Child Behavior Community
14.2k Members
Avatar universal

is it speech delay or autism. Pleas help.

My son is 3 years and 9 months old. I am bit worried on him. I am not sure if this is speech delay  or any other issues Austism.

• Developed  his speech, I mean conversational like. He speaks 2-3 words and communicate all his needs
• He also know A to Z and 1 to 20 and he can know all the items in a picture card like if you ask him to pick the card for a “baby crying “ he would pick and give it to me and say “baby crying”
• Does not like school much. May be he went to pre school only a month back ( when 3 years and 3 months ). He sits there only when his mom is around. When she is around he sit there in her lap and attends class. He was home schooled till then.
• He has no hearing issue.
• He is a picky eater but now days he has expanded his choices of food.
• Some times he likes to play with other kids and some times not. He speak English but the kids he plays with does not know that and they speak Indian language. At home we speak to him in English as he is coming back to Australia soon.
• He did not know till 10 days back to hold pencil in 3 fingers. My wife taught him for 3 times now he holds and draws. Initially he used to hold it the way the Curious George monkey character holds it.

Social -
• He appears to hear what others talk even though we feel is tuning us out as later we can see that he had heard and understood what we were talking
• He connects some times with people very well especially adults and kids and some times he does now. He likes grown men more. He also sometimes would jump to a stranger and be very comfortable with them.
• He prefers to be touched cuddled..
• He like peek-a-boo and play games like cooking food, playing doctor etc
• He understands others feeling like if he did something bad or naughty then he would look at his mom and would say “Sorry Mamma” with all right facial expression
• He hears when he is talked to understand everything even does 2-3 part instructions like “ Bring the shirt and close the door for the cupboard”
• He likes to scribble and would show what he has done
Speech and language
• He speaks with right tone and pitch. He likes to speak  to me in length but not very clear. Most of the time it is 2-3 word sentences like “ Need a water” etc . But what he says is clear.
• He does some time repeat what is asked like his name but some times responds correctly.
• He  clearly knows to communicate his needs. If he does not know something he would  hold my hand show me what he needs.
• He does not engage in conversation.
• He like to watch TV a lot. We have recently cut down is cartoons.
Non Verbal Communication -.
• He has very good eye contact actually he really looks in to the eyes with affection.
• His facial expression matches what he says.
• He can easily pick up facial expression of others like if I am upset or angry at him.
• He makes a lot of pointing gestures when taken to a mall and all  
• He is not having any sensitivity to smell noise etc
• He walking posture and general composure is good.
• He likes to play with me like kick the ball, throw the ball, catch the ball, push toy cars.
• He lines blocks and stacks but he is no obsessed with it. If I remove he is okay and move out.
• He does not have any issue in adapting to changes like his bed changed etc
• He like Thomas train very much and play with it like pulls the lever stops the train and the release it.
• He likes to out side always in the garden. We have fish pond he likes to see the fish birds etc
• He is bit tidy and arranges the book on my table evenly but if I change it he does not mind.
• He does not repeat actions or flaps hands

Thanks for reading till here. Will my son improve ? Any valuable inputs much appreciated
8 Responses
Avatar universal
Your son may be confused by hearing two different languages.  Always encourage him to use his words, and say to him "use your words."  Einstein didn't talk until he was 4, so I wouldn't worry too much about your son, he sounds very normal.  But you need to encourage his usage of words, and if you speak English and he speaks English, he may be finding it difficult when playing with other kids to communicate.  It's got to really confuse him when he says something to a child who speaks Indian and they don't understand him, and he doesn't understand them.  Kids learn a lot from each other, and this may also be impairing his social skills which you can understand.  It sounds like his only play mates until pre-school spoke Indian, so he may feel withdrawn when around other children in fear that they won't understand each other.  He obviously knows his words, but has found them useless around playmates.  Keep talking with him, and encouraging him to use his words.  Once he has playmates that speak English I think he will improve.  
973741 tn?1342346373
Hi.  Well, your son does not sound autistic!  That is good news right?  I think that he sounds like he comes from a loving home and that you are taking good care of him.

