ASD Or Speech Delay

Updated on September 10, 2016
M.K. asks from Sterling, VA
14 answers

I posted on here before about concerns with my son having SPD because of his delayed speech along with some sensory problems/issues. Since the last time I posted and our actual eval with the SLP and OT with EI A lot of his sensory seeking has subsided. The hand flapping which he did only about three seconds a couple times a week has gone away and the main concern of him looking out of the corner of his eye which he did daily has somehow disappeared also. So I do not think that those are any longer concerns as of right now. He does still have some feeding issues but that could have to do with the two-year molars still coming in. I'm hoping after all of his teeth are in he will get back to eating the way he did six months ago.

But his results for his eval still have me concerned along with a couple other behaviors that I'm not sure are just a typical 2 year old or not because I'm not really sure where you draw the line on "repetitive behavior" or "obsessions"
He had his eval done at 24 months.
His adaptive/self-help, fine motor skills and gross motor skills were right on track at 24 months.
His receptive language and social – emotional are at 18 to 24 months but his expressive language was 14 to 17 months and cognitive was 18 to 21 months. They did say that the areas where he is delayed definitely have to do with speech and I am hoping it is just a speech delay and nothing more. He did qualify for speech therapy four times a month to help with the speech and feeding I'm crossing my fingers that this will help. I think it will since he has over the past couple weeks picked up several words and started using two word phrases. His lack of name response also has me very concerned though. If he is engaged in anything at all he will not respond to his name unless he really wants to but I would say it's a 70%–30%.

He has recently mastered going up and down the stairs on his own and wants to do it constantly along with opening and closing the baby gate at the bottom of the stairs he can do it 20 minutes straight if I let him but I usually stop him after about 10 minutes – he gets upset at first but is able to calm down within about five minutes. He also still has a thing with opening and closing cabinets and doors he likes to open the cabinets and put his blocks in and then close it continuously for about 10 minutes and he also has to open and close all the doors in the house. Granted none of these activities last more than five or 10 minutes but it is something he does several times a day. Not sure if this is considered "repetative behavior" or just a typical toddler learning to do things.

I will say I had not been worried as much over the past couple weeks since certain behaviors had subsided but I still have a nagging feeling that there's something more I am really hoping it is a speech delay and the therapist can help with that.

What can I do next?

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So What Happened?

UPDATE: his pediatrician, SLP and OT seem to think it's just a language delay and have no concern for ASD.

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answers from Oklahoma City on

Good grief! He's young. He's not supposed to be talking in paragraphs and stuff. He's behind in speech, I get that. It could just be he has a mom and dad that do all his talking for him. Maybe he makes a sound and you know what he wants so you hand it to him. He has no needs for words if you are doing that.

I think you should just let it go. Wait until he's at least 3 or maybe even 4 before you go through all this stuff again. He's going to be one way this week and next week another part of his brain will be learning and he'll act like a totally different kid. It's okay, it's normal.

It is highly possible he'll have problems later on but addressing them now is sort of like putting braces on a 5 year old. They're baby teeth and braces are doing something but it isn't anything that is going to last because those teeth will come out and his permanent teeth will come in later on. He's this kid now but tomorrow and next week and next month he's going to be developing some other area and the things you're addressing are going to be a thing of the past, gone.

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answers from Chicago on

Our son did this as well. HIs thing was running water. We had to run water in the sink, flush toilets, run the shower. And, guess what, he grew up to be a kid who absolutely loves water...swimming, taking baths, fountains. All within the absolutely normal range. He's 14 now, and something he's really looking forward to is being a teen volunteer at the Shedd Aquarium.

There is a magnificent books called "What's Going On In There", written by a neurologist, who describes...well, what's going on in there and why it is not only "normal" but fundamental. There is another book called "The Scientist in The Crib", and the basic principle is that for little ones the whole is like one big lab...they are "experimenting" with their environment to figure out how things work, and like scientists they have to replicate their "findings."

I'm not a professional, but all this was true of our son, who is one mighty fine kid (if I say so myself)!

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answers from Washington DC on

well, here's my expert advice.
i haven't met your son and have no medical training, but i'm so glad you think what i have to say carries more weight than the professionals who have actually evaluated him.
and my weighty opinion is that they're right.

