3 year old developmental concerns. Please Advise

[TheExProphet]

I don't know where else to post this but I'm pretty desperate. I'm a single father and figured this forum would be full of parents with young ones that could guide me.

I have concerns about my 3 year old son. He just turned 3. He has only recently started combining two worded phrases/sentences. His only diagnosis is "expressive language delay". He attends daycare 5x a week. He receives speech 3x a week. He has been seen by a DP and he ruled out ASD. But the whole visit was via zoom, and he saw my son for maybe 10 minutes. Most of the visit was parent in-take and reviewing notes from his SLP and daycare provider. My son now has an IEP for speech. He will start 3-K in the Fall.

Stats1)
At 18 months scored a 1 on the MCHAT
2) At 24 months scored a 0
3) Index finger pointed at 11-12 months/Never hand-led
4) Wave, clapped, fist pumped all at around 14 months
5) Showed us things, and brought us things at around 13-14 months (still does this)
6) Joint attention and name response have always been strong
7) Very connected to people and her environment, loves sharing her curiosity
8) Very good eater, sleeps well
9) Appropriate play skills albeit prefers pretend toys (like kitchen or doctor sets) does not seem interested in cars at all…someone mentioned that being odd once.
10) All milestones were on time, with the exception of speech, babbled a month late
11) Has always been delayed in speech but receptive first emerged at around 11 months and continued to blossom. He understands almost everything in both English and Spanish

Concerns
1) His talking consists mostly of two worded phrases/statements that revolve around him asking for things or claiming things e.g “my toy” “my doll” “mama I want a cookie”
2) He still jargons 95% of the time, with the occasional word thrown into her sentence or some 2 worded phrase e.g “daddy baba jadom….my…aha…toy!” the other 5% of hir speech are clear words or clear two worded phrases
3) Toe-walking seems to increase when he’s barefooted. Still hasn’t tapered off. By now I would have thought he’d walk completely flat
4) Chews on soft things (like his sleeves) but not on hard surfaces/toys, just one things with soft corners. I believe it soothes him like sucking his thumb used to soothe him.
5) Sometimes runs and forth, tapping the same area as if he were playing tag. This happens maybe once a week? For a solid 3-minutes more or less. Same with him walking in circles. Very sporadic and random. But combined with my other concerns, perhaps it’s all relevant.
6) Was biting kids at school, seems to have tapered off. School says he’s very social, and he has great joint attention, but can be quite hyperactive.

 

[jalapeno_pretzel]

Look into a pediatric occupational therapist (in addition to keeping up the speech therapy). Regardless of any diagnoses, they can evaluate and provide therapy for your concerns if they think it's necessary or helpful.

 

[Disturbia]

I have a 4.5 year old who has sensory issues. She didn’t get a diagnosis until she was 2.5 years old and we barely got any free state therapy sessions. Pediatrician didn’t notice and she never told us therapy is free. She goes to public school for 2.5 hours (they cut everyone’s hours from 5 to 2.5 even though she specifically needs more peer interaction per IEP). They reduced the places they offered services so she had to move to a school far away (last year she was in the same school as our 7 year old). We had started daycare at 2.5 and were forced to go into the public school system in order to get her the state sponsored therapy. They evaluated her in person for barely 20 mins and put her goals so low that she quickly met them. Some things she already knew (shapes, matching, counting to 10 etc) and they assured me if she met the goals she will just have goals reevaluated and will not change her benefits (lies). In 3 months they said she met the goals and so she does not qualify for summer school. So we had to pay for private therapy (1 speech and 1 OT) during summer and we liked the progress and continued it (insurance covers some but it’s still a signifiant expense) after she went back to school last fall. Once they cut her hours we had to look for daycare and they all had 1 year waitlist and we finally got into a new daycare that opened this Feb. So once she comes home around 11:15 am I drop her there but we pay $2,000 per month (no part time hours). It’s a lot of runaround. Speech Therapy is hard to find so keep it and continue if possible. She sucks 2 fingers unless she is busy (so school says they don’t see her doing it much). Buy Billy shoes and try gel insoles. I also got some under armor flip flops but they only have big kid sizes (some shoes have soft round spots on the soles which helps with sensory issues by massaging the foot). I definitely see that she needs PT but the runaround with her and 2 other kids is just already excessive.

Recently her ST (she has a son with sensory issues) told us that we should be seeing a developmental pediatrician who can recommend the number of sessions and so the state cannot deny her the therapy she needs.

