Toddlers: 24 Months+
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Speech issue and difficult decisions to make

Hello everyone, kind thoughts, advice or experiences are much appreciated.  :-)

Our precious little boy just turned 3 less than 1 month ago.  I have been in tears trying to decide what to do and how to help him the best way I can.  At home, with friends and family he is a pleasant, playful and kind child.  He follows directions at home, potty trained himself at 2.5 and is extremely smart and playful - a JOY to be around.  He listens & interacts as he "should" as mentioned on the developmental guidelines that I've read (other than an expressive speech delay). 

The issues that we're having is that he is delayed in speech (although doing much better with great progress over the past 6 months), and also some sort of social anxiety (not diagnosed, just noticed in certain situations).  It is difficult to explain but I will do the best I can.  With any situation where he feels uncomfortable (doctor's offices and other places where he is being evaluated, sometimes even large groups) he will hug me and not participate or simply cry until we leave.  He is extremely stubborn and usually will not give in no matter how hard we try.  I know this is not always considered "normal" behavior for a child at 3, but at home and out in public places (park, science center, zoo, most other places) he is fine.  We have play dates with other children, go to the pool daily in the summer, have kids over our house, etc...and he does fine around others, interacts and plays.  Sometimes becomes shy and stubborn, but that's just his personality at times.  Overall pretty good though. 

We recently started him in preschool based on his IEP to help him do better with situations that he doesn't want to participate with.  He would cry for hours until I returned.  I pulled him out (not for that reason - although it BROKE my heart each time I picked him up).  We removed him because when I would arrive, he would be sitting at the table with nothing in front of him, tears in his eyes, teachers sitting nowhere near him - not interacting at all.  They didn't use the picture schedule or help him in the ways that he needed while there.  My husband and I were planning on moving him to another preschool but thought it might be better to start him in the fall.  We're due in march with our new little one and we're afraid it might be too much change for him at once. 

Today I tried to start him in speech (which is the only real thing that I was concerned with).  We had our appointment this afternoon and the therapist said she would not work with him until he was evaluated for a developmental delay.  I literally started crying, that was the first person who mentioned that to me.  I've had him in early intervention for speech since he turned 2.  While at speech today he was shy and refused to play with her toys.  This is how he gets at most offices, when I asked him why he acted that way his response was "wanna stay home, mum."  As soon as he got in the car, he was fine!  Smiling, happy and talking.  We went home and I cried to my husband as he ran around and played with his brother. 

Here is the problem I'm having, I KNOW what will happen when I go to get the developmental screening.  They will shut the door to start, he'll say "no" and refuse to participate (as usual).  Then they will want him to go to more therapy which he hates and the cycle will continue.  I've seen progress with him in the past year with these situations that he is uncomfortable with, he is getting better.  In my eyes it wasn't a "problem", he has a stubborn personality -- all kids are different, right?  It is my hope he will continue to grow out of this.

Just a note - some of you may be thinking why start speech but not preschool?  Here is why - preschool was 3.5 hours twice a week and speech is only 1/2 hour twice each week.  He is also familiar with receiving speech (although this was a new office that we were starting).  I thought it would be an easier adjustment for him and also he has about an 8 month speech delay and this was my true worry. 

In my eyes every child is different and will develop in their own way.  I don't want to harm him by putting him in preschool when we're already having a ton of change with the new baby and also if he's not ready (which in my heart I don't feel that he is).  I also don't want to deny him therapy/preschool if he truly needs it.  I see the entire picture of him where the therapists only see him when he is upset and unwilling to participate in these tests. 

Both sets of grandparents were shocked that the therapist today even mentioned needing a developmental screening (because they see him like I do).  It's shocking to those who know him, but I see him at the doctor's offices so I have a better understanding of how he acts in these situations. 

My heart tells me to wait on preschool until the fall but continue with speech services, allowing him to mature for the next 6 months before trying preschool again.

This is really hard for our family, I appreciate your advice!  :-)

Re: Speech issue and difficult decisions to make

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    Bare with me as I'm on the iPad. My 3.5 year old is very similar to your little guy, your description of him when you go places he doesn't really want to be at describes mine to a T. He also has a speech delay . However he is in preschool and receives speech there. If I were you I would contact the school district and see what kind of speech they provide . We did walk in speech for a month or two and then found out our school system provides it, the evaluation was done in our house in his environment and the first 6 months the therapist even came to our house for therapy. My little guy is a wild outgoing talkative boy, at home. At school he is a quiet, well behaved, shy little boy who wants to just take it all in, teacher says he socializes but is not by any means a social butterfly if you will. But each time he goes he becomes more confident and never shuts up about what he did and what all the other kids were doing around him. He's improving everyday (twice a week for 3 hours) and has made a HUGE improvement since his first day ( last fall) .Change is hard for the little ones but if there is a school, or even a daycare or camp where you can drop him off it might be beneficial to have some time where he is away and more independent. Maybe try talking it up or giving him a special item he can take ( I was a teacher, one of my students used to bring a small family photo everyday) will help him get through the day. I think it is good for kids with speech delays to be places where they feel a little uncomfortable, not to the point your son did at his last school but so they do learn to play with other children and interact with other adults, if your gut tells you that he might have a developmental delay than I would have him screened, even if he shuts down ( he may surprise you if the one doing the eval is well trained) . But if your gut tells you that he's fine and that's his personality than I would wait it out. Do what you think is right, you know him best- hang in there he will turn out just fine :)
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    PP above gives great advice ^^