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answers from San Francisco on

Wow he sounds completely normal to me, do you tend to overthink and worry about things? You yourself may have an anxiety disorder, you might want to get yourself evaluated.
I'm not trying to be mean I'm being serious.

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answers from Miami on

You are doing just fine, MK. Keep paying close attention to your child. If you hadn't up to this point, you wouldn't have ended up with a thorough evaluation. It is ABSOLUTELY NORMAL for you to question what is happening with your child.

Early intervention is the key to dealing with learning/developmental differences or delays. The speech therapy he is having is key. But even more important is the work you do with him at home. You should be watching his speech therapy carefully, taking notes, and doing the home program every single day, twice a day. Morning and night. Your little guy may balk, but it still gets done.

Let me talk about that a little bit to you. Speech therapy is hard work! My son decided that he was tired of it, no matter that we couldn't understand most of what he said. At 3 years old, he had a meltdown during therapy one day, and wouldn't work with her. As you know, speech therapy is expensive, and I could not afford for him to be doing this. I took him home, put him in his room and told him point blank that he was being punished for being mean to "Miss Betty". I brought him a sandwich and supervised occasional trips to the potty, but he had to stay in his room all day. When he realized I meant business, and that he was NOT getting to come out of his room, he volunteered to me that he would be nice to her from then on and would work with her. I immediately sat down and did a full lesson with him, and then let him come out of his room. He never pulled that stunt again.

Sometimes you have to do "investigative work". I knew something was "off" that they weren't finding. I asked for an OT evaluation, and nothing came out of the eval. But the speech therapist listened to me and went to the OT on my behalf and told her that I was really good at discerning issues with my son, and would she just work with him some? She did, and by the end of the first session, she told me that he did indeed have sensory issues that needed to be addressed that had not shown up in the eval. It was astonishing to me to watch all the things he could not do in that session. I wondered why her eval didn't address these things? (I think she modified her evaluations after that...) He did 6 months of OT with her, and it made a huge difference.

So the thing I'm trying to say is that sometimes you can't take a single eval's results "to the bank", so to speak. If I had just accepted the OT's original eval results, he would not have gotten the help that he needed. You already know he has some sensory issues. Remember, when there are sensory problems, children seek it out in all kinds of ways. You give them a "sensory diet" that helps retrain their nervous system. The earlier you work on it, the better the results will be. I do hope that you will get him some occupational therapy, along the lines of what I've been talking about. It makes so much difference for a child who has some sensory issues.

I do think that you've gotten some really good results on the speech and language front. You have benchmarks to meet and between you and the speech therapist, you can meet them. You need to put a lot of work into this. The language work is so important. She can give you "carryover activities" for language while they are developing his speech skills to help you at home. He loves order - work with that! As he gets older, work with him on organizing his brain - show him pictures that tell a story, and have him help you put them in order. Having cards that you lay face down in rows, where you find the matching card will help with memorization. These are in education stores, and the speech therapist can help you find similar aides.

Even if your child does not have ASD, he has delays that need to be addressed. Look at this as an adventure with your son to get him school-ready. Once he gets to grade school, you don't want to have to start this adventure then - school moves fast and you don't want him to be behind.

Ask your speech therapist for names of books to read, especially about your son's penchant for repetition. One of the posters gave you the name of a book to read - check that out.

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answers from Norfolk on

There's a wide range of what passes for normal.
Your son sounds fine to me.
Kids - even teens - -and adults - will not 'hear' you if you don't have their attention first.
It's actually a useful skill to have if you work in a cubicle environment.
It's not only normal - it's desirable.
You concentrate on your work - and ignore the general hubbub going on around you.

At about 2 our son very carefully 'helped' me with the newspaper recycling.
He took out one page at a time from the bin and spread then ALL OVER the living room floor and then rolled over them giggling the whole while.
I have pictures!
Yeah it was a bit less fun washing the newsprint marks off him.

I can't help but think that all this analyzing might be getting in the way of engaging more fully with your son.
Your son can be normal - and unique - all at the same time.
Jump in puddles, do some tummy flubbies, make cardboard/pillow forts together, etc.
Enjoy him - and take pictures!