I would go ahead and get his speech evaluated by a speech pathologist at this point.  My son was your son's age when he attended preschool for one half day a week.  He had difficulty acclimating, trouble with fine motor skills to the point he'd avoid them (involved holding a pencil and using tongs), had articulation issues with speech and tripped a lot.  He also didn't want to participate in the classroom circle activities an tended to wander the room.  I wrote it all off to immaturity.  

I was wrong.  My son has a developmental issue with his nervous system called sensory integration disorder.  The first thing I did was have his speech evaluated.  It was within normal.  But I needed to know this.  If it wasn't, we would have begun speech therapy.  I agree that the two languaged may be confusing but that is the case with a LOT of little kids that do just fine under those circumstances.  What I started doing for my boy was speaking slowly and using proper mouth and tongue placement when speaking and having him watch me.  I also did exercises for the mouth----------  put on music and play freeze with funny faces (turn music on and off), run tongue along bottom lip, move it side to side, do tongue push ups.  I purchased a cd called "speechercize" which we really like.  Drinking thick liquids out of a straw such as milk shake, smoothie, apple sauce, blowing a cotton ball across the table, blowing bubbles into a cup with a straw, blowing bubbles in general and sucking a lolli pop all work the oral motor muscles.  All enhance speech.

Kids of your son's age are just coming out of parrell play--------- meaning they play alone but along side another child.  He should begin interacting with his peers.  This comes naturally for some kids and not so much for others.  A language barrier or speech issue will make it more difficult for sure. What you do in this case is socialize him like crazy. Take him places---------  go to the park and play with the other kids.  You or your wife stay with him and guide the games and interaction.  Chase is a biggie at that age.  Good because the kids are excited, interacting, and you are also working on the nervous system.  Have another mother and their child over to your house for a play date of 1 to 2 hours.  You oversee the kids and have things in mind they can do.  Even the simple game of rolling a ball back and forth can entertain kids of this age and allow for positive social interaction.  But your goal is to expose him and help him learn how to play with kids (also at home, you are like a peer in that you make him give you turns, share with you, you win games sometimes . . . so that he can handle that with his age mates).  

My son's speech issues and fine motor issues were due to something called motor planning.  This is how the brain tells the body to do something and organizes itself to do it.  Scribbling is not uncommon at your son's age.  But working on the proper grip early helps later on.  I found hand over hand helped------- actually placing the hand on something like scissors or tongs and showing my son helped him get the input to the brain how to do it.  And with coloring and grip--------- break your crayons in half.  It forces a better grip.  They also sell short little crayons for this purpose and it is all that is used in an occupational therapists office.  A short pencil like which is used in golf is also the best to use and a grip on it is helpful.  Start by having him trace shapes.  That is pre writing.  To draw---------  take a piece of paper for each of you----------  you draw something like a shape that will build into something else and then he copies you.  But honestly, at his age----------  I'd not be concerned about scribbling.  

We had our son evaluated by an occupational therapist to diagnose his sensory integration disorder and have been seeing an OT once a week since.  Amazing how far my son has come!  One thing that really has helped is the physical or "heavy work" we do with him.  He's at a park every single day running, jumping, climbing, rolling, skipping, swinging.  He swims.  He kicks soccer balls, He hits a ball with a bat.  You could fill up a laundry basket with items so it is weighted and have him push it across the floor.  Play push up where he pushes the wall as if to "push it over".  Have him jump on a mattress on the floor.  All of these things work directly on the nervous system and help organize it.  
Good luck
Avatar universal
Thanks a lot  specialmom and mammo ! It helps.

I am bit sad today. Today we took him to a developmental paediatrist.

At her office he exhibited some signs of classic Autism.

