Concerns About 4Yr Olds development...where Should I Begin?

Updated on November 19, 2009
J.T. asks from San Antonio, TX
32 answers

Hi everyone,
Thank you for taking the time to read my post as I am finding it very difficult to cope or reason with the possiblities that my son may be delayed in his development. My son is 4yrs old and an only child. I work during the day and my husband works nights so Ryan has always stayed home with one of us. Just a couple of weeks ago we moved out of the country and into a community with many children around his age. I never noticed there might be some troubles with his development until he started interacting more with children his own age and the difference is some what shocking. He has played many times before with other children but i guess i just didn't see it in the past. My son was born with a cleft lip and palate so speech has been an issue but I think there may be something more to it and im not sure where to begin. Ryan is verbal but you can't really carry a conversation with him the way you can with most other 4yr olds. And when he gets upset about something he doesn't tell you "Im sad because..." he resorts to throwing a fit and saying "I want my bike" for example. Im having trouble putting into words what some of my concerns are but im hoping some parents will understand. Any advice will be exteremly helpful. My heart hurts for my son and i want to do the very best for him.
Thank you in advance.

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S.T.

answers from Houston on

My children are on the autism spectrum and honestly, from what I read here, he doesn't sound delayed. He sounds like a typical little boy who hasn't been trained how to act. When mine start acting that way at about 2 is when I start teaching them how to act when upset. they don't automatically know how to act appropriately.

S., mom to 4 on Earth and 5 in Heaven

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K.K.

answers from Killeen on

1) stop comparing your son to other 4 year old. All children develop at their own rate. Even the so-called "average" child does not exist but is a grouping of children some who develop faster and some who develop slower to get a round about age for certain things to happen to give parents a heads up of when to start asking their pediatrician quiestions.

2) The speach this is normal with your sons cleft palate. Call your pediatrician and get a referal for speech therapy, then call ECI (Early Childhood Intervention - I know sounds like CPS but they aren't) they stop helping at 3 years old but will tell you where you can get help for free or on a sliding scale based on your income to get your son's speech brought up to his age level.

3)The tantrums when he is upset sounds a lot liek something my oldest did. It took me awhile to realize that she did not understand the concep of "feelings". I had never taught them to her (just like walking talking and other things, children are not born knowing what emotions and feeling are and have to be taught what they are and how to express them). I bought a few childrens books on the subject (mine and my daughter's favorite was by Jamie Lee Curtis) and we began discussing what feeling were and how to express them. It helped almost immediately. I do not know if this is your son's problem in this area, but it is a good place to start.

If he does not respond to the help I have suggested, then I would consider that perhaps there is a bigger medical/psuchological problem going on and have him diagnosed. But, I wouldn't go there until you have given these a try and see if your son catches up to other kids his age. It could just be the fact that he has had very little exposure to other kids to help further his development in these areas or to call your attention to developing these things sooner...

Either way, good luck!!! ;-)

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L.B.

answers from Odessa on

I would seek intervention. If nothing else, but for them to reassure you things are fine. I would start with ECI and let them guide you were to go. Just type in Early Childhood Intervention in Google and find the number for your local people. My daughter has recently been diagnosed with Down's, and I know it's difficult to think of your child being delayed in any aspect. Denial is a dangerous thing, though. My daughter is not behind in her milestones yet, but we have started physical therapy anyway. I'm so glad we did. They have shown us some very, very simple tricks that have brought great results quick.

I would meet with a speech therapist in a heartbeat for guidance with your son. You'll be amazed at the simplicity such guidance is. Your heart will feel better.

You're in my prayers!

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K.B.

answers from Houston on

Hi J.-

The best thing to do is to talk to your pediatrician and request that he/she refer you to a developmental pediatrician who can screen for developmental delays. That is the only way to find out for sure what (if anything) is going on with your son.

I know exactly what you are going through. When my son was 3 1/2 we enrolled him in preschool and suddenly noticed that he was not interacting with the other children in a typical way. It was only once we observed him with other children that we saw the difference since he was our oldest we didn't know what to expect from a child of his age. Once we saw a developmental pediatrician we learned that my son has Asperger's. Although getting a diagnosis is scary, it also allows you to redirect your frustration and sadness to more proactively help your son.

It's possible that you will go through the evaluation process and have the doctor reaffirm that your son has no delays, or has delays resulting from his cleft lip but nothing else. Regardless of the outcome, it's always better to know for sure.

Good Luck,
K.