Once she is older we plan on taking her to a neuropsychologist (we had our 7 year old evaluated because teacher said he wasn’t doing his class work but he has above average brain activity despite being below the min age of 8 and no signs of ADHD, ADD or Autism). Magnesium (Calm gummies) and L-theanine (stress gummies) combo helps calm down but right now I stopped all gummies .

We do use ARK (multiple heads, vibrates) and she talks more when that need to chew is satisfied.

I researched choline (some kids vitamins have it others don’t) and stop dark chocolate (has lead and cadmium). Magneisum (epsom salt baths or gummies - don’t give at night our DD has developed cavities and has to undergo general anesthesia and root canals next month). The ST recommends liquid vitamins and a water pik (more powerful vs brushing).

https://hiyahealth.com/products/kids-daily-essential

Keep the therapy and daycare going. He will improve slowly. Try to massage his feet and calves. Our DD has bony growth on top of her arch from toe walking.

 

[Disturbia]

Matcha tea (l-theanine) and black tea helps keep them calm but I don’t give more than a few spoons from my own cup.

https://wellnessrd.com/l-theanine-for-adhd/



California baby eucalyptus ease bubble bath and Calendula lotion is calming as well (strong fragrances are irritating).

It’s important to remember that eventhough all this is overwhelming right now, it’s temporary and they will be productive smart adults one day. Edison was kicked out of school but his mother told him he was special and he went on to do great things

https://www.childrenlearningreading.org/blog/thomas-edison-story.html

Do make sure you start swimming lessons (our DD is in private lessons; she doesn’t listen much in the group session) as the highest risk is they have elopement issues is of drowning.

Edited to add l theanine info

 

[Disturbia]

Also give Florastor after antibiotics, give yogurt, reduce sugar and increase fiber (maybe try Weetabix?). There is a link between gut issues and behavioral issues. Some probiotics are better than others.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10028704/#:~:text=Children with ADHD who took,composition of the gut microbiota.


I was watching the video below (explains how gut issues cause heart disease) and it mentioned gut micro biome and improvement in autism

 

[holden]

Obviously I can't diagnose your son, but I can share my experiences with DD21.

DD21 is adopted from foster care. She came to us at 2yo. When she joined our family she was not talking. She said her first words with us. She was a toe walker.

Her speech was unclear, though I could understand her (I was a stay-at-home mom and so familiar with her speech). We had her evaluated before the age of 3. They said she didn't qualify for services. They told me she was trying to say words that were "advanced" and that's why people couldn't understand her.

She was a toe walker for a long time. I can't remember exactly when that stopped, but I don't think she was doing it in elementary school.

She was recommended for and received speech therapy in elementary school. She exited the speech therapy sometime around third grade.

She was a decent student in elementary and middle school - "As" and "Bs". She was a figure skater but struggled to advance in the sport.

In high school she struggled due to depression and anxiety. I won't go into all of the details, but the high school years were extremely challenging. Friends came and went, and she spent a good deal of time in her room.

She is now in college and doing well. Her depression and anxiety are much better.

She recently came to us and told us that she suspects she is on the Autism spectrum. She gave reasons why, and they made a lot of sense. Loud sounds and bright lights bother her. She has difficulty making and maintaining friends (she always has). She has poor hygiene and wears the same clothes often.

She has no kinetic sense - no sense of her body in a space. For example, she is a terrible driver. You know how when you drive you "become one" with the car? She doesn't have that. When I'm on the phone with her and she's driving, I hear the constant "beep" telling her that she's going out of her lane. When she was figure skating, she enjoyed it, but she wasn't good at it. She struggled to do the spins/jumps correctly. She could do the basics, but she couldn't advance because there was no connection between her mind and her body.

There are other reasons too, but I won't go into them here. We don't know for sure if she's on the spectrum, but she is neurodivergent in some way.

All of this to say...keep fighting for testing and services. Anticipate that your child's needs might change as he grows. Understand that these things are not easy to diagnose, especially when kids are young. Sometimes you only notice things in hindsight.

If you are there to support your child and advocate for your child, you will be doing the right thing. It's okay if you don't know what he needs. Do your best and love him lots. It will be a journey, and there is no quick fix.

If your face lights up when he enters the room, you are on the right track.

Take care.

