Receptive and Expressive Language Delays
I suspect my stbad has intellectual/cognitive delays or deficits that are causing her lack of receptive and expressive language. She was @1mo premature, and has been slow to reach other milestones. She is now 14mo, and still has no expressive language. I had initially suspected a hearing problem, as she did not respond to her name, but I have no longer suspect that is the case (although we are having a hearing evaluation done next month). She is a poor problem solver, and is not responsive to simple commands/requests. I have been trying to teach her sign language for the basics such as "more, milk, all done, eat", but if she does attempt to do them, they are completely out of context. I am not too concerned about autism as she does engage well. Have any of you had experience with a kiddo that just doesnt seem to "get it" (for lack of a better broad spectrum descriptive). I really want to be proactive in getting her the services she needs. I am already working with the birth to three program, but honestly, they have not done any assessments, and haven't been much help. I was wondering if the Bayley Scale assessment, or other assessments should be done. Any insight would be so helpful
Our AS is much the same way, with the exception of the history of prematurity. He has been involved with our EI program since he was about 9mos old, but I think that has helped him minimally. He has severe expressive and receptive language delays, though he does respond to his name and signs "more" in context - that didn't start until around 20 mos, and we haven't been able to get him to learn any more signs since then. He can differentiate between different cues for food/drink, by indicating nonverbally what he wants, but that's about it...

He *was* diagnosed with autism, despite my thoughts that his happy, bubbly, interactive personality didn't qualify. Apparently, part of autism is not being able to use social cues - mimicking, mirroring, copying language, etc - to learn. THat is more of a sign of autism than of straight cognitive delays. FOr example, DS can't watch me do something and then do it himself, like a typically developing child - it *has* to be hand-over-hand. And I definitely can't "talk" him through it. I can't even get him to go "find Daddy" - and he's 2.5.

DS makes eye contact, initiates roughhousing play, cuddles, gives hugs and kisses (though not on cue), babbles, and has what may just be typical toddler quirks in behaviors (no rocking or other stereotypical autism behaviors) - yet, despite all that, autism does seem to be a fitting diagnosis.

THat being said, I think it's high functioning, mainly affecting his communication skills...and am desperately working on getting him the therapy he needs to hopefully someday be close to "normal."

Good luck. The road ot figuring out what is "wrong" can be frustrating Unhappy
How long have you had her? If it has been since birth, then it could be from any number of inutero/birth issues. But if you haven't, then there could be some trauma/fear stacked on top. It is amazing how much an infant can be affected. Our very first kiddos 15years ago included a baby who was traumatized and it caused her issues all around for quite awhile.

Having a ds with an ASD, I can tell you that some can engage really well. So I wouldn't rule that out. However, I wanted mostly to tell you that where therapies help, I think what helped him (and Monkey with all her issues) the most was working with them myself, doing right brained learning activities, etc. Monkey, btw, tested in the 5th percentile for receptive language and 1st percentile for expressive at 11mo. She now would likely test in the very top percentiles! She does need explicit instruction/walk throughs for new things. Like I had to show her how to get the babydoll in and out of the toy stroller I bought her. We also had to TEACH her things most kids just "get" like climbing down from the couch, stepping out the door (while holding on), etc.

Anyway, we do counting, ABCs, letter sounds, Sparkabilities, etc. With my son, we did Teach Your Baby to Read (the 1960s version) which jumpstarted his speech (went from saying Mama at 22mo to signing or saying a normal amount of vocab a two year old 3, articulation was the only concern). BTW, Monkey *loves* Sparkabilities (6-7min samples of each level are available on YouTube. Try Babies 2 and Toddler 1). She can now sing several parts of the ABCs and count to 8 (though she does it by counting to 4 then counting 4-8). But the thing that matters most is looking at picture books together, playing with various toys together (taking care of baby, loving on bear, figuring out how X works, dancing to the toy guitar, etc). Finger plays are good also.

Just a warning. MANY times when you're doing right brained learning, certain play things, etc you will not see progress right away. In fact, programs like Teach Your Baby to Read impress upon you not to test your kids, just keep going steady, they'll show you when they're ready. Same with speech, playing, finger plays, etc. It is okay to do 5 little monkeys forty days in a row before you get two signs from your little one. And most probably she'll surprise you with how much she does when she finally DOES do it. My son went from 2 words to 70 in about two months, but he waited the full two months to do ANY of it, from what I could see (btw, don't expect 70 words in two months. My son was older and all kids are individuals).