-Like The Dr gave him some blocks he stacked them
-He gave him some toys he line it.
- She gave him a car and turned the wheel and started looking.
-One toy fell down and he picked to get it and his head bumped and he did not cry, just brushed it off.
-When he was playing the Dr called his name and some times he responds and some times now and that he would look at her between his fingers.
-The Dr said he has eye contact but not that much.

The Dr said he shows some signs belonging to Austism but not fully. He said his speech is also delayed compared to other kids. She said he have BORDERLINE AUTISM but that also not sure and she wanted to see him next  month again after his speech therapy.

We are bit confused now as -
- He never lines up toys at home and and even if he did and I remove he will move to some other game.
- With car he always pushes it around it at home and play with me like he pushes to me and i push it back
- He really looks into my , my mothers , his fathers , grad fathers eyes affectinately
- He hears his name when we call and he responds to instructions.

I was freaked out to see what he was doing in the Dr office !

Does my Son have Autism ? is this bordeline autism curabale or can he out grow it ! Can he learn and live a normal life !

Many thanks in advance for any advise !

Avatar universal
Also ,

-He is 3 years and 8 months now and HATES hair cut. he screams like anything for this :-( Is it normal ?
- He used to love brush his teeth and now a days he is not interested
- He is fully potty trained now which he never used to be and hardly wets his nappies.

We are so confused. Any advise or experience sharing would be a GREAT help !

Avatar universal
She said he have BORDERLINE AUTISM but that also not sure and she wanted to see him next  month again after his speech therapy.  --  your words

Our nephew has been diagnosed with PDD-NOS (pervasive developmental disorder - not otherwise specifice) which is a high-functioning form of autism.  Today he is an adult - holds a responsible job, attended college, and is a father to a wonderful little girl.  If your son is indeed "borderline autistic", he can lead a very happy and productive life.  But, if autism is the issue, then do not hesitate to get immediate help and intervention - it will make a huge difference in his future.  All the best ...
973741 tn?1342346373
I want you to know that those are also signs of sensory.  Not feeling pain is an underactive nervous system.  My son did all of the same things with blocks-------- stacked, lined, etc.  He'd stare at wheels as well.  He is not autistic but has sensory integration disorder.

I'm on the way out the door but I will come back to this post upon my return.  Don't fear.  They do AMAZING things with children these days-------- really amazing.  My boy has sensory and you'd probably not know unless you knew what to look for after early intervention.  I'll get back to you in  a bit.
973741 tn?1342346373
Okay, I am back and have re read the whole post to refresh myself.  

Again, I speak from the experience of my son and the numerous things I have now read about developmental delays (of which speech, autism, adhd/add, and sensory fall under).  I don't fully know what your physician means by borderline autism.  

My son did much of what you describe your son doing in a doctor's office.  I have a question for you--------- can you put the blocks in a certain structure (such as a stair step) and have him repeat it?  That is a motor planning test that occupational therapists give little ones and my son was your son's age the first time he was evaluated for sensory.  My son wouldn't do it and they said then that they didn't know if it was motor planning or if he would not veer from his own plan.  But it was a flag.  Quite quickly after that appointment, I would play the game of building something and asking my son to copy it.  He got better at it.  The other question I have is---------  when your son holds a train by a train track---------- does he pretend the train is driving on the track?  Does he pretend the car is a car and he drives it, says vroom vroom or anything?  That is pretend play and you want to look for this.  Some kids have trouble organizing play due to motor planning----------  we did something called "floor time" to help our son organize himself into a play situation.  But he wandered a bit as a young child.  

I think a speech evaluation is excellent and I'd go ahead and try to do an occupational therapist evaluation.  OT's work with sensory kids and autistic kids and can maybe help you see where you are headed in terms of a full diagnosis.  Kids LOVE ot and that is where my son learned to hold a pencil correctly and write his letters.  Much of it is play for the nervous system as well which helps a child with any nervous system issue.  They also direct a lot of focus to social skills and behavioral aspects of a child.  But I think it would be worth a visit to see what they say.

The issue with a hair cut, hair brushing, etc. is sensory related most likely.  Look up tactile defensiveness.  We still have this issue at 6 with my son.  

