all the alphabets, can count, can name colors, shapes, animals, body parts, can do phonics (he knows all sounds of each alphabet. He loves reading books (pretends to read books) and singing. He plays correctly with his toys. My concern is he does not seem to understand instructions and does not respond when asked unless the question is educational. He understand basic instructions like wash your hands, kick the ball, shoot the ball, eat, drink, etc.  He has not constructed sentences yet but can sing songs like happy birthday, head shoulders knees and toes, old mcdonald, etc (some words are not perfectly clear yet like ha-day to you for happy birthday but understandable). His eye contact is not consistent. He used to say yes or no to respond but not anymore. He does not call us mama or dada (he used to say dada). I know he knows how to say mommy, daddy, baby, etc because whenever he sees one, he could say it. He can say his name but when you ask him what his name is, he will only respond when he feels like it. He has a great memory, especially with puzzles, blocks. He loves to color. He can tell me what he wants to watch like "Marney" for Barney, Wego for Diego, etc. He does not point but will lead me to what he wants like he will get my hand and lead me to the pantry or he does the food searching himself when he is hungry. Please advise.
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