    I'm not in your position but I have a very shy, stubborn toddler as well who is about to turn 3. He used to cry and completely breakdown in new situations, or even around family he sees all the time. I would have to take him into the other room until he could calm down but even then, I couldn't put him down.

    My son has since grown out of this but I do agree with you that all kids are different and they develop differently so this might be something he outgrows.

    What does your Pedi say about all this? I think any and all evaluations that are offered could be beneficial to get. It's better to rule something out than not know about it IMO. I know your heart is telling you one thing, but I would listen to medical professionals on this. Can you get a second opinion? I know you are scared, but maybe you should go ahead and get the evaluation for a developmental delay.

    This must be so hard for you, I can only imagine. Good luck to you.

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    I would ask the therapist to continue working with your son for 3 months and if she still is concerned about a developmental delay then you could have him evaluated.

    My son behaves much the same way. One thing that helps - I have him pick out a few toys from home to bring to the speech therapists office. That helps a lot when he shows her his toys. 

    I'm remembering when my son was 2, we were trying to get a hearing test done on him and he refused to participate. He sat on my lap and refused to look at the audiologist at all, he just stared into space. She even rung a COWBELL next to his head and he didn't flinch. She said, and I'm pretty sure she was joking, "he's either really deaf, or really stubborn". And even though I knew he was just being stubborn it still stressed me out until he passed a retest 6 months later with flying colors....

    Hang in there!
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    Bigboobsmcgee, thank you so much for the advice!  Your little one sounds like mine, he has been greatly improving with age (this behavior was worse at 2 but now I can have a conversation with him and talk it through) and with the advancement of his speech (which in my mind plays a big part with how uncomfortable he feels at times.)

    I totally agree with the evaluations being helpful, but my husband and I are hesitant because in the past 2 months he's had two different new appointments and we're pretty sure he'll act out on this one.  If he refuses to participate in the eval they're going to suggest more therapy and this will increase his anxiety.  This is why we decided to tackle the speech first for a little and then move on if the issues are still there.  It's unfortunate that the sessions meant to help him are the main things stressing him out...that's our problem.  :-(

    He's been to the pediatrician and the doctor has seen him many times at his worst, I've asked if he's concerned with the behaviors and he said that it seems to be his personality.  He didn't suggest that anything would be wrong otherwise.  Up until the speech therapist the other day (who had only known him for 30 minutes at the time she told me to get the evaluation - I haven't heard that from anyone, and believe me, I've asked!)

    I have to follow my heart, I'm 100% in for getting therapy he needs, but I also know some kids need time to mature and I've seen a lot of progress as he's gotten older so far.  I'm trying to tackle one thing at a time and not totally overwhelm him. 

    Thanks again!!
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    QTee you make me feel so much better!  I know that some kids have issues that need therapy and some are just really stubborn.  Our speech therapist from the fall said that he was the most stubborn child that she's ever worked with!  He knows what he wants and when he says "no" he cannot be swayed, he means it!  I'm hoping that this trait will help him as an adult.  :-)

    I'm going to watch him with caution, right now it just doesn't seem like therapy is needed or would be helpful...it might be the opposite for him and make things worse.  Maybe he'll need it in the near future though, I'm not ruling it out. 

    Thank you again.  :-) 
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    My almost 4 year old has been in EI since he turned 2 for speech. He is the social butterfly of the group, so I don't have experience there. My question is why they evaluate him in unfamiliar settings. Put me in a room with people I don't know asking me to do things and I will get a little freaked out (think about a big job interview). I know I have more coping skills than a toddler. 
    DS was evaluated at home with his own toys and some of their activities. It was in our living room with mom and little brother in the baby swing. Of course strangers make things a little uncomfortable but it's better than an office setting especially if that is something he struggles with. 
    DS did twice a week for 45 minutes in a classroom for a summer. It was once a week for 2 hrs in a classroom with some services at daycare and home the next school year. He did the same program over the summer and morning preschool for 3 year olds this school year. It is a 50/50 classroom so half the kids have some sort of delay (most are speech) and half are typically developing. It is wonderful. He gets to be around other kids and they understand some of his needs. 

    It seems to me that you don't have a developmental delay as much as anxiety. I think some structured time without mom might help, but it's hard with another one on the way. We didn't do any big changes for #1 for 3 months before #2 was born. We are trying the same thing now that #3 is set to arrive soon. If your pedi doesn't think there are developmental delays, you should be fine. You would probably notice those before age 3. 
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