Developmental Delays in 4Yo Son (Long)

Updated on April 26, 2011
S.H. asks from Columbus, OH
14 answers

I have an extremely smart, sensitive, lovable 4 year old son who is my entire world! He knows all his basic pre-k stuff (colors, shapes, letter recognition uppers and lowers, numbers, animals, body parts, and can recognize his spelled name) my problem is that he doesn't talk!

I had been questioning the pediatrician every well-check visit since he was 18 months old as to whether he should be talking and she didn't seem concerned until he turned 3. We were then referred to a speech therapist for an evaluation and an audiologist for a hearing test. His hearing came back perfect! He was then diagnosed with a speech delay in March of 2010 and we have been attending speech therapy once a week since October 2010. He does not use speech to communicate his wants or needs, he simply repeats things/statements that he has heard or uses one word statements of his own. I have never been able to have a conversation with him and most days he is perfectly content to sit and play alone SILENTLY. I hate it! My problem now is potty training and trying to get him to do simple tasks that he should be doing such as dressing himself. Does anyone have any recommendations as to how to begin potty training with a child who does not speak? Our speech therapist does not recommend using sign language since he can talk he just chooses not to, and he is able to communicate his needs by pointing or taking you to where he needs you to be to get what he wants. It's as if he doesn't quite understand that he needs to tell people using his words what he wants exactly. We have tried using picture diagrams to help him understand that he can potty like a big boy and he will show me the picture for dirty after he has gone in his pull-up. Right now I'm just so frustrated and don't know what to do anymore. We have been trying to potty train for almost a year now and he has only been successful a handful of times. I know he understands that he should use the toilet, I just can't figure out how to get him to "tell" me when he feels the urge to go. If I just take him every 30 minutes he won't do anything and then he starts to have meltdowns throughout the day. Please help!

On another note, I guess I'm just looking for some support or encouragement from other moms who have gone through or are currently dealing with the same situation. He has been tested for Autism by a child psychologist and it was determined that he is not on the spectrum but she couldn't say for certain why he is not talking. She said it appears that he just chooses not to. I don't know how to get him to break through that wall that keeps him from talking. I'm am dying inside waiting to hear him call me momma or tell me I love you, or anything that is addressed directly to me. If you have never heard you child speak your name you can not understand the heartbreak that it truly is.

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So What Happened?

Thanks everyone for you great responses! I am currently working with our public school district to get him enrolled in the fall for pre-k. They have special education and typical peer models in the classroom and he will get speech and occupational therapy at school. I'm excited that the program is 5 half days, so he will get a lot of help and hopefully get him back on the right track. I guess my main concern was that he wouldn't get what he needs at school, so we will have to wait and see about that. He is doing much better at speech therapy the last few sessions and talking a lot more at home. The therapist does not think he has selective mutism but more of an anxiety issue. With time, love and lots of prayers we will get through this and overcome! Thanks so much to everyone who took the time to read this and offer support....it really means a lot! God Bless!

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D.S.

answers from New York on

I had a friend who's daughter had selective mutism. She did overcome it but with counseling. Get another opinion from another pediatrician. Good luck!!

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B.O.

answers from Portland on

I am really surprised that the SLP suggested not to use sign language. That practice is waaaay outdated. Most of the SLPs I know recommend using it simultaneously with speech. Perhaps you would benefit with another SLP's opinion, maybe one that has more experience with selective mutism. And I agree that 3 is a really long time for your pedi to have become concerned.

I am so sorry you are going through this. I know it is heartbreaking. I work with children ages 3-4 that have the same types of issues, and it is very hard on the parents. But I also see wonderful advancements made with the children when the right SLP and support system is involved.

I think it is great that he is communicating with you on some level, like when he points at the dirty pull-up picture. I really believe on building on strengths, and right now that is his strength. He may not yet know when he has to go potty yet, he might still be figuring that out. I would suggest for you back off from taking him to the toilet for awhile (or less frequently at least, every 30 minutes is excessive, I would suggest taking him only at wake up time and after meals/naps), and start a written record of when he does go in his pull-up. After a few weeks, you can look over your written record, and might be able to see a pattern emerge. Then you might be able to start taking him to the potty based on that pattern.

I am definitely not an expert on speech issues, but I have had success in using written records to help children learn to recognize when they have to go potty:)

I wish you the best!

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C.B.

answers from Cincinnati on

My heart just breaks for you. What a great mom you are for advocating for your child. As others have suggested, I would look into getting a second opinion. I also suggest putting him in a Play-Based (REALLY important that it be play-based) Preschool and contacting Ohio Help Me Grow. (http://www.ohiohelpmegrow.org/parents/parents.aspx) They only deal with 0-3 year olds but may be able to give you contact information for support for older children. Good luck and I am so excited for you to hear him call you mommy for the first time!!

