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Receptive Language Delay in 27mo

CeeCeeSugaPieCeeCeeSugaPie
in Special Needs

My DS is 27 months old now. He was a preemie so we do see EI to make sure that he is meeting his milestones. At 2yo they did an evaluation and reported that he had a slight delay in receptive language, but that she though tit was more due to him being tired. The only open time they had that day was close to nap time. Anyhow, I was pretty shocked about this, but they said that it was not a big deal and that she hated to even have to mark it that way. The lady from the Parents As Teachers program as well as our pediatrician always reports that he is very advanced verbally. It is so confusing. He knows entire songs and large portions of the books we read at night.

I have recently noticed though that he often ignores people, including me. He seems to have trouble sometimes answering questions. He doesn't always answer to his name. I don't know if this is him just being a stubborn toddler or something more.

Of course, I decided to Google receptive language delay. Lots of links come up to sites about ASDs. My son does have some "odd" habits. He is almost always carrying something, that usually has to do with dogs. It was an empty 101 Dalmations Pez dispenser, a small decorative dog from my kitchen, a slinky dog toy from Toy Story. Whatever he picks, he wants it with him, in his hand preferably, at all times. He even sleeps with it. I never really thought of this as that "odd" before. Am I wrong?

He also is a little socially awkward. I have always attributed this to him not being in a group daycare until recently. He is also an only child.

I spoke with my pediatrician about the evaluation. He said that he did not see any delays at all and to not worryI can't help but worry though. Should I have pushed EI for Speech Therapy? Right now, they just have him a Watch status. I don't want DS to fall behind, when therapy may help now. I also don't want to blow the whole thing out of proportion either.

 Sorry this is so long and rambling.

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Re: Receptive Language Delay in 27mo

  • finsupfinsup member

    Did they give you a percentage of delay or a percentile rank on the delay?  That is key information.

    Some of what you describe could be quirky toddler behavior, but it could also be red flags for an ASD.  The only way to tell is to watch closely and see.

    For me, the wait and see approach doesn't work so depending on the severity of the delay I'd be pushing for more.  In your case if he doesn't meet the standards for therapy through EI you may need to look into a private evaluation or wait until he is 3 to get him evaluated through your school district.  No matter what, a second opinion doesn't hurt.

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  • kcisthebombdotcomkcisthebombdotcom member
    Since its been a few months since his last eval I would call and let them know what's going on. I don't think you should be overly concerned yet, but a receptive language delay + limited response to name/instructions + social delays is worth investigating further.
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  • CeeCeeSugaPieCeeCeeSugaPie
    imagefinsup:

    Did they give you a percentage of delay or a percentile rank on the delay?  That is key information.

    Some of what you describe could be quirky toddler behavior, but it could also be red flags for an ASD.  The only way to tell is to watch closely and see.

    For me, the wait and see approach doesn't work so depending on the severity of the delay I'd be pushing for more.  In your case if he doesn't meet the standards for therapy through EI you may need to look into a private evaluation or wait until he is 3 to get him evaluated through your school district.  No matter what, a second opinion doesn't hurt.

     They probably did, but I would have look at it when I get home. My cousin is a SLP so I may ask her opinion as well as calling EI back. I know sometimes you have to push to get results and I am certainly willing to do that.

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  • CeeCeeSugaPieCeeCeeSugaPie
    image-auntie-:
    imageCeeCeeSugaPie:

    My DS is 27 months old now. He was a preemie so we do see EI to make sure that he is meeting his milestones. At 2yo they did an evaluation and reported that he had a slight delay in receptive language, but that she though tit was more due to him being tired. The only open time they had that day was close to nap time.

    Anyhow, I was pretty shocked about this, but they said that it was not a big deal and that she hated to even have to mark it that way. The lady from the Parents As Teachers program as well as our pediatrician always reports that he is very advanced verbally. It is so confusing. He knows entire songs and large portions of the books we read at night.

    I'd double check around the receptive language delay. Unless he was so tired he was falling asleep and uncooperative, I doubt he'd test as delayed unless he really was delayed. This could be a function of poor auditory processing. Either way, this could play into why he can't answer questions.

    The bolded could be considered a red flag for ASD as well. Being able to recite text from books or DVDs might be related to a strong rote memory or echolalia. DS could recite entire books by your son's age, even turning the pages at the appropriate place. He's dyslexic as well, so it's clear he was working off memory.

    I have recently noticed though that he often ignores people, including me. He seems to have trouble sometimes answering questions. He doesn't always answer to his name. I don't know if this is him just being a stubborn toddler or something more.

    These are sometimes red flags and sometimes just quirky toddler behavior. How did he do when his pedi ran the M-CHAT screening on him?

    https://www.autismspeaks.org/what-autism/diagnosis/screen-your-child

    Of course, I decided to Google receptive language delay. Lots of links come up to sites about ASDs. My son does have some "odd" habits. He is almost always carrying something, that usually has to do with dogs. It was an empty 101 Dalmations Pez dispenser, a small decorative dog from my kitchen, a slinky dog toy from Toy Story. Whatever he picks, he wants it with him, in his hand preferably, at all times. He even sleeps with it. I never really thought of this as that "odd" before. Am I wrong?

    Again, this could be toddler quirkiness, of it could be a so called ASD special interest. When DS was about your son's age, he nearly always had a pair of small toy steam locomotives in his hands unless he was actively playing with some other toy. He sometimes napped with them or with an antique O-guage model train engine.

