3 yr old language/conversation delays

[2brilliantbabies]

Many thanks again for the guidance that I have received so far.  Now, I need to ask a new question.  My daughter, that I have been discussing previously, continues with her inability to answer open-ended questions and actively converse.  Is this something that can be addressed adequately through speech/language therapy?  Is there a larger problem that I am unaware of?  Is there some kind of processing problem? At this point, we have discussed Autism and Asbergers, both of which I do not feel are the issue, unless I am misinformed.  In all areas, beside conversation, she is a happy, healthy, loving little girl.  She is very active, and but does have a somewhat short attention span. She maintains good eye contact, does not care what she wears, eats pretty much anything (if we can get her to sit at the table long enough), is very loving & empathetic.  She doesn't have any unreasonable fears and is not a daredevil.  She can be somewhat shy around new people.  She does speak, answers most yes or no questions, sometimes she ignores us I think.  If someone appears to have hurt themselves, she will run over and say "OK, (name of person)?"  She uses please, thank you, and welcome at appropriate times.  "C'mon (name of person).", "Let's go.", "Gimme", "Hey wook (look).", "Wook at dat!", "Whatcha doing?"; if we are going somewhere its "Go School", "Go see cows?", "Go town" or "Go find Daddy" (fill in with where ever we are going).  She will sometimes speak to inanimate objects or toys..."Hi puzzle", "Hi rock." Generally though, she gets her needs/wants across through one or two word phrases. Instead of I want chocolate milk, its just "chocolate nilk (milk) please." Also at bedtime, its "Goodnite kiss."  Never "I want" or "I need" or "Can I have" I try to get her to mimick me in speaking the correct way and using sentences, but she just echoes the last one or two words.  She said, "Swing please." I said to her, "Audrey, say, I want to swing please."  Again it comes out "Swing please."  When I break it down into two words each: "I want" (she will repeat) "to swing please." (She will repeat.)  Then I will put the whole sentence together and it is still "Swing please."  If she is having a good time she will giggle and say "Hey this is fun."  But if you ask her if she had fun, she will not answer.  The doctor asked her questions like, "If you are hungry, what do you do?" (No answer.) "If you are cold, what do you do?" (No answer.)  I thought maybe she was being shy, so when we got home, I asked her the same questions.  No answer.  Today she got into my wallet and found a picture.  She looks down into my purse, "Hey its dark in dere."  Pulls out her sister's picture and says "Dat's sissy in dat picture." (That's quite good for her, especially if unsolicited.)  She likes doing flash cards, but again, it requires only a one word response.  I have scheduled the first meeting for her speech eval. with the school on 4/27.

[xmsrlong]

IQ testing was done twice, once using the Baley Scales of Infant Development and the one at UNC was the Mullens.  UNC first tried to use the Stanford Binet IV, but that test is largely for very verbal children who can pay attention to very long winded questions.  There are several other tests that are useful but IQ is not stable at this age (2-3).  After 4 years old, the IQ is a little more stable and by 7 very stable.  My son's IQ could go up or down.  In autistic children, the biggest obstacle is cooperation with the tester.

I don't know anything about the TOVA.  With the Ados, depending on which one they use, the child enters the room and their are certain types of toys in the room and the tester.  In our case, we were allowed to be there.  The toys consisted of a ball, some blocks, bubbles and a stuffed animal.  I knew when we entered the room that he wasn't going to be interested in those toys and I said that to the tester.  I told her I didn't think they were age appropriate but that I've since learned that is the point of it.  The tester tries to engage the child with very little language.  Looking for eye contact, imaginary play and adaptive skills.  Adaptive skills is what is really missing in autistic children along with imaginary play.  The point of the test is to see if the child will engage on a social level.