 

[JediBonas]

My twins were both speech delayed but my son was the worse one so I'll share his experience. He was barely babbling at 18 months, started speech therapy before 2. I'm not sure he even said his first word until he was over 3, at that point they had me put them in a mixed pre-k school (so half the class had services, half did not). That definitely helped, my daughter more then my son, but he started using words more. He is 12 years old now and still in speech, mostly for pronunciation, but they expect him to lose services after next year for speech. He has always been SUPER hyper, so the ADHD diagnoses was not a surprise. There were days back in maybe 2nd grade he'd be incontrollable and I would have to pick him up from school. As he got older that thankfully stopped. He never did the toe walking but I remember my daughter doing that and my concern, but it didn't end up being anything with her, just how she liked to walk. He also would chew on EVERYTHING, especially shirt sleeves and necks, but hated the rubber chewing necklaces I'd try to have him use. I think that was an ADHD thing, he outgrew it as he got older.

You're doing what you can and supporting your son, that's the most important. I remember my pedi thinking I was being over-anxious when I first brought up my speech delay concerns, but she still got the ball rolling for IEP services. It can be scary and stressful as a parent but you're doing your best, just remember that. My kids are in 7th grade now, both in honors courses and on highest honor roll, my son is still getting speech services, although way less and less intense then in the past.

 

[SandyinMonterey]

My daughter was a micro-premie, weighing 1.7 lbs., born at 28 weeks. She had major speech delay . My daughter also had an IEP. Is your son receiving speech therapy from his school? Is he going anywhere else for speech therapy? Such as a private therapist? In my experience, dealing with public schools for speech therapy was laughable. Took her to the school and also took her to a "day care" type of place (run by the school system) that was for kids who needed speech therapy. There were 3/4 speech therapists and teachers and they never did anything 1:1. They told me that therapy was done during play interactions and "just stepping in." What a joke, they'd come out for about 10-25 minutes, walk around, talk a little bit and called it therapy. With speech therapy via a public school system, they are only required to do what they consider "they most appropriate." They set the bar low and keep it low. But the one thing I did get out of it, connections. Moms and Dads of speech therapy kids develope a connection and become the best source of information. Started taking my daughter for private speech lessons. $50/week (this is over 10 years ago). My insurance wouldn't cover it. It was only then I started seeing a difference. I felt it also important to keep my daughter with kids that were speech delayed. To be among the kids that were talking and hitting their milestones (all my daughters milestones were delayed). When it come to Pre-K and going forward, she went to a "regular" school. I would definitely check in with pediatrician (in person). They could recommend and refer you to specialists. Looking back, I was so scared. I was always fighting for her, to get her the best care and resources. Afraid that if I didn't, where would she be, how would she be. But, hey, as a parent, that's our job, right? Try to make some contacts, do research, look for groups (like a play group). My daughter is graduating high school in a couple of months, with honors (cum laude) and will be studying engineering and a minor in computer science.

 

[Disturbia]

I also wanted to add that our DD also has occupational therapy to better grasp things and have more body awareness (something like a weighted blanket and a swing help). Also a scooter with handles




Scooter with handles (make sure basement stairs have gates and it’s only used on flat areas)


Toys that encourage a stronger grasp and scissors

 

[Disturbia]

My daughter was a micro-premie, weighing 1.7 lbs., born at 28 weeks. She had major speech delay . My daughter also had an IEP. Is your son receiving speech therapy from his school? Is he going anywhere else for speech therapy? Such as a private therapist? In my experience, dealing with public schools for speech therapy was laughable. Took her to the school and also took her to a "day care" type of place (run by the school system) that was for kids who needed speech therapy. There were 3/4 speech therapists and teachers and they never did anything 1:1. They told me that therapy was done during play interactions and "just stepping in." What a joke, they'd come out for about 10-25 minutes, walk around, talk a little bit and called it therapy. With speech therapy via a public school system, they are only required to do what they consider "they most appropriate." They set the bar low and keep it low. But the one thing I did get out of it, connections. Moms and Dads of speech therapy kids develope a connection and become the best source of information. Started taking my daughter for private speech lessons. $50/week (this is over 10 years ago). My insurance wouldn't cover it. It was only then I started seeing a difference. I felt it also important to keep my daughter with kids that were speech delayed. To be among the kids that were talking and hitting their milestones (all my daughters milestones were delayed). When it come to Pre-K and going forward, she went to a "regular" school. I would definitely check in with pediatrician (in person). They could recommend and refer you to specialists. Looking back, I was so scared. I was always fighting for her, to get her the best care and resources. Afraid that if I didn't, where would she be, how would she be. But, hey, as a parent, that's our job, right? Try to make some contacts, do research, look for groups (like a play group). My daughter is graduating high school in a couple of months, with honors (cum laude) and will be studying engineering and a minor in computer science.