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answers from Pittsburgh on

I think it's hard for us to know, because we can't see him. And even if we could, every toddler is different and we aren't experts at knowing what is typical. Each of us only really knows our kids, and our kids are not your kid.

However, I think you'll be able to talk to the therapist about these things, and that person will be able to help you. At least in my case, although we qualified based on speech, the therapist was a developmental therapist (meaning she did type of therapy, not just speech). She was so knowledgeable, I learned a lot from her about development in general, not just speech. Hopefully, you will also get someone good who can help answer all these questions based on her interactions with your child. Fingers crossed for you.

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answers from Portland on

I will respond without reading ahead - our son was misdiagnosed with Autism - one of the key things they looked at was how focused he could become and play independently on his own. The type of thing you describe would have been stuff he would do. But so did another one of my kids. Stacking, un-stacking, closing a cupboard door, opening and putting something in, close, open, remove, repeat ...

I thought it was great how focused he was and how he could play well on his own (me watching) for an extended time, but they were concerned. My child had speech delays and a few behavioral issues. Also slow to walk. My son in the end needed tubes.

And years later, we realized had allergies (excess fluid in his ears, just enough to make hearing muffled, but he still passed a hearing test). When speech is affected, it throws development off a bit. Fluid (even just a tad too much) made his balance off. He wobbled. So he sat a lot of the time or stood hanging on to things, and played very quietly and repetitively - because let's face it, he wasn't communicating that much. He couldn't - he was finding it hard.

As a new mom, I didn't know his behavior was entirely typical. I think sometimes people look for things, and any typical kid will have some behaviors that seem to fall into different categories. That was our experience. I share it, because I've known a few other families who had the same experience and grew frustrated.

I think he sounds pretty typical. Once our child's speech came along, it was like night and day - huge leap in development.

ETA: I should add (after reading Doris' response) - there was something 'off' with my son's development, but it wasn't where they were going. So I shouldn't say it was entirely typical (his speech delay etc.) but his playing was. It's just combined with his other delays, they started to be concerned - and automatically wanted to rule the bigger concerns out.

It was actually through speech therapy that I met other moms and started realizing my son just was having a hard time hearing. We had known that, but got sidetracked with his misdiagnosis.

Doris is right - trust your gut and ask lots of questions. I do now. That's what I took away from that experience.

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answers from Springfield on

i think that once you get in to the swing of things the speech therapy will help him out and he will be all good after that. and i don't see anything else in your post that says there is any other issues. i worked in a todds and 2s room for several months and many children liked to do certain things. like hiding the blocks in the cabinet. children will pick up on an activity they love and will do it often since its so fun. next week he may be wanting to do nothing but scribble with a crayon..
with the stairs. he learned them, now he wants to master them and will do it till he is satisfied. (unless he is like my kids and just think the stairs are a playground of fun)
relax and let him learn. let him explore and play. guide him to do it all safely. and encourage learning new things and you will be all good

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answers from Los Angeles on

My 20 month old engages in many "repetitive" behaviors, but he's definitely not autistic.

Just a few months ago, he would repetitively open and close doors -- open, close, open, close, open, close, for over 20 minutes (and only 20 minutes because I always try to redirect him at that point). Same with cabinet doors. He still does it, but not as much. He would do this throughout the day. I think it's a way for some kids to learn/explore/absorb their environment.

Last night, we were looking through a baby vocabulary type book with a bunch of different pictures. His favorite page was the "transportation" page and he kept pointing to four of the pictures -- bus, fire truck, car, and truck -- repeatedly for over 15 minutes while I sounded out the words. I think he just wanted to hear and "learn" the words.

If you're concerned, definitely monitor the situation, but if the pediatrician, SLP, and OT aren't concerned, I wouldn't be too worried.

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answers from Las Vegas on

Putting things in and taking things out of cabinets, drawers, boxes, etc. over and over is a normal toddler behavior. It is how very young children learn and begin to understand the world around them. Many times, children this age have more fun with boxes and common household objects (measuring cups, cardboard tubes, spoons, plastic cups and bowls that can stack), than with "learning/educational" toys and gadgets that are marketed for that age group. I had a bottom drawer in my kitchen that was the "play" drawer. My son loved playing with little toys and things he stashed in there while I was in the kitchen making dinner or cleaning up. I could keep an eye on him, and he was occupied and having fun.