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J.K.

answers from Austin on

J., I hope this makes you feel a bit better. My son will be 4 on the 26th of this month. I have figured out that he is basically about 6 - 8 months developmentally delayed. He had a major speech delay and I think that either contributed or was just a factor in his development delay. He is not potty trained yet.. He will pee but not poop, and he has such anxiety about having to pee in toilets he is not familiar with. We too can't carry a conversation with him like you can with your typical 4 year old. However, we are not overly concerned anymore, he is developing, and that is what is important.. We have him going to an amazing school that is strictly geared towards helping children with speech development delays and other developmental delays. He has progressed immensely since being at this school.. The name of the school is Capitol School of Austin, they are located in north central Austin.. It is a very expensive school, I started working so we can afford it and fortunately my parents are helping us out as well with the tuition.. All the teachers are certified speech therapist or pathologist.. If you want more info don't hesitate to contact me.. I have come to conclusion that I will probably hold my son back for kindergarten, he will be an older 6 year old starting, but he will be more confident and prepared... Hang in there, as long as he is developing whether it be at the level he should be or not, you should feel good about things..... J.

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S.R.

answers from Austin on

You sound like a wonderful mommy who wants what is best for her little guy. He's lucky to have you.

I'm a Speech-Language Pathologist. If your little guy is four, you would not go through Early Childhood Intervention (ECI) as their services are for Birth - three. Once a child is three, the public schools take over. Hence, this is who you would call for evaluations, etc.

You said you had moved? Contact your local school district re: a speech evaluation for your child. They will guide you through the process, timelines, services available, etc. You did not indicate if he was in speech - I realize he may already be. If intereted in private speech, ask the pediatrician/neighbors/etc. re: clinics in the area. Most take vaious insurance plans, etc.

Good luck with everything. Hope it works out well for you and your family.

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L.C.

answers from Corpus Christi on

I feel your pain. My son has a speech delay and it hurts to see kids and adults react when they hear his speech. They assume he knows less than he knows. I'll bet your son's "fits" are because he is frustrated with his speech. I'm sure my kid knows that he is not communicating like the other kids and it frustrates him when we don't understand him. He is in speech therapy and has improved by leaps and bounds since he began the therapy. Is your son in speech therapy? I'm sure it will help. The public school also offers speech therapy and occupational therapy services. I hope this helps. You're not alone.

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A.M.

answers from El Paso on

Hello. You mentioned that your son has not been around other kiddos too much, that compounded with the possibility of residual effects of the cleft likely accounts for some of your concerns. Are you in a community with American children? Also, do you have access to American service providers? Doctors, SLP's? Highly recommend an eval if possible. In the meantime, give your son frequent exposure to other kids his age, American, if possible... Speak in short, concise sentences to him (model what you want him to say) and start talking about feelings at home so he has opportunity to start figuring them out. Also, read read read read read. Talk about what you're reading. Sounds like he could use the vocabulary boost... Good luck and keep us posted..

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G.H.

answers from McAllen on

Hi J., my niece has a 4yr old with the same condition as Ryan,thing is you wouldn't notice it. Nathanal is a little different but who isn't,throwing fits all children do that, carrying a conversation with a four year old is impossible they have a mind of their own, when you get a group of 4yr old's they interact their way there is no normal way. Ryan sounds as normal as any other 4yr old.If you are really scared talk to his Dr.Don't be sad you are just being a loving mother who cares about her child even if her heart hurts.Always be there for him you are a special person (a mom) love him that is all we can do as moms. I am not a professional just a mother of 29yrs. Good Luck and God Bless you and your family.

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M.H.

answers from Austin on

I don't want to alarm you but I have a friend who has a 3 year old that has some of the same problems. It was only recently that the thought of autism crossed my mind. I read up on the signs and a few of the signs are terrible tantrums, being very independent (not wanting help), and a very low vocabulary. They also have trouble relaying their thoughts into sentences. Of course these signs also match the description of many other things including slower development. It is something to look into if you feel there is a chance this might be the cause.

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E.M.

answers from San Antonio on

J.,
I'm sorry that you are going thru this situation. I have a 4 yr old son that is speech delay so I can relate. My best advice is to act now. Get him some speech therapy. I'm a strong believer on early intervention. My son has been with speech therapy since he was 2 yrs old and from being non verbal he speaks up a storm. Take action don't feel bad about the situation that you and your son are in. Remember that no one can help him like you can. Get him the help he needs. If you live in San Antonio let me know so I can give you information were you can take him for speech therapy. Always remember that God gives us what we can handle....and you can handle this!

