Intro and so many questions (LONG)

Lovenyc

My 25month old son has a speech delay. He has just a few words but I've always felt he understood everything being said around him. He follows commands like "let's brush your teeth" "throw that away" "go get your jacket"...

A little background: He has battled chronic ear infections since 4months of age (as soon as he started daycare) He has since had 2 sets of tubes and had his adenoids removed (in July)

I've noticed his language just hasn't progressed and he is way behind the peers in his class. I raised a red flag w his pediatrician at his 18 month checkup and at approx 22months. he said "let's just see what happens" He felt his chronic ear issues might be a factor in the issue.

I asked daycare for a recommendation for a speech therapist. The outside speech therapist "met" with my son at daycare yesterday. the teacher told me she observed him for approx 15-20 min. I get a call from her last night and she basically said she thinks there's something wrong w him She said she thinks there's a "sensory" component to his issues

I asked her why and she said the following

1. the teacher took out a box of toys and ALL of the kids were interested in the toys and julian just wanted the box

2. she asked him to get his sneaker and he didn't

3. most of the kids were sitting at the table and he was laying on the floor

4. he is trying to bite kids

5. he wasn't able to point to simple objects in a board book

i was literally blindsided

I said "are you saying you think my son is autistic?"

She said "i don't make diagnosis. but no i don't think he's autistic but i do think there's a bigger problem than just speech" She told me I need to get a referral for early intervention.

I looked up "sensory intergration" issues and he simply doesn't fit the bill. I am not in denial or sticking my head in the sand but it's just not sitting right in my gut. I feel strongly this is a speech issue. I plan to have a lengthy discussion with his doctor tomorrow at his 2yr checkup. I guess I'm looking for any advice on what my next step should be.

kcisthebombdotcom

Speech delays are often caused by sensory issues. Not every kid with sensory issues has autism. Regardless, it seems like there's more going on based on the speech therapists observations so it would be wise to get an ei referral and ask your pedi for a developmental pediatrician referral.

Lovenyc

Thank you. I spoke to the director at the daycare and she was also taken aback by the therapist's evaluation. The school has not observed consistent red flag behaviors. I plan to have his hearing checked again in a couple weeks. I will be calling EI for an evaluation. I also looked for the top developmental pedi in my area and the website specifically states:

" Even the smallest or a fluctuating hearing loss caused by multiple middle ear infections can negatively impact speech-language development. Milder hearing losses are more difficult to identify during the course of everyday activity and can more often go undetected."

kcisthebombdotcom

Lovenyc said:

Thank you. I spoke to the director at the daycare and she was also taken aback by the therapist's evaluation. The school has not observed consistent red flag behaviors. I plan to have his hearing checked again in a couple weeks. I will be calling EI for an evaluation. I also looked for the top developmental pedi in my area and the website specifically states:

" Even the smallest or a fluctuating hearing loss caused by multiple middle ear infections can negatively impact speech-language development. Milder hearing losses are more difficult to identify during the course of everyday activity and can more often go undetected."

I would absolutely be finding a new pedi too. Someone who wants to take the wait and see approach with a kid who has documented issues with hearing isn't a good one. Since the slp thinks there might be sensory issues you may want to have ei bring an ot in for a sensory profile. I was completely shocked my son was dx with sensory issues--I thought many of the things they saw as issues were just normal two year old stuff. Treating those issues helped him learn to speak and he's doing great now. While middle ear infections/fluids can cause speech and language issues there are also kids with those same issues who have age appropriate language so try not to assume.

Lovenyc

Thanks. Definitely not assuming anything. Just trying to process a tidal wave of information thrown at me all at once. The resources I have found via the web have not really explained sensory issues in a concrete way. I will feel better equipped once I sit down with a professional who can walk me through what my little guy could be dealing with.

funchicken

"The Out of Sync Child" is a really good book that explains sensory processing disorder. I highly recommend reading it.

Lovenyc

Thank you. I had a very long discussion with his pediatrician this afternoon. The call has been made for an EI evaluation and we will begin speech therapy.

CaptainSerious

What you are describing made me think of my son, who just underwent an auditory processing evaluation.  I wonder, if you look up the symptoms of auditory processing disorders, how many of them remind you of your son?  Maybe that's a place to start?

CaptainSerious

You're right, auntie.  I just read this quickly and missed his age.  Sorry for confusing matters!

Assembly_Reqd

Here's my take on it. (hearing loss mom) You have to adjust your speech expectations based on the age you KNOW your child had full access to all speech sounds. For example, if your child gets tubes at 9 months old, you cannot measure him against other 9 monthers. His hearing age is a lot younger. Most kids will catch up at a faster rate than a day to day correlation, but you still need to adjust your expectations. Most words on average take 50 repetitions before the meaning and the word are put together in you child's brain. That's before they even figure out how to speak the word.