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J.K.

answers from Cleveland on

Hi, S.! I highly suggest getting your son into an early intervention preschool. These preschools are play-based and your son would get the services that he needs, such as speech therapy, on a weekly basis. I would also strongly suggest continuing private speech sessions as well.

If I were you, I would contact your local school district to find out which schools in your area offer such programs and get him enrolled in school as soon as possible.

I went through this with my son, but he was 2. He is now 4 1/2 and went from saying just 2 words to almost entirely caught up in speech with his peers. Preschool was the best thing that we have done for our son!

Good luck! I understand how sad and frustrating is can be when all you want to hear your son say is "I love you". It will happen!

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B.W.

answers from Seattle on

You should contact your local school district. They are required by law to provide services to kids with delays. There may be some variation by district but in ours it needs to be a significant delay in one area, or a less significant delay in two areas. It sounds like your son has both speech and social delays. That doesn't necessarily mean autism, because the speech can cause the social problems (be careful-there are those that will tell you different!) but therapy and developmental preschool can help! It has helped my son. He didn't say much consistently until 2 1/2, and now at almost 4 is starting to really get chatty. He still has some work to do, and tends to shut down in social situations and says less at school than at home, but we have seen so much progress!

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E.W.

answers from Cleveland on

I have been through what you have been through. My son is now 12 and we did the same things you did. What I have done since then could fill a book. I have an opinion on everything you have listed here. You do need to have him evaluated by your district at no cost to you. I don't always agree that public schools are doing their best for these type of kids. It is too early to rule out the autism spectrum. My son was not diagnosed until 4th grade. I disagree with not using sign language. If there is some anxiety here that is causing him not to speak then he needs some type of outlet. If it is cognitive then the sign language can help. There is a great youtube called signing time i believe. My sister has had my niece on it since a young age and she does not have language or speech issues. My friend has a daughter who has selective mutism. This is caused by anxiety too. I have a lot of information and a lot of experience so if you want to chat please send me a request.

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K.N.

answers from Cleveland on

I babysit for a little boy that is the EXACT same way. It can be very difficult, and me not being mom, it took awhile to figure out things, like why he wouldn't eat lunch, what he does or doesn't like, because he would just sit there or repeat me when I asked if he was hungry or didn't like something.

He is mostly potty trained though, I'm not sure what his mom does at home, but I just tell him to go potty every couple of hours. Not every 30 minutes, but often enough to avoid accidents, and he really has issues with number 2 in the potty, but we have mastered staying dry. I have also noticed, that he is even more quiet if he is in the process of having an accident or after. He turns away from me while playing and will no longer babble to himself, because for as much as he doesn't talk to anyone else he does talk to himself when he plays, his issue is very much the back and forth of communicating and NOT speaking. So maybe you can try to figure out if your son has something specific he does right before an accident and get him to the potty in time.

good luck, and you are not the only one with a child like this. And I have seen first hand how hard it is, and really from what i see it's not about the ability to speak or say words, but they don't seem to understand the back and forth of a conversation. ANd something else I noticed, this little boy will have conversations with my daughter who is 8, but while us adults are always telling him to say goodbye, or hello, or trying more or less to make him talk, she just talks to him and doesn't seem to care one way or the other, so maybe getting your son around other kids in a positive environment would help him.

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H.L.

answers from Cleveland on

Lots of great suggestions everyone. Once he's older, something you need to watch for is his reading. A child with delays will also often have reading delays once in school. My first suggestion is to not send him to kindergarten until he is six years old. Trust me on this, I'm a teacher, you will sorely regret sending him sooner.

My second suggestion is to have him screened for reading the second half of kindergarten by a Wilson Reading Method tutor (or inquire for the results if your school does a reading screening, ie. DIBELS, in kindergarten).

If there is a delay, don't delay, and don't expect the school to be the sole entity to take care of it. Schools aren't provided with enough $ to give a child the intensive tutoring that may be needed. If there is a delay, invest in Wilson Reading Method tutoring for a minimum of 2 years 1-2x/week.

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A.O.

answers from Columbus on

I guess the one thing that sticks out to me that i did not like was them telling you not to use sign language. I would use whatever i needed to, to help my child communicate. I would say, if he is willing to use it, use it!! I agree with the other person, I would get a second opinion and try some other speech therypists(sp?) and dr's. Others have other ideas that just may work with your son! Good luck!

Updated

I guess the one thing that sticks out to me that i did not like was them telling you not to use sign language. I would use whatever i needed to, to help my child communicate. I would say, if he is willing to use it, use it!! I agree with the other person, I would get a second opinion and try some other speech therypists(sp?) and dr's. Others have other ideas that just may work with your son! Good luck!