I also employ anything I can for my boy.  I'd start googling autism, sensory etc. and take bits and pieces from everything you read and start implementing at home things that may help.  I've used autism tools for my boy even though he does not have autism, adhd behavioral techniques even though he does not have adhd, etc.  

It will be okay.  Early intervention does wonders.  Feel free to message me any time if you need anything including just support.  Good luck
Avatar universal
Thanks for the encouragement Jdtm !

Thanks a lot specialmom !

When I show my son to build a shape he would do it not that frequently but some time.

Also he does play pretend play , like he play COOKING with utensils , he uses fishing rod to catcg fish ( platic ones ), he has a doctore kit and uses the stethescope there….

He has Thomas train characters and make them run on tracks ( does not make sound though ), he has cars and he pushes them around, he can recoganize shapes in clounds…

The child development paedeiatrician mentioned that he shows some signs which are seen in autistic spectrum but not fully. So she is not able to tell fully what it is and she said it may be a borderline case of autism but again she was not sure. She said she wanted to see him after a month after his speech therapy.

The areas which she told that made her feel this way are -

He has eye contact. But not that good. When she asked him his name ( he was playing ) some times he did not respond and some times he did. He also looked at her between his fingers.
He lined up  rings given.
He stacked the blocks.
He was given some other clored blocks which he tried to put in mouth.
She gave him a  car, it had a noisy wheel, the moment he saw it he looked at the wheel.
A toy fell down and he took and slightly bumped his head and did not cry.

Now the strange thing is -

Generally he si AFRAID of doctors. This doctors office he just came in cooly.
He play well with his toy cards at home. he pushes the same to me and I push it back.
He has blocks at home which he stacks and lines up. If I try to pull one he would take it back and tell me No No. but he is not obsessed. If some other things are shown he moves out.
He likes to have his THOMAS TRAIN always  RUN on track in back ground even if he is not playing. Now I have removed the thomas train and he is not interested it any more

I mean basically he is not obsssed with anything. he does lining, stacking , pretend play etc etc. He likes to watch birds fish etc. he likes to play merry go round.

The main isssue we are sick worried is

He , at 3 years and 8 months, speaks only 3-4 word sentences that too on his needs and what he wants. he does indulge in conversations and some echolalia , like he prompts back what we tellhim.
His pronounciation is good and more of the time his teachers understand what he says.
He babbles a lot
he says his ABC  till Z and loves to say it again.
If I aask him "How are you ?" he would not say anything and look interested. I would say "I am fine", he would repeast back.

I mean he is not interested in conversing or asking questions. Also he is not that keen to mingle with peers I mean if any peer approaches him he would just show karate to them. Ocassinlayy he like small babies standing laughs seeing them and hold their hands. he also likes adults like if the driver of the school bus call him he would go to him and he would pick and keep him.

We are confused what is wrong with him. I mean he shows some signs of autism which I read on net and also some signs of Sensory disintegration disorder but not sure what is he.

We are worried if he would ever talk in conversational mode, would he make friends, would he be able to go to normal school and learn, would he able to lead a normal life ?

Most of the kids, we have seem at 3 year 9 months speak weel have conversations, ask questions etc. Looks like he is having more than 1 year of expressive speech delay. But he can understand language can follow 2 -3 part instructions like " Pick the shirt, close the door and bring it to me". he also know to wear his shoes and dress by him self and never wets his nappies and tells when he needs to go to bathroom.

I mean can he be independent !

Lot I wrote thanks for readu till now. Would love to talk to some one on this.

Have an Answer?
Top Children's Health Answerers
189897 tn?1441130118
San Pedro, CA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Fearing autism, many parents aren't vaccinating their kids. Can doctors reverse this dangerous trend?
Is a gluten-free diet right for you?
We answer your top questions about the flu vaccine.
Learn which over-the-counter medicines are safe for you and your baby
Yummy eats that will keep your child healthy and happy
Healing home remedies for common ailments