I send you a big hug,
Elisa

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R.L.

answers from Houston on

Most 4 year olds are not good at communicating feelings such as sad, mad etc. Throwing a fit or yelling is pretty typical behavior. It sounds like with his speech issues maybe he is having trouble communicating. It may help to enroll him in a part time daycare where he can interact with other children his own age on a daily basis in a structured environment. I would also suggest to discuss your concerns with your pediatrician. It doesn't sound to me like there is anything to panic about or be too concerned about yet. If you pediatrician thinks testing may be a good idea then I would move forward with that, but if they are not concerned then I wouldn't worry about the testing yet.

I'm sure he just needs time to catch up!

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D.H.

answers from San Antonio on

Hi J.,

With you son being 4 your local school district will supply whatever therapies are required at no cost. If Ryan has a speech issue I am assuming you received Free speech therapy through your local Early Childhood Intervention company. The state provides all services. The earlier you can get him help the better. Also, therapist can come to your house, day care or wherever your adorable is.

Like I said, the quicker you act the better for him. I have a daughter with Down Syndrome and Type I diabetes. She began therapies at 7 weeks and now at 9 she is in second grade, reads does math and is in a completely inclusive classroom.

Good luck,
D

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J.M.

answers from Austin on

Hi J.,

Try and work with his diet, his chemistry is not set in stone, which happens around age 18 or 19. So until then we work with the basics, which are baby probiotics, calcium, and mineral supplements. Then change his diet to a more natural one.

www.creeksideherbhouse.com

That is my free teaching website, what we teach is on the theory page, there are books on the reading page you can get at any library, or find them on line to do your own research.

I sure hope this helps, as good nutrition is essential for proper growth.

Blessings
J. M
[email protected]____.com

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C.M.

answers from Chicago on

Your son does not sound terribly delayed to me for his age, so much as socially isolated. Children learn speech patterns and social behavior from other children just as much as adults. With respect to the speech issue, you don't indicate whether he been working with a speech therapist. There are a number of organizations that provide free speech therapy starting as early as two years old. With the cleft lip and palate, he would definitely qualify. Finally, as a person who was born with a cleft lip and palate, I can highly recommend that you contact your local Children's hospital(s) to see which participates in the cleft palate clinics that are run world wide. They have a wealth of resources and help parents navigate the multiple issues that face children cleft lips and palates (orthodontia, ENT issues, etc.).

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S.B.

answers from San Antonio on

I reccomend contacting your pediatrition for a developmental screening. If they won't help I would contact your local elementary school. The Early Intervention Services are for birth to age 3. Once a child turns 3 they are turned over to the local school system for services. The school should be able to do a screening and provide services like speech, OT and even possibly a preschool to meet your childs needs, if needed.
I can tell you, having a child w/special needs, that the earlier the treatments are received the better. You may find your son doesn't need any services, better safe than sorry.
S.

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M.O.

answers from Houston on

I would run not walk to the pediatrician. Sometimes we as parents see things and say hey it's ok it is a phase. We try to wait for it to work itself out. However I think for now this should not be one of those times. The key things I read in your post are lack of social ability, lack of being able to turn take to hold a conversation, lack of emotional control, extreme tantrums over every day things that lead to screaming the same thing over and over-- all of these tell me your child may be at risk for Autism. I speak from experience as all of this is part of my daily life. Go to your pediatrician. Tell them what you see. Ask them to refer him elsewhere for a closer look. Research. There are lots of places to get info to see if you think this could be the situation. Do so and take that research to the doctor with you. Explain what you see and what you feel. Mother's instinct is just as important as anything else when it comes to your child.

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P.H.

answers from Austin on

Since you've just moved you'll have to start over finding a new speech therapist/pathologist (and I presume he's been seeing a speech therapist for years now,right?!) so this new person will be a great help to you because if s/he sees any other delays that might warrant an evaluation s/he will likely bring that up. You can also ask their professional opinion, as speech professionals work with a wide range of children from those with just speech delays to children with multiple delays. A new set of eyes on your child will likely be very helpful, so don't see this new community as part of the problem, but rather a great opportunity for new help for your son.
There are therapy groups (in Austin, anyway) that deal with social communication for children, and something like that might be helpful for your son. The tantrums might really be language based, though, because to not be understood or to fully express yourself must be very frustrating!
I have a son with "global developmental delays", so have been advocating for him all his life. He started OT and PT at 9 months, and speech therapy around 18 months. He's now 6 years old. It's a whole new world out there in "special needs land", but full of amazing people who've helped my child, so they are a wonderful addition to our life.
It's okay for you to feel sad and scared, but you also have to be brave and take action for your son to get him the help he needs. Those first months with his cleft lip/palate must have been very difficult, and look how far you've all come! You can do anything!

