What is wrong with my son

[roxanne9117]

At about 18 months, I noticed my son was still acting like he was about 15 or 16 months.  He would always pull his family members towards whatever he wanted.  We would always repeat a phrase that was not to big for him, hoping he would eventually say it.

My son is now 28-months and says about 20 words and three phrases.  I was concerned when he made 24-months and was not speaking like the other two-year olds that I heard.  I asked his pediatrician at his two-year old check-up; she did'nt not seem concern one bit, and stated that all children learn at different paces; he will get it she said.

Four months later, he still has not improved that much.  Since May of this year, I tried to get him to see a speech pathologist, in which I he was recently evaluated on Wednesday, Aug. 27th.  It was noted that he not only has a speech delay, but he has receptive delays as well.

It is my concern that he has a speech delay, however, he understands every instruction or direction that we tell him to do.  For instance, if I say we're getting ready to go, go brush your teeth.  he will get his bathroom stool, pull it to the sink, get his tooth brush and toothpaste, turn the water on, put the toothpaste on his toothbrush, and begin to brush his teeth.  When he's finished, he'll flip the toothpaste cover closed, turn the water off, rinse his mouth and spit, then put his toothbrush back.  He can get  his shoes when asked, he'll throw away things when ask, etc.  On the flip side he is not speaking.

He also display extremely bad tantrums that are intensified 5xs more than a regular toddler tantrum; all because we can't understand what he wants.  He also bits.  Can anyone explain what may be wrong with my son?

[Rebecca Resnik, PsyD]

Hello,
   it sounds like you have finally received some good information about what is happening with your son. The diagnosis you were given is formally called a 'mixed receptive-expressive language delay'. Like the pathologist, I too would have been concerned that your child had reached 2 and was not able to start putting two word utterances together (e.g. mommy go, want cookie)  In the vast majority of cases, we don't know why some kids take longer to master language than others, but we do have lots of research to show that early speech language intervention helps many children. Routine speech language therapy can help kids catch up to peers and function better at home and school, so take all you can get from your local school system (or find private services as well). Check out the website for the American Speech Language and Hearing Association   www.asha.org to learn more.

  I know it can be difficult to detect a receptive delay based on what your child does at home. I hear many parents who are perplexed by the child's capabilities in the home setting versus test results. If life were all about functioning in the home setting, many kids would not have significant problems. However, children have to be able to do things in unfamiliar settings, solve novel problems, and do tasks on demand. At home everything is familiar and he has been given lots of support for mastering day to day tasks (even by just getting to watch what you do). School is going to be more like the tasks the pathologist asked him to do for the tests, and it is a concern that he is behind same aged peers.

   As far as his behavior goes, I do not doubt that he is far more frustrated than most toddlers. Most toddlers have acquired enough language to be able to make themselves understood (though no toddler can do so well when he/she is upset or angry). I recommend you check out two books that might be helpful: The Kazdin Method by Alan Kazdin and How to Talk so Kids will Listen and Listen so Kids will Talk by Adele Faber. Both of which have great advice for how to avoid and diffuse tantrums.

Best Wishes
Rebecca Resnik