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C.M.

answers from New York on

I'm sorry that your going through this with your son. I think that you should get a second opinion, a new speech therapist and a new pediatrician. There should be no reason why his dr would wait until he was 3 yrs old to decide to take action. Find someone that takes your concerns as seriously as you do. Good Luck.

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E.E.

answers from Cincinnati on

Sabina,

I feel your pain! I have been there and it was so hard! It sounds like it could be selective mutism. Selective mutism is an anxiety disorder. It is a phobia of talking. Basically the kids are too scared to get the words out. Check out http://www.selectivemutismcenter.org.

We went through something a little similar with our daughter several years ago. She did speak okay at home for us just not at school or to anyone she did not know well. She was delayed in speech and we did some speech therapy which was pretty worthless since she would not talk for the therapist. It was not until she started preschool until we realized how severe the problem was. Selective mutism is rare and a lot of pediatricians don't even know about it. Whatever it may be you definitely need to call your school district and have your son evaluated. It's FREE as is the services your child qualifies for. After four years old the district is in charge of intervention, not Help Me Grow. Honestly our district was not even sure what to do but got info from our psychologist (we started the process with an evaluation at Childrens) and info we gave them from http://www.selectivemutismcenter.org. They were successful in helping our child. I wish you and your family the best! Oh and the potty training, I know, it's the most frustrating thing in the world, we went through it too. We found out it is common with the selective mutism as well as other anxiety disorders. It will come. Follow his cues he may seriously be scared. Check out this article that was in People magazine a few years ago about a boy named Jacob who sounds a little like your son. http://www.selectivemutism.org/news/people-magazine-spotl...

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J.D.

answers from Cincinnati on

I understand how you feel. My child is 11 and cannot talk at all. He does not have any creatine in his brain which is the chemical that helps you talk. We went to see a neurologist and they did an MRI and found that. Every once in awhile he will say I love you. My pediatrician didn't seem concerned either with him not talking at 3 or 4. My mom became a buttinsky which I'm glad or we would never know what is wrong with him. My son also has some characteristics of Autism. The neurologist ruled it out because he was too social.

Try using pictures from a magazine of his favorite things and a toilet picture and put them on divider sheets in a binder with velcroe. Put pictures of items available or on hand on the front of the binder with velcro. If he wants something, he has to bring you the picture. Use pictures of clothing also.

Maybe you should have him pick out his own clothes and dress himself.

Every once in awhile my son babbles so I babble back at him.

M.M.

answers from Cleveland on

There is a website at www.cherab.org that is a support group for parents who have children with apraxia. They are a wonderful group of people and are also in on some cutting edge nutritional advances called nutriiveda. I really think they would be a great support group as many of them struggle with the same issues as you have mentioned. I wish you the best and hope you can find the support you need.

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D.S.

answers from Houston on

trust me I can relate. Here is a question I have with him being non verbal. Yes his hearing is good but does he have fluid, ear infections or a wax build up. The reason I ask this is my almost 3 yr old was very non verbal. He couldn't follow directions and etc. He has tubes but he was still getting ear infections. long story short we finally got rid of the ear infections after 3 antibiotic rounds. Even after the infections were goine he still couldn't hear.

Like yours he passed a partial hearing test. He wouldn't let them do a complete hearing test. But we knew he could hear still waiting to do the abr.
that should be a week away. Any how I took him to the doctor Thursday and he had a major wax build up. She cleaned out his ears the the best degree she could cause he wouldn't cooperate. And within 2 days he picked up 50 words. We attempted like you potty training with no sucsess.. We are still working on it. I am going to give him a couple of weeks of actually being able to hear and comprehend things before I go full blown.

I feel like rushing him to much to fast won't help. Now I disagree with your speech therapist. I think teaching him just the word sit would be a good way for him to tell you he needs to potty. He may just being stubborn but they also might be missing something. Take him to an ent and get him checked. For reasons of being sure and not forcing something he can't do. Just cause he can pass a hearing test like my son doesn't mean he can hear. Also the telling you after he dirties that he needs to dirty is normal. My oldest did that.

You need second opinions on him. An ent and a second audiology test which includes an abr. Most ents have an audiologist in the office. Get a second pediatricians opinion. I think they are missing something on him from my personal experience. They were with my son. By the time they got the ear infections cleared up everyone was missing the wax cause they couldn't see it from his ears being so swollen. If he has fluid he does have hearing but its like hearing underwater. so He won't be able to say alot of words. Get second opinions for your piece of mind. if you want to pm me feel free.

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