language delay in 3.5 year old

My son is 3.5 (will be 4 end of December).. He has had speech delay since speech developed. He has always been a bit behind his peers.  The pediatrician was never concerned and didn't validate my concerns until he turned 3.  Then she referred us (with my demanding) to have a speech evaluation.  It showed he was about a year delayed in both receptive and expressive language.  We started services about two months ago. We actually started both speech and OT because we started to notice some sensory issues- most noticeably his anxiety around screaming children/crying babies.  We also noticed him getting overstimulated in a crowded pool with a waterfall/waterslide... the water would fall on his head from the waterfall and his eyes would roll back. He was smiling and enjoying it, buuut it looked weird.

He has done OT and speech for the past month or so.  We have seen great improvements for him.  He still struggles with his panic and anxiety around babies crying, but is getting better.  We recently brought home a new baby, so this has been very challenging for him and us.  

So, his speech is growing lots.  BUT, we are now noticing that his speech is lots of repeating things we say to him. Short conversations between he and us often resurface weeks later. They are usually in context and not random.. For example We tell him "you go pee pee on the potty and you will get a treat"  He is currently sitting on the potty and says "you go pee pee on the potty and you will get a treat. Yaah, a treat" That is just one example.  There are a million.  

I have read about echolalia.  He doesn't do much repeating questions we ask.  

Now, we have also noticed some auditory processing issues.  The OT has said he has many symptoms of SPD.  Autism was ruled out by an evaluation through the public school system.

It should also be noted he was adopted internationally from a 3rd world country around the age of 6 months.  We know for certain his time in utero was difficult and that his birthmom was quite stressed the entire pregnancy.  He was born possibly early weighing 5lbs.  At 6 months of age he weighed 12lbs when we brought him home.  He is now quite tall (95th percentile) and healthy (75th percentile for weight)

My question:
Is the repeating of phrases and snippits of conversations from the past a part of his language developing?  Should we be concerned?  We are about a month into speech therapy.

Thanks

[Limonada]

My first thought is that you might want to consider an evaluation by another pediatrician.  It's great that you finally got the referrals for speech therapy and OT, but you might also want to request a referral for an overall cognitive assessment by another doctor - from you described, it sounds like yours wasn't taking you very seriously.

My son will be 4 in October.  At 2 years of age, we'd noticed that he was behind his peers as far as his speech was concerned and our GP first sent us for a hearing test (which came back fine) and then referred us to a local childrens' centre for an assessment by a speech pathologist.  We had to wait 5 months for this, at which time they confirmed the delay and he was put on a waiting list for a group class - 6 sessions.  We noticed only slight improvement after completing this - it wasn't until he did individual sessions one on one with a speech pathologist last summer that his speech really began to take off.  We also moved him from a home daycare to a more structured, formal daycare centre in October and I cannot tell you what a difference that has made!!  

As part of the assessments done by the childrens' centre, we were referred to a pediatrician for an overall cognitive assessment.  The ped had been worried that our son had autism before seeing him, based on nature of the report sent to him by the centre, but when he actually saw our son, he concluded that he was a normal little boy whose speech delay was unrelated to any other issue....he was just a late talker.  He made a follow up appointment for this coming September but indicated that we only needed to keep it if we were concerned about his progress.  I just cancelled it because DS' speech and vocabulary has grown by leaps and bounds...he's doing less repeating of what we say, more initiating and speaking in complete sentences.  He can also be understood - most words - by other people, not just DH and I who spend the most time with him.

So what I would recommend based on my experience, is a) you see another pediatrician, if possible and b) you give the OT and speech therapy a bit of time.  Our son has been in the "system" for almost 2 years now, but it wasn't until he'd had an initial assessment, a session of group classes, a follow up assessment and a round of one on one classes that his speech really took off.  It does take time, and children respond differently to different kind of environments and therapies.  From the very beginning, I figured that our son would respond better to individual teaching, but they insisted that a group approach was better for children that small.  Once he was able to sit and do exercises one on one with a speech pathologist, he did so much better.

Good luck - and congratulations on the progress your son has made so far, even after just a month of being in speech therapy...that's fabulous!!

[specialmom]

Hi, I too am a mom of a child with sensory integration disorder.  It is quite interesting how it affects a child and each situation is different.  I also noticed that some things will disappear and new ones will crop up but overall, the things that are the most problematic tend to intensify with age.  

With regards to speech, it can often be delayed actually due just to sensory rather than a general language delay.  If a child has trouble with motor planning, they will often have trouble with speech.  For example, if someone asks them a question . . . the brain has to process what has been said to them and organize it so that they can understand it.  Then the brain has to organize the response.  Then the third step is to send the message back out to the oral motor group to articulate the words.  Any kinks in the nervous system along the way will delay the process and sensory integration disorder and issues with motor planning are the culprit.  Other areas that you may see issues with motor planning start to surface is in the area of fine motor tasks.  Anything new may be avoided completely or be very difficult for a child.  They may not want to use scissors, hold a pencil, coloring is a dreaded task, or using tongs is out of the question.  They just act not interested but in actuality, they are avoiding it because it is hard.  (I used a hand over hand approach to do a new task).  These kids often wander the preschool room as well and find it difficult to sustain a task there.  (usually it is better at home where they are in control of their environment).  I've found that doing what they call "heavy work" in the occupational therapy world will help calm and organize the child's brain so that they can take on a task.  This includes things like doing animal walks including the crab, leap frog, slithering like a snake or bear walk.  A child can jump up in down in place.  They can push a laundry basket with some items in it to give it some weight across the kitchen floor.  Actually crawling on the hands and knees is "heavy work".  And a piece of chewing gum gives a quick organizational affect to the nervous system (we did this on the way to preschool!)  All of these things (and a zillion others) worked really well for my son.

Auditory processing is another thing that your OT will begin to work on. What I really love about occupational therapy is that it addresses the nervous system directly but also they begin working with a child to fit into the world in which we live in.  They work on classroom strategies so that a child can succeed in school (even in preschool), eating strategies, ways to handle regulation/modulation problems as these kids can be a bit volatile.  

So, in answer to your question------ yes.  It sounds like a processing issue as to why he is repeating things.  I think this will improve over time.

I'd google "heavy work" and sensory processing or integration disorder to get ideas (or ask me as we do it every day) for things that will help the overall picture.  

My son has been doing occupational therapy for 2 years now and we've seem a dramatic improvement.  He's going into first grade next year and I hope it goes as well as kindergarten.  We're been thrilled with how things are going thus far.

One side note, language issues can often lead to a child that struggles socially.  I'd try to set up one on one play dates for your little guy that are rather short and you are there to help him through.  Self esteem can take a hit without this help.  

Wishing you lots of luck and if you ever have any sensory questions, please ask.  Your son sounds like he is coming along great and you've done everything right to start early intervention.  I wish you and your boy much success!