Your pediatrician, SLP, and OT have all given you a professional opinion. Do you trust them? If you have a concern about something else have you asked THEM what they think?

It would be a great idea for you to learn about child development and for you to understand that there is a very WIDE range of "normal" or "typical" behaviors and growth progression. Your library or bookstore will have many resources on this subject. Not all children develop at the same pace. As long as your son is progressing and not regressing, and as long as the professionals who are treating him believe he is on track in all other areas, you might consider that your unchecked fears may lead you to look for things that just aren't there.

Keep up with his speech therapy and the recommendations of his pediatrician and other professionals who are treating him. Continue to provide your son with age-appropriate and safe things to explore around the house, and let him grow and learn and develop at his pace.

You seem to be a very attentive and caring parent. You are not going to let things slide if issues become evident down the road or if new things develop. In the meantime, try to relax and enjoy this wonderful time in your son's life.

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answers from Portland on

I think your child has a high sense of order. The sameness of opening/closing all doors, a quest for mastery of his gross motor skills---- this is stuff I've seen in many, many toddlers and preschoolers. I've known many children who had a high sense of order -- lining up like objects; one had stuffed animals that she dressed each morning out of their pjs and then put in pjs and to bed each night. Each baby doll in our toddler room, when played with by her, would have a pillow to lie on and a blanket to cover it. And they ALL had to have the same thing. That girl just graduated summa cum laude in with a BS in Chemistry. Just saying, these are a different sign of intelligence compared to what we typically think of as toddler play. I think it's fairly typical for a child to visit an activity repeatedly a few times over the course of a day.

Consider life in its wholeness: I'm sure we all have things we do a few times a day because it suits us to do so. Also consider the dopamine angle on this: when we engage in activities which give us a sense of security or mastery, we get little 'doses' of dopamine from our brains to encourage us to do it again. Liken it to routinely checking your social media or email or phone.... it's the same thing. We feel (mildly or strongly) compelled to engage in that way because the novelty of it gives us a little dose of that 'feel good' feeling. It's a very chemical thing that's happening. :) All that to say, from my perspective, I'd just enjoy your kiddo, talk to him often about his world, and don't worry about the other stuff. If they've taken ASD off the table for now, accept that and know that toddlers or older, our kids can be quite the mystery!

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answers from Santa Fe on

To me he sounds normal and I wouldn't worry. My son began speaking early but his best friend when he was 2 to 5 had a huge delay in speech. I remember at age 3.5 this little guy did not talk much...he was like a little caveman the way he spoke. But then eventually he completely caught up. I think my advice to you as a mom is to relax and don't get caught up in worrying about every little thing. Every child is so different in how they mature, their speech, their reading, their empathy, and so many other things. Be sure to read 3 or so books to him every night. Right now keep it simple with some board books. Reading every single day, pointing out letters, words, signs, colors, numbers, etc will all really benefit him by the time he is in school.

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answers from Portland on

After your SWH: do you think we know more than the professionals who know your son? I suggest you let go of your anxiety about being on the spectrum. Worry doesn't change anything and affects your ability to be calm and rational. Worry affects your relationship with your son. If you're anxious he's likely to also be anxious.

Really, how could we know any more than professional people who know your son?

What is your question? The only way you will know if it's ASD or speech delay is to talk with a professional person. My grandson was diagnosed with speech delay and other learning disabilities when he was nearly 3. It is common to have several diagnosis that go along with ASD. My grandson and his mother had support from a speech therapist, a physical and occupational therapists, as well as his pediatrician. He saw a psychiatrist who managed his case work and prescribed medication. Those are the people to ask.

You need to talk with the professionals treating your son.

What you describe related to repetition sounds like repetitive behaviour and not as typical toddler behavior. My other grandchildren, did not do anything like this. They took things out if the cupboard. Only put things back into the cupoard when they were helped to do so. They didn't repeat any behaviour over and over in sequence. My autistic grandson lined up cars and blocks for 15-20 minutes. When he was through, he was very upset if anyone moved them.

To know whether or not your son's activities are typical for toddlers, you need to talk with the professional people helping him.

I understand looking for signs he's a typical toddler is normal. We all hope things are just a phase.

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