    He also is a little socially awkward. I have always attributed this to him not being in a group daycare until recently. He is also an only child.

    Most well developing kids are hardwired to interact socially; those who have few opportunities to play with peers typically catch on very quickly. My DS's pedi tried to explain his issues as being an only which is part of why he got his ASD dx just before he turned 7.

    I spoke with my pediatrician about the evaluation. He said that he did not see any delays at all and to not worryI can't help but worry though. Should I have pushed EI for Speech Therapy? Right now, they just have him a Watch status. I don't want DS to fall behind, when therapy may help now. I also don't want to blow the whole thing out of proportion either.

    EI is going to have very specific guidelines to determine if he qualifies for services. Sometimes it's easier to get services if you can demonstrate a delay in another area as well. I'm sure EI is watching his gross motor development- is he where he should be around sensory process and fine motor? Most kids who have ASD do have some degree of differences in how they process sensory input. This is sometimes seen in a limited diet, fussiness about clothing, a dislike of loud noises from sirens, fireworks, automatic hand dryers.

    I have called my EI and am waiting a call back from her. We are very fortunate in this regards, as my MIL is the Executive Director for the state's Governor's Advisory Council for Exceptional Citizens and has a lot of influence in these circles. Hopefully that will help if any treatment/therapy is needed.

    I don't know if the pedi did the M-CHAT, but I will ask him on Wednesday when we have appt for something else. I did the M-CHAT online and plan to print it out to bring to the appointment. Sometimes I get in the Dr's office and just draw a blank so I have to write down everything, especially since DS is usually having a conniption.

    Speaking of toddler quirkiness, I forgot to mention that he used to insist that my hair be in a ponytail. I was quick to write this off as a quirk, but my DH insisted that it was a little odd. I just figured it was because he was used to seeing my hair in a ponytail though. He does have several interests, including dogs, trains, tractors, but whatever chosen item he has decided to tote around is a little obsessive. We lost the Pez dispenser (which was the first "thing"), and he just moved on to different item, aftering getting upset and asking for the Pez dispenser several times. No violent tantrum or anything though. He will scream if I try to take said item from him. Occasionally, he will let me hold it for him while he is doing something else.

    We have seen a huge improvement socially since he started daycare, but he still doesn't seem quite a social as other kids, IMO. Our daycare provider has also noticed that he seems to be a little trouble with transitions as well.

    Thank you so much for everyone's responses. I really appreciate it. :)

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  • CeeCeeSugaPieCeeCeeSugaPie
    I wanted to add that I had a little trouble with the M-CHAT. There is room for some grey area in there. DS points with his middle finger, not with his index finger. He will often bring me things, like if he wants me to read him a book, or help him with something or do something for him, but I don't know that he brings me things just to share them with me, except maybe "flowers" (AKA Dandelions) from the yard. I guess I will have to keep a closer eye on this. I feel like we interact all the time. I have just never thought about how meaningful those interactions are.
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  • CeeCeeSugaPieCeeCeeSugaPie
    image-auntie-:

    M-CHAT has very little grey area. It should specify index finger- not a whole hand or some other finger. #7 is one of the "critical questions". It is part of a shared reference- the child points to something. DS did this at about 9 months- he saw pigeons perched on the Bloomingdale's sign. He pointed with his index finger, said "birds" and looked back at me to make sure I was looking. It's how he passed M-CHAT which is only a screening questionaire.

    This site explains the follow up interview associated with M-CHAT. The dandelions would likely count, btw.

    https://www2.gsu.edu/~psydlr/Diana_L._Robins,_Ph.D._files/M-CHATInterview.pdf

    A lot of people mistakenly believe that all kids on spectrum are aloof. Many on the higher end of the spectrum are very engaged with one or two people in their lives- a preferred person if you will. Usually mom.

    DS's first love is trains. But he has gone through a number of other areas of interest- cars, marine life/oceanography, the Titanic, ships, history, space, music. He's pretty well rounded. And has the highest grade in his Western Civ and Astronomy classes as we speak. He never tantrummed which is sort of unusual given his gender and dx, but he's still pretty intense.

    I just went back and found a better website for the M-CHAT that actually interactive and followed up with more questions when I answered No to some of them. The first one I found was more of just a list. Thank you for the link though!

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  • KelleyBeanKelleyBean member
    This is just my perspective so take it for what it is worth but we went through the EI eval process at 2 with DS. I started raising questions about his speech with his pedi at 18 months. He told me boys develop slower and that it was no big deal, not to worry. When he hadn't progressed much at 2 and started showing social issues at daycare I pushed for the EI eval. He came back delayed but not enough to start any therapy. They told us to come back in six months. Six months later DS is now showing several ASD symptoms including poor eye contact, delayed echolalia and hyperfocus. He always does better with caregivers he is comfortable with and some days you would think he is just a quirky toddler, others, not so much. My point is, I should have listened to my mommy gut and pushed things much earlier. We have wasted a lot of time. He is now going through the full eval process and will likely start special preschool and therapies in the fall with an IEP since he will age out of EI. Just as an FYI, he passed the M-CHAT with flying colors twice. If you have any question, bring things up with the professionals and do not be afraid to be firm. I wish I had done this. Good Luck. 
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