Speech / language development question (very long, sorry)

nictel

Ok, I've managed to keep myself together the last few months, but a question has popped into my head the last few days, and I wanted to get others takes on this, especially SLP's (although anyone with any info is welcome to post).

Background - DS was diagnosed with Oral / Motor Dyspraxia (childhood apraxia of speech) at around 27 months by an SLP and a neuropsychologist. (Contreversial, I know.)  He had few words, but lots of communication intent - some sounds, pointing, gesturing, bringing items for help, some pantomine etc.  He also has low muscle tone in his core and face due to prematurity.  We were advised he might not speak until 3, and would likely have poor quality of speech until around 5.  He tested age appropriate for receptive speech and cognitive abilities.  ASD was ruled out.  Fast forward 2 and 1/2 months, and he starts speaking.   Within another two months or so he has a few hundred words (many are approximations) and started using two and three word sentences.

For the most part, he has spontaneous speech.  Likes to tell me what he's doing, what I'm doing, what he wants to do, what he wants me to do, etc. etc.  Also likes to talk about what he sees.  He speaks very simply - might say something like "Mama eat cereal" or "Moon high up in the sky" when we see the moon at night.  He answers simple questions like "Where did we do today?" or "Who came over to play?", "What color is that?"  Every now and then he might get a question wrong, such as "Where is the cat?"  He might say, "under the table" or he might say "meow."  Is that echolalia or a processing issue? (Or not paying attention and being 2 and 1/2 with a speech delay?)  I had read that echolalia can be answering a question with something that sort of fits, but not completley.  (Such as meow in the previous example.

Here is the gist of my questions - he does do some repeating of what I say.  For example, if I say, "Mama eats soup with her spoon", he might say "Mama eat spoon."  If I say, "Look the grass is green!", he might yell "Grass green!"  How can I tell if some of this imitating is normal speech development in a kid with possible apraxia, or the beginning of echolalia?  My SLP has assured me that kids with speech delays learn speech partly through imitation, and that some repeating is normal at the age of 2 and 1/2.  She also said that since he's only had speech for about 3 months, it might take him a little while to have truly spontatneous speech (especially for a kid with apraxia).  She also said that even if a kid had some echolalia (although she doesn't really think that he does) it is not enough for ASD - he has no other ASD concerns  - just speech and motor planning, and he has been professionally evaluated due to the speech delay.  His delays in socialization and pretend play have dramatically improved to just about age appropriate as his speech has started to come in, per his last IFSP evaluation

He does NOT repeat TV or full sentences, but sometimes goes around the house "singing" his favorite songs - ABC, Twinkle, Twinkle, etc.  He's hard to understand, but you can usually figure it out.  If I say, "Say Hello", he will just say "Hello", (not "say hello")  Sometimes he will repeat the end of what I said, or a summary of what I said.  If I ask "Do you want to go outside?"  He might say "Outside!" instead of saying Yes.

One last thing - if I say "Good night, Brian" he'll say "Good night, mama."  If I say "Bye Brian", he'll say "Bye mama."  But sometimes when I say "Hello, Brian", he'll repeat "Hello Brian" and laugh.  If I then say, no, what do we say, then he'll laugh and say "Hi mama."  Does he think it's funny?  'Cause he's scaring me a little

So, is my SLP right?  Could this be normal speech development for a kid with delays, possible apraxia?  Or could she be wrong, and could this be echolalia and should I be concerned?

I realize this is long, and the crazy is pouring out a little, so bear with me.  I'm pregnant with #2, and am a little hormonal, and not taking my usual medication for anxiety, while my OB alters my dose. 

jsugrin

My oldest had a speech delay, not as severe, but as he started talking we went through all the same things.  My youngest can speak it long sentences, today he threw out a 8 word one for example, and he does everything you've described too.  My vote is totally normal.  I know my telling you not to worry isn't going to matter but I honestly think these are not things to worry about.  I hope you're OB gets anxiety meds situated soon, I know that's no fun to deal with.

bugmommy

That doesn't sound like echolalia at all to me, just normal repetition.  Both of my guys have ASD and do echolalia to some extent (older DS MUCH more than the younger one).  When DS#1 was younger he would literally repeat the question you asked him - "do you want yellow or blue?" and he would say "yellow or blue".  He recited sections from books, tv, etc.  This stuff he would come up with totally out of context.  We could be at the park and then he would start reciting a book while on the swings.  In your example about where is the cat, my DS would ALWAYS do the animal sound first and then maybe answer the question appropriately.  In your example about the moon, he would say certain things like that every day, but it would always be under the exact same circumstances, using the same words, and with the same tone (like a tape recording).  