Okay, natives are restless....
In our state Early Intervention (Through the county serving Birth-3) would assess a child and provide the recommended services. The eval usually would include a special ed teacher, a psychologist and whatever specialists need to be included - usually speech language and often PT or OT. I would push for the eval(s). One thing that is difficult is to assess if the language is on target with the rest of the development. Here, before school age, if a child is cognitively on target but language is behind, they might get speech language services. If cognitive also behind, the child might get teacher and speech language- etc. with the motor skills. In school this changes -Unless there is a specific diagnosis of severe delay/disorder (autism, MR, Downs Syndrome) a school age student will not get those services unless there is a discrepancy between the cognitive and the language. So if cognitive and language both a year behind, a school age child would not likely get services in school.
So your little one is young, and I would push for the formal eval process to get the needed services- or determine that they are not needed. I would ask what the process is and how to get it started. I would also let you know that they may adjust her "age" due to the prematurity when doing the testing. So if a child is a month premature, it is not unusual for her to be a month behind on milestones. I hope that makes sense.
Thanks so much for your responses. They were invaluable! I really do believe our stbad has issues that need to be addressed, and it is all the more difficult when I get resistance from cw, family, and friends. They think she is just a cute happy baby. She is a cute, happy baby WITH delays. I have always been proactive in my childrens' development. If I had listened to my pediatrician when my daughter was young, I would have never taken her to the ENT to have her hearing checked. In so doing, not only did we discover huge adenoids that were blocking her eustachian tubes, but I also followed up with speech therapy, and she was diagnosed with apraxia. My mommy gut tells me there is something wrong with our stbad, and I want to have all the evaluations done prior to our adoption, so I can inform our cw of her needs.
Talk to your Peditrician about having a genetic Microarry. Basically genetic testing for anomalies. My AS was delayed - but in some things. I said he had swiss skills. He was good at somethings, but totally missed others. He waked at 17 months, started single words @20 months. He had issues with the suck/swallow/breathe thing.

He had EI services from the age of 6 weeks. Progress was/is slow but he is getting there.

In October he had genetic testing done and he has 2 chromosomes where there is a dupication. The dup on #15 is the cause of his Austistic like behaviors. He is loving and cuddly and kind and generous and empathetic......but he is routined and hand flaps, limited eye contact, rote conversation, spins for hours on end.

More is known about genes and possibilities every day. % years ago - nothing about the dup15. now there are groups and studies and research - AMAZING things. Be cause you don't know the genetic background - your Pediatrician may be willing to try. If your little one has a small head (microcephaly) that combined with being a preemie and delays will get most insurance to cover the testing.

Sometimes a medical basis will help stear treatment.

I agree with the repetition and books and pointing and repetition and songs and music and did I say repetition will help.
I want to say that sometimes private help is better than ECI. Here, my chances of getting an OT out here is next to nil so I'd use ECI (unless by miracle I found an OT with an opening). But for Monkey, for example, I used private home health for speech and physical therapy (btw, PT is another that is hard to find; but our PT took us because our ST told her that we ALWAYS do every bit of homework and my kids progress better than one would expect). But I prefer private because the number of visits is about double (for the children I've had).

Another reason to look into private therapy is because, here, ECI's standards have tightened so a kid who needs therapy may not qualify; but they would qualify according to private therapy companies and medicaid. This also is what happened with Monkey.

Anyway, just a consideration. Here, all foster kids are checked by ECI. We have used some ECI services for some kids (OT, dev therapy, spit up concerns, behavioral social worker, etc); I just WAY prefer private therapies when available.
My AS-8yo has receptive/expressive language delays. Even though after therapies he is really just dealing with the receptive part of the diagnosis now. It takes him a really long time to comprehend. It is not that he doesn't hear you, it is more like he is trying to piece together what you are saying. It is frustrating at times. Sometimes I have to slow down when I tell him something or repeat myself many many times. Working with him has improved his behaviors a lot also. It will also help to know that he was a late talker. He started talking at 25 months. He was thought to have autism but it was ruled out completely when he was 3.5 years because he engaged well. He was also diagnosed with cognitive delays early on as well. Because I was able to get him EI & into speech & occupational therapy he has come a long way. He is now on target with his peers.
Thanks again for the additional info Happy. I know they can't diagnose auditory processing at this age, but I wonder if there is some sort of evaluation that can be done. Sometimes when you say her name she will look, but most of the time she completely ignores you and goes about her business. It is not a hearing issue, as she is quick to turn if she hears another noise. She will also start to scream and cry for no apparent reason. This will last for @ 30 seconds, and then she "moves on". I am really trying to pinpoint the areas of difficulties by running her through a few "tests", i.e seeing if she can find an object, follow simple command, get a small object out of a container, etc. Very interesting to see how she problem solves
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