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J.T.

answers from Victoria on

I always thought you could tell the difference between a day care kid and a stay at home kid. The stay at home kids seem to be less verbal but have much better manners than the talkative daycare kids. If your truly consirned take him to the doctor and have them do an evalueation(sp) for him. It sounds like he just needs some more interaction with other kids. Good luck.

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M.A.

answers from Houston on

I understand your concern. I have 2 sons who have needed years of speech therapy. My younger son's therapist told me that children in need of speech therapy often are also in need of some occupational therapy for their fine motor skills, particularly handwriting. Ah, that's why my older son struggled so with his handwriting! My younger son was in preschool at the time and we began using "Handwriting Without Tears" at home. He is now in first grade with much better handwriting. We were very concerned about our older son's development when he had to begin speech therapy at age 3. Let me assure you that they do turn out alright--he is now in grad school and I never would have thought it possible 20 years ago when I could understand very little of his speech.

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C.W.

answers from Waco on

Hi J.
I know you are concerned about your little boy. It is a good thing that you can see that he may have a problem and get right on it. Have you had him tested. Is his hearing ok?.....if it is only a speach thing that is upsetting him that can be fixed with some professional help....a little thearapy........Just keep on trying to re assure him that all is ok- and that it is not acceptable to throw a fit. some kids just throw fits for no reason at his age- some is normal .....it is what ever he thinks he can get by with at the time.....but if you think it is because of his difficulty I think the loving attention you give him ...lots of hugs and reassurance to build his self esteme and some thearapy would help.....especially before he gets into the school system where kids can really be cruel.
I would suggest getting him tested and take that road to get him the help he will need later.
good luck and blessings

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B.H.

answers from Houston on

Hi J.,
My daughter (5) was born with a cleft lip/palate. What I have found to be most beneficial to her is interaction with other children. Now that your son is now surrounded by other 4 year old children, he will likely begin to advance much more quickly. He will begin mimicking their behavior and their speech (sometimes for the best, sometimes not). If you find that after a few months you are still concerned, you should contact his cleft team just for peace of mind.
All my best,
B.

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D.M.

answers from Houston on

J.,
I would definately check into this with your doctor - but only for your peace of mind. If your son has been somewhat on his own during the first 4 years, he could not possibly have an example from piers to know how to act. Right? He sounds like my first son. I was very concerned that he seemed socially inept at 3 when he started interacting with other children who had siblings. It was shocking and I did think something was wrong. He soon caught up though and is now a thriving young adult with just as much savvy as the rest of the crowd.
Take heart Mama. He's probably just fine.
D.

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S.S.

answers from Houston on

My nephew seemed a little behind at that age from how my kids were at that age. I checked into testing with a friend and he was able to get free testing with the local school district with a diagnotician(SP). He was fine---and is now 6 and right up with everyone. If your worried call you local elementery school for help!

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S.H.

answers from Houston on

Dear J.--I certainly understand what you're going through. I have a mentally challenged son, and it has been a LONG road to finding him the help he needs.

I would suggest this: Your school district will test your son free of charge to see if he needs any special helps before entering the traditional school setting. Call your local elementary school and ask to speak to the diagnostician. She will tell you what they can do or she can direct you to someone who can help you.

One more word of advice: Don't let others tell you that you are imagining things or being paranoid about your son. Trust your "gut instincts"--you know him better than anyone, and God gave you these instincts to protect him. Remember to put his needs FIRST--by saying that, I mean don't think the problem will go away if you put off doing what needs to be done. I've seen many parents who just can't admit that their child may have a problem. All this does is hurt the child. The earlier you get help for him (if he needs it), the farther he'll be able to progress.