I think the fact he can retell historical events (what you did that day) and answer a variety of "wh-" questions is very, very encouraging.  It sounds like he's made some amazing progress in a short period of time.  Congrats to you all!

nictel

bugmommy:

That doesn't sound like echolalia at all to me, just normal repetition.  Both of my guys have ASD and do echolalia to some extent (older DS MUCH more than the younger one).  When DS#1 was younger he would literally repeat the question you asked him - "do you want yellow or blue?" and he would say "yellow or blue".  He recited sections from books, tv, etc.  This stuff he would come up with totally out of context.  We could be at the park and then he would start reciting a book while on the swings.  In your example about where is the cat, my DS would ALWAYS do the animal sound first and then maybe answer the question appropriately.  In your example about the moon, he would say certain things like that every day, but it would always be under the exact same circumstances, using the same words, and with the same tone (like a tape recording).  

I think the fact he can retell historical events (what you did that day) and answer a variety of "wh-" questions is very, very encouraging.  It sounds like he's made some amazing progress in a short period of time.  Congrats to you all!

Thank you for listening to the crazy   He does sometimes try and sing his favorite song, or a song we did at mommy and me the day before, but it somehow seems typical even if we weren't necessarily discussing that particular song.  It seems like he just likes those songs and wants to sing and dance with them, or have me sing them with him. 

He does repeat parts of what I say, but he could never ever repeat a whole sentence or phrase, and not in the same tone.  It almost seems like he's agreeing or confirming what I said.  Example - I say, "Time for Brian to eat dinner!"  and he says "Brian eats.  Momma eats."  Not word for word, but part of what I said.  A confirmation, almost.  He also does it more depending on the tone of my voice.  If I emphasize a word, such as "Brian, look, a FIRE TRUCK."  He'll point and say "Fire truck", as if to say, Yes, I see the fire truck.  (Of course, he can't say that whole sentence, so he just points and say 'fire truck' as confirmation.)

I should add too, that of course, that speech therapy, especially PROMPT is all about repitition and imitation.  He spends 1 hour a day, twice a week, being prompted and told to repeat what was said to him, so I wonder if that might have something to do with it.

Thanks again - nice to know if others think I'm completely nuts, rationalizing a serious problem, or just a concerned mom.  It's hard not to obsess when you have a kid with a delay (and too much time on your hands!).  I'm going to try to get back on the wagon, and as Auntie puts it "Stay away from Dr.Google.  He is not your friend right now."

emilyann21

It sounds like your LO has made lots of progress! I'm an SLP and everything you've described sounds typical. It doesn't sound like he has echolia...yes, he's repeating some of what you say but it's not everything and, as you've said, it's more of a confirmation that he sees the same thing or wants to do the same thing. If you're wanting to get more "yes" and "no's" from him then when you ask him a yes/no question and he responds with something else, say "Yes you do want to go outside?". That way he's hearing the "yes" or the "no".

 As for the saying "hello brian" to himself, it sounds like he's just being funny especially when you said he'll say it and laugh but then will correct it when asked. He might know mommy is a little anxious and trying to make you laugh...go with it. Be silly with him. It really sounds like he's doing well and learning how to express himself and use his words more and more.

Hope he continues to improve!

MaxandRuby

I do not know much about speech but my almost 3yr old (typical) does a lot of the things you wrote about.  So for me I would tell you what he is saying sounds normal.

futrkingsley

Sounds totally normal to me and funny.  It sounds to me like he's trying to joke with you and you aren't getting it. LOL.

As for the repeating, that's what all kids do as they learn to talk.  Heck some repeat themselves over and over (much to the annoyance of anyone nearby!).  DS sometimes gets stuck on a word and will repeat it three times in anotherwise normal sentence.  It's like his little brain is stuck but mostly I think it harkens back to his therapy and his habit of practicing a word that wasn't quite right until he could get it to come out correctly.  So he might say, "The resiree, resaree, referee says no goal." He's 2.5 now and completed one year of speech therapy in December.

meldoo2002

As an SLP that sounds totally normal to me.  Repetition is HOW children learn language.  If he's just getting speech being able to repeat 2-3 words of your sentence is all he can do.  You should be modeling short phrases for him that are around 2-4 words so that he is successful repeating those.  I would be really surprised if he's actually apraxic if he's made that much progress in that little time being as young as he is.  I say YAY to his progress and I hope you have a full on talker very soon!