The therapy is now $130+ for ST; our insurance covers it as our DD isn’t talking yet but because she is walking OT is only covered 80% after a deductible of $1000!

Also with ELBW preemies sudden adult onset retinal detachment is a concern so definitely get yearly eye exams.

https://pubmed.ncbi.nlm.nih.gov/23726667/

It’s very encouraging to hear the end result of years of therapy. Our DD is a year ahead intellectually and being born late fall has an extra year to catch up to her peers before kindergarten.

 

[Dreams&wishes]

My son didn't crawl and started walking at 12 months, he wasn't really bubbling and started saying his first words at 3 yrs started talking around 4 but it was very hard to understand and he developed a stutter. He had to have OT to "link left and right side" of the brain.
He is now 11 his stutter is almost gone he still has some clarity issues with his speech very minor. Other than that he is super smart, very popular with his peers and he plays heaps of sports.

Courage a 3 yr old is very young and still does funny things. By all means keep an eye on him if you are worried, but keep being positive as it could turn out totally fine.

 

[mjkacmom]

My son didn't crawl and started walking at 12 months, he wasn't really bubbling and started saying his first words at 3 yrs started talking around 4 but it was very hard to understand and he developed a stutter. He had to have OT to "link left and right side" of the brain.
He is now 11 his stutter is almost gone he still has some clarity issues with his speech very minor. Other than that he is super smart, very popular with his peers and he plays heaps of sports.

Courage a 3 yr old is very young and still does funny things. By all means keep an eye on him if you are worried, but keep being positive as it could turn out totally fine.

I think it’s great to be positive but I don’t think this is a wait and see situation. Early intervention works, and the earlier the better.

 

[Disturbia]

I think it’s great to be positive but I don’t think this is a wait and see situation. Early intervention works, and the earlier the better.

I think the problem that Speech delayed (sensory processing disorder causing speech and language impairment) kids have is different and they require intense early intervention but can catchup with it (but not without).

 

[PrincessShmoo]

I have concerns about my 3 year old son. He just turned 3. He has only recently started combining two worded phrases/sentences. His only diagnosis is "expressive language delay". He attends daycare 5x a week. He receives speech 3x a week. He has been seen by a DP and he ruled out ASD. But the whole visit was via zoom, and he saw my son for maybe 10 minutes. Most of the visit was parent in-take and reviewing notes from his SLP and daycare provider. My son now has an IEP for speech. He will start 3-K in the Fall.

Well, it's been a number of years since my children were that young, but I'll tell you what I remember about it. Our daughter had no speech issues, but our sons both had some. Older one basically just "babbled" and I, even as his mother, couldn't always understand what he was saying. It didn't stop him from "talking" however. When he started Kindergarten they recommended speech therapy at school. He was in that for the whole time he was in elementary school. The younger one didn't talk at all. A lot of pointing and grunting. I had started using sign language with him by age 3, but once he started school he started talking - full sentences. He never had any speech assessments done. Neither one of them had any other socialization issues.

 

[SandyinMonterey]

The therapy is now $130+ for ST; our insurance covers it as our DD isn’t talking yet but because she is walking OT is only covered 80% after a deductible of $1000!

Also with ELBW preemies sudden adult onset retinal detachment is a concern so definitely get yearly eye exams.

https://pubmed.ncbi.nlm.nih.gov/23726667/

It’s very encouraging to hear the end result of years of therapy. Our DD is a year ahead intellectually and being born late fall has an extra year to catch up to her peers before kindergarten.

Our insurance denied speech therapy saying that being born premature isn't a medical condition. So, even though she wasn't breathing when she was born and had to been intubated and life flighted to NICU in SF and spent 3 months there then another month in another hospital with medical costs over a million dollars, "being born premature isn't a medical condition." I had letters from USCF doctors, speech therapists, specialists...and still denied. Took it to a lawyer and they did say we had a very good case and would take us on.
Her eyes have been checked every year since she was born. She does wear glasses.

 

[easyas123]

The younger one didn't talk at all. A lot of pointing and grunting. I had started using sign language with him by age 3, but once he started school he started talking - full sentences. He never had any speech assessments done. Neither one of them had any other socialization issues.

