Good session with the speech therapist today. We spent a little time on the “Why” of it all. The bad news is that she can’t tell me instantly and comprehensively what the problem is, and then fix it five minutes later. Your tax dollars NOT at work, people.
The good news is that she didn’t tell me after the first few session that she was pretty sure he was autistic. She told me that today, and that as she’s gotten to know him her feeling has changed. Autism isn’t the end of the world, and of course we would deal. But that’s a loaded word, and I’m grateful she didn’t make me deal with it at the same time I was digesting the fact that my baby needs intervention on the scale of 3x a week.
He’s getting great help. I love his speech therapist, in particular. Whatever the problem is, he’s making progress. But eventually we’re going to have to decide what the cause of the delay is, as his ongoing treatment will need to be more customized as he gets older.
While Elliot’s therapist is only available to me a few hours a week, Dr. Google is on call 24/7. I’ve been doing a lot of research. I’ve also gotten lots of great comments and notes from wise mothers and therapists (thank you so, so much!) with valuable information.
The most common causes of speech delays (combined info from multiple sources) and my take on whether that’s what we’re living with.
Mental Retardation/Intellectual Disability
Marked by delays in language, auditory comprehension and gestures. He definitely has language delays. He tested poorly on comprehension, but I think there was a lot of “won’t” in that “can’t.” It’s my feeling that he understands us most of the time, inclusive of times when I’m talking about something conceptual or referring to something not visible. He’s a gesturing fool. If this is the reason, it’s a mild case. I think it’s unlikely.
He passed his hearing tests as well as a baby his age can. They won’t be able to test him in more detail for about a year. We’ve already got our apointment set with the pediatric ENT for that time. If he has hearing loss, it’s mild. He can clearly hear. Theoretically possible there’s a distortion issue, but I doubt it.
This is when the central neurologic process required to produce speech matures late. Most common in boys, and often runs in families. We’ve got no family history of this, but last time I checked he IS a boy. Certainly possible. This is my favorite option.
Expressive Language Disorder/Apraxia
I think these are two different things, but I haven’t been able to tease them apart. ELD seems so widely defined that I feel like apraxia can fit in there. Someone smarter than I am will have to explain it to me. The hallmark here is that children have normal intelligence and hearing, but a brain disfunction makes it difficult to translate ideas into speech. When I asked about it today, his therapist said apraxia is definitely a possibility. He does not, however, show a physical groping for words with his mouth that is apparently common with apraxia. That’s one strike against, but not enough to put this in the unlikely camp. These kids are more likely to deal with things like dyslexia when they’re older. Entirely possible.
Receptive Aphasia/Auditory Processing Disorder
This a receptive (no kidding) language issue. The desriptions I’ve read of aphasia sound too severe to fit. In general, he understands us. I don’t think this is it.
The many variants and severities of autism would require me to write a book. I know autism can have a late onset, and it’s possible that we’ll see more as he grows that takes us back to this path. But if he’s autistic, it’s not profound. (I have heard about severe, profound late-onset autism, but I’m going to call that a unicorn for now and leave it alone.) He doesn’t display unusually repetitive behaviors or express extreme focus on things or actions. He’s very attached, demonstrates eye contact, responds to his name, etc. He is slow to warm up with strangers, which is why he set off alarm bells by refusing to demonstrate those things in his initial evaluations. So, he’s still in the common diagnosis window (up to 36 months) but I don’t think this is it.
I’ve left off my list other common causes of speech delays that I know are not possible. Those include cerebral palsy, selective mutism, psychosocial deprivation, bilingualism, structural problems and prematurity.
I also read about something called Einstein Syndrome. Aside from the fact that it seems to have been made up by some dude with a book to sell, I think this is an excellent option for us to consider. Or at least for me to contemplate along with my fantasies about finding out that I am Oprah Winfrey’s lost half sister.
jaysaint 