Perhaps your Aunt can tell you about what is controversial with the ADOS because of all the testing done, I think this one is probably the best, even though I don't think it was scored correctly.  Parental reports are just not as accurate because we see things differently than others.  I can send you some studies by email if you like.  Some of them have excel charts with them as well as Power Point charts.  My e.m.a.i.l address is foxglovenursery at at mac dot dot com.  Remove the at at and use the symbol and remove the dot dot and put a . in it.  I had to spell it that way because there are software programs on the internet that troll for that information and we all don't want to get spammed.

[tomel]

What can I expect with the ADOS test? What are some of the things they do?

[tomel]

Where do you get info on the ADOS? I am taking my son somewhere where they do the TOVA test for ADHD and the ADOS.
I have been told some of those test are contraversial. My great Aunt who had been a special needs teacher (who is also a member of MENSA, why couldnt I have inherited that) had told me that. Also, what is used for testing IQ at this age? I didnt think it was done so young.

[xmsrlong]

Autistic Diagnostic Observation Schedule.  Yes, our son has had one of those also.  There are very few people who are well trained to give this test.  There are a few versions of the test depending on the age level.  In his case, any score from 12-22 is in the autism range.  It's suppose to be highly accurate.  When we had him evaluated at UNC, they first did the ADI-R with his mother and me which is an interview that lasted 5 hours!  He scored in the autism range on 2 out of three areas.  However, on the third area, stereotypies and repetitive behavior, he did not score high enough to be considered autistic.  A child is suppose to meet all three areas for a diagnosis for autism.  Then they decided after a couple of weeks that they would give him the ADOS.  He scored an 18 (at 29 mos old) on the ADOS, which I highly disagree with.  One of the reasons he scored that high was a lack of eye contact some anxious behavior and he used very little language.  Once the test was over, I told the examiners that I'll show them how to elicit what they were looking for.  When I played with him, like boys like to be played with, he was talking up a storm and laughing and so forth.  The look on their faces was priceless.  What I didn't understand at the time was that the ADOS is used to push the kids to show the symptoms of autism.  I don't know if they use the test to determine if a higher functioning child has autism, as it is not as apparent unless they are pushed.  I disagree with his score after reading a large study and the scores along with IQ for dozens of children.  Typically, the higher the IQ, the lower the ADOS.  However, in my son's case, his IQ was normal but he had a high ADOS.  I think it should be a 14, not an 18.  I pointed out this seeming contradictory score to the UNC folks and they seemed to be surprised that I went to that level to research it.  Anyway, I don't think it matters now because I'm no longer trying to convince myself or others where my kid is on the spectrum because as he ages, it is becoming all too apparent to everyone that he is on the HFA side.

[xmsrlong]

The first preschool was in a church and they are exempt from the ADA laws.  In our state, we have the infant to toddler program up to 3 which he was in.  After 3, its taken over by the school system if the parents wish to continue.  We live in the south where of course most preschools are run by churches.  Oh, I forgot to tell you we also use probiotics which have made a big difference in the bowel movements.  Until we started using them, his stools were basically "oatmeally" and after they were solid.  We've thought about Montesorri as well but for whatever reason, we took a different route.  As the structure increases for him, he'll struggle more I'm sure because his biggest problem is of course focusing in a chaotic room of other kids.  However, this time last year he was unable to handle preschool at all and we took him out.  He was running for the door and trying to leave.  Now he realizes that it can be fun and most days he enjoys other children.  Fortunately for us, our son is  a very good imitator which will serve him well in learning from school and his peers.  Most ASD kids are not very good imitators.  I've learned that imitation skills are one of the most important prognosticators of whether a child will continue to learn and grow.  Without imitation skills, a child is unable to learn in his natural environment.  Now if we can just get him to use more imagination in play he'll be fine.  He's starting to, but its very slow growing.  You can teach a child imaginary games, which they can learn rotely, but I'm not sure how you teach them to come up with the games themselves.

[tomel]

I was reading some of your blog.  You talk alot about the DSM-IV, I was wondering do you know anything about the ADOS test?