Had something similar in our family. My youngest brother wouldn't talk, or couldn't talk. My folks took him to all the Dr.'s, he was put in speech classes, and tested for being deaf. Then, when he was about 5 he just started talking. My grandmother used to say he must not have had anything important to say until then and couldn't have gotten a word in anyhow with his older brother & sister talking over and for him!

OP - hope you are able to find a medical professional who can offer some words of wisdom and/or assistance w/ this.

 

[princesscinderella]

My nice did not start talking well until she was about 5. She is now a young adult with no learning delays or issues. It’s sounds like you are doing a wonderful job as a parent.

 

[bwilcox]

I am a speech language pathologist in public schools in my state. A large percentage of my caseload is preschool age children with speech impairment/language delays, such as your child. Obviously, I cannot diagnose him, but here are some of my thoughts based on what you wrote:
1. I see lots of positive signs: putting two words together to request, strong receptive skills, pretend play, connected to people.
2. I predict that you will see an increase in his expressive language when he begins 3-K. He will have lots of other children modeling language to him, as well as speech therapy. I am sorry that a previous poster had a bad experience with public school speech therapy. That is not the case for all school districts. I'm biased of course, but I spend lots of time and effort working with my speech kiddos, as I know the other SLPs in my district do as well. Ask your SLP how you can support what he/she is working on with your child at home.
3. Request a physical therapy evaluation through the school to address the toe walking.
4. As far as autism which has been brought up: usually there is a large social communication component to this diagnosis. For instance, the child doesn't show an interest interacting with others. The only thing you wrote that makes me question this possibility in the slightest is the running in circles, but that could just be for sensory input.
5. Jargon is not uncommon with children with a language delay. It could be a result of him trying to tell you more than he has the vocabulary/ability to put together, so nonsense comes out. I usually see jargon decrease as expressive language increases.
6. It is developmentally appropriate that his limited utterances revolve around making requests for things he wants. This is where children often start (after single word label like momma and milk). This is not something to be concerned about.
I see this time and again. While your child's speech is delayed, he WILL develop speech. It is just taking a little longer.

 

[TheExProphet]

I am a speech language pathologist in public schools in my state. A large percentage of my caseload is preschool age children with speech impairment/language delays, such as your child. Obviously, I cannot diagnose him, but here are some of my thoughts based on what you wrote:
1. I see lots of positive signs: putting two words together to request, strong receptive skills, pretend play, connected to people.
2. I predict that you will see an increase in his expressive language when he begins 3-K. He will have lots of other children modeling language to him, as well as speech therapy. I am sorry that a previous poster had a bad experience with public school speech therapy. That is not the case for all school districts. I'm biased of course, but I spend lots of time and effort working with my speech kiddos, as I know the other SLPs in my district do as well. Ask your SLP how you can support what he/she is working on with your child at home.
3. Request a physical therapy evaluation through the school to address the toe walking.
4. As far as autism which has been brought up: usually there is a large social communication component to this diagnosis. For instance, the child doesn't show an interest interacting with others. The only thing you wrote that makes me question this possibility in the slightest is the running in circles, but that could just be for sensory input.
5. Jargon is not uncommon with children with a language delay. It could be a result of him trying to tell you more than he has the vocabulary/ability to put together, so nonsense comes out. I usually see jargon decrease as expressive language increases.
6. It is developmentally appropriate that his limited utterances revolve around making requests for things he wants. This is where children often start (after single word label like momma and milk). This is not something to be concerned about.
I see this time and again. While your child's speech is delayed, he WILL develop speech. It is just taking a little longer.

Hi there, today he had an OT eval, and she said his version of running in circles isn't atypical because he doesn't do it enough for it to warrant further investigation, for example he can go days without doing it and when he does do it, the whole thing happens under a minute. She wants to work on the toe-walking, says he craves sensory input but doesn't meet the markers to be diagnosed for SPD.

 

[Dreams&wishes]

I think the problem that Speech delayed (sensory processing disorder causing speech and language impairment) kids have is different and they require intense early intervention but can catchup with it (but not without).

View attachment 842854

Apologies I haven't been clear. 100% therapy needs to be done. My son has been with a speech therapist since he was 3yrs old (he had language delay as well as stuttering)and he is now 11 and saw an OT for a few years. I was just trying be positive and say that sometimes, we think the words but with the help of therapy ,these things resolve themselves.

I think it’s great to be positive but I don’t think this is a wait and see situation. Early intervention works, and the earlier the better.