Please feel free to email me if you need support or have any questions: [email protected]____.com

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S.O.

answers from San Antonio on

I don't know how to address your specific concerns. But, keep in mind each child is different, and many, if not most boys are not very verbal. My older son is now 6 and still would rather show me he's upset then tell me why he is upset. My 3 year old is similar, but holds a conversation much better than my 6 year old boy. Ha. My 6 year old has gotten better over time; but it is due to me teaching him how to talk. You have to acknowledge that your son is upset (or whatever feeling) and then tell him how to verbalize it. "I know you are very angry right now. But, instead of stomping your feet, try telling me that you're angry because... That way I can help you. I can't help you if I don't understand why." Then, back it up with discipline when he throws a fit. Allow him to be angry. Allow him to not verbalize it if he so chooses. Allow him to be alone if need be. But, don't allow the fit. My son still would rather not talk to me when he is upset. But, he has come to me later and explained things to me when he feels he needs me. It's a huge improvement. But, no matter what: the fit can't be allowed.

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S.M.

answers from Austin on

Contact the Child Find of your local school district IMMEDIATELY and have him evaluated. School district have a certain number of days before they have to respond to you request, and the school year is almost over. I would also have his eyes and ears tested because that is the first thing they will ask for. My son has autism. When he gets upset, he reverts back to the "comfortable" request phrases. If the school cannot get to him before the year is out, I would have him evaluated at a speech/OT clinic.

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L.M.

answers from Houston on

Being around other children, especially those who are just a little older than him will help his development immensely. Not that staying home with your child is a bad thing, I would have loved to have been able to. But, the interaction around other kids means a lot. From the time my little one was in day care I could tell when he was moving toward being the oldest one in a particular class which was based on developmental level. When he was one of the younger ones, he always seemed advanced for his age. As those older kids started moving to the next class and younger ones would come along in his class, I would notice his development slowed. As soon as they moved him up, we were back on the fast track of development.

Additionally, he needs to be seeing a speech pathologist if he is not already. Children who need special assistance with any physical or developmental problem are afforded that from birth. Your pedi should have already suggested it to you. You should contact your local school district to obtain information on beginning services with the local speech pathologist now. It has to be frustrating for the child. I understand his frustration with trying to make people understand what he is saying. You and your hubby are around him all the time, so you know when he pronounces a word wrong what he might be trying to say. For example, my son called a banana a mana, a nuuu-nuuu was a motorcycle based on the sound the motor makes, lel-low was yellow (he used those until he was able to say the bigger word). I remember every time my son went to visit my parents, who live away from us, I would have to give my mom the "Dwayne Dictionary" which was an explanation of how he said certain words and what he meant by them.

I know as a parent you only see the perfect side of your child. It's hard to admit there is a problem. But, once you get over those fears of my child is not perfect and start getting him some help, you will be amazed how fast he progresses.

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L.J.

answers from Houston on

Reminds me so much of my son at that age. But don't worry, there are so many things that you can do to help him catch up with his peers. I will tell the first thing to do is consult the pediatrician. Tell him/her your concerns about his speech/langauage and socials skills. She can recommend a psychologist in your area that will do a full assessment on him and tell you what his delays are, how far behind he is and also tell you his strengths. The strengths will be helpful when you seek therapy. Also visit your elementary school that your son would go to when he is 5 and ask for an assessment. It is very important that you get him qualified for PPCD (a public preschool/therapy program). It will makes things much easier if he needs any kind of speech/social or occupational therapy once in Kindergarten.

So with these two evaluations, the school being free, the psychologist may cost a bit, you will be guided by both of the direction you need to go.

Sounds to me like your son probably just needs a year of therapy to get him up to peer level by Kindergarten. Believe me, the sooner you get help for him, the faster he will catch up with his peers.

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J.C.

answers from Austin on

Take him to your local public elementary school and explain your concerns. They can evaluate him and offer PPCD (Preschool Program for Children with Disabilities) speech therapy, preK or whatever is appropriate. Or maybe tell you that everything is okay.
I think pediatricians often miss problems because their time with a child is neccesarily very brief. If you really think there is a problem, be persistent.
You also might want to do a search on develpmental milestones for 4 and 5 year olds. There are lots on the internet by groups such as the American Academy of Pediatrics. It will help you know what things to teach your child at what ages.
Good luck with your search.

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C.K.

answers from Austin on

I would take your boy to an occupational therapist so that they can observe him and share their expertise with your family.  They may say that all his development is in the range of normal, or they may see some issues that need healing.  I would recommend visiting the folks at From the Heart. Also, research sensory integration therapy. See if any of it seems to apply to your son.
If you think it's more behavioral than physical, then consult with the folks at For Kid's Sake.
Good luck!

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T.S.

answers from Austin on

Mention all of this to your pediatrician and request an evaluation for speech therapy to rule out any speech-language delays.

Visit this website for information regarding Speech-language Milestones www.speechlanguagemilestones.blogspot.com

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