I also agree that your pedi should have been more proactive. If there is a sensory component at work, it will make it even more difficult to attend to the task at hand. Your body is always interrupting your train of thought.

Welcome!

Lovenyc

Thank you. I think my pediatrician (and 2 ENTs) had been hesitant to push for intervention earlier on because his ear issues have been so severe (roughly 20 ear infections in 25 months, give the tubes time to clear the chronic fluid) and he has not presented any other red flags apart from his delayed speech. The daycare director & teachers have been closely monitoring him and he has not shown any consistent red flag behaviors.  Both were taken aback by the speech therapists observations and felt that a 15 min observation was not enough time to make that "diagnosis" particularly when this therapist does not have direct experience with sensory disorders.

My doctor was very thorough yesterday. He said it doesn't hurt to have an EI evaluation. He believes my son's speech is at 18months. He said he would need to be 33% deficient in one area or 25% deficient in 3 areas to qualify for EI. He said he is at roughly 22-23% deficient in his speech. So he might not qualify but it's worth a shot. We are going to get another hearing test done in a couple weeks. In the meantime, we will start private speech therapy soon. 

I have been an absolute wreck for the last 48 hours. I have been second-guessing everything. Have I been in denial all this time? Have we all completely missed the signs? Have all of his doctors missed every sign? I am over-analyzing every single move he makes now and it just sucks. I will do whatever it takes to help my son. There's nothing more in important to me. it's just that none of this is sitting right in my gut. (not to say it SHOULD ever sit right in my gut, but over the last 2 years, I've learned to listen to my gut when it comes to my son and his health)

I kept all electronics off in the house last night. He sat with me and read his books, pointed to objects, tried to say the words. I think my husband and I need to be more diligent about engaging him on a daily basis. 

I'll keep you posted. 

Lovenyc

Assembly_Reqd: I really don't know if he's ever had full access to all speech sounds. The ear issues started at approx 4months and have been non-stop until mid-August. This is the LONGEST he's gone without an ear infection/fluid ever. It's been approx 2 months. Hopefully the hearing test will give us some answers. Thanks for the info!

kcisthebombdotcom

Lovenyc said:

Thank you. I think my pediatrician (and 2 ENTs) had been hesitant to push for intervention earlier on because his ear issues have been so severe (roughly 20 ear infections in 25 months, give the tubes time to clear the chronic fluid) and he has not presented any other red flags apart from his delayed speech. The daycare director & teachers have been closely monitoring him and he has not shown any consistent red flag behaviors.  Both were taken aback by the speech therapists observations and felt that a 15 min observation was not enough time to make that "diagnosis" particularly when this therapist does not have direct experience with sensory disorders.

My doctor was very thorough yesterday. He said it doesn't hurt to have an EI evaluation. He believes my son's speech is at 18months. He said he would need to be 33% deficient in one area or 25% deficient in 3 areas to qualify for EI. He said he is at roughly 22-23% deficient in his speech. So he might not qualify but it's worth a shot. We are going to get another hearing test done in a couple weeks. In the meantime, we will start private speech therapy soon. 

I have been an absolute wreck for the last 48 hours. I have been second-guessing everything. Have I been in denial all this time? Have we all completely missed the signs? Have all of his doctors missed every sign? I am over-analyzing every single move he makes now and it just sucks. I will do whatever it takes to help my son. There's nothing more in important to me. it's just that none of this is sitting right in my gut. (not to say it SHOULD ever sit right in my gut, but over the last 2 years, I've learned to listen to my gut when it comes to my son and his health)

I kept all electronics off in the house last night. He sat with me and read his books, pointed to objects, tried to say the words. I think my husband and I need to be more diligent about engaging him on a daily basis. 

I'll keep you posted. 

Take a deep breath. You don't need to panic that an slp think your child needs to be evaluated for sensory issues. Sensory issues do not always equal autism. Sensory issues could simply be a case of your child's nervous system is a bit immature and with time and therapy will regulate. Try not to worry too much--easier said than done, I know.

southernbelle79

The really good news is... Early intervention can never hurt! If it turns out your son doesn't have any issues, there is no harm by him visiting a therapist. I would rather err on the side of caution than to not get intervention and find out years later that it could have helped him along!

Lovenyc

Totally agree. I made the call to EI. Waiting for a case worker to call me. We will also meet with a speech therapist this week. I have been reading a lot (maybe too much) and everything seems to point to a speech delay. Time will tell.