next steps at age 3
![[Post New]](/jforum/templates/default/images/icon_minipost_new.gif){kind=icon}
Anonymous
|
I'm looking for advice on what best supports would be for 3 year old with expressive language delay, social skills delay. Child will likely go into PEP Pilot/Classic next school year. He is currently in a daycare and needs some help with redirection, attention to non-preferred activities. No behavioral issues (yet). Large vocabulary, echolalia/scripts/gestalt, but not enough functional communication for his age relative to peers. 1:1 interaction at school (does not have an aide) seems to help. Enjoys social interactions. Every day/week seems to be learning/talking more and more.
Appt with developmental pediatrician not for almost a year from now. Should I be seeking private OT and ST? Thoughts on looking into 1:1 aide at school to help with the engagement? Thought on doing half day school instead of full day and then supplement with a nanny for more 1:1 interaction? Without a diagnosis, would RBT be something to even consider? |
Anonymous
|
Hey OP. My child sounds somewhat like yours with high functioning autism. My son’s difficulties are mostly social and functional language. Assuming there isn’t financial hardship, I would definitely do OT and SLP private pay. At the very least, do an evaluation with them to see where your child is relative to expected at that age. We pay with HSA and it’s $70 for 30min of speech and $140 for an hour of OT. My son is sensory seeking so we’re working on that in OT. Both offer good guidance. I observe what exercises the therapists do and try to do as much as possible at home.
I’d say generally all the therapies are worth considering but may not be accessible without official diagnosis. 3-4 for us has been huge in terms of progress especially in the last couple of months. Improvements in receptive language, still scripting but speaking more functionally than before, and less tantrums. I’m very hopeful for my son. He will be starting inclusion pre-k this fall. My child did not do well in school setting due to lack of 1:1. I’m taking a break from my career to spend time with him. I’m hoping with the improvements he’ll do better in the classroom setting this fall. |
Anonymous
|
Has your child been evaluated by CPSE? That is your first step- qualifying him for services at the preschool level (SEIT, OT, PT, SLP etc.) and an IEP to work on specific goals that would enable him to attain skills that will ultimately prepare DC for kindergarten.
Would parallel path a developmental pediatrician privately because the lead times are very long. Whatever services they recommend that aren’t covered by your school district you can seek out privately. |
Anonymous
ABA |
Anonymous
| ABA will be very expensive if you don’t have a formal diagnosis. |
Anonymous
|
OP, dev ped wait sounds too long. Are you on Children's waitlist? If yes, call individual locations periodically and ask for cancellations. I am in MD so I called Takoma Park and Rockville front desk every week, was given an appt in less than 3 months. But you need to be ready to drop everything and go if they tell you there is a time slot tomorrow.
Without diagnosis it's hard to afford 1:1 services. Yes, sounds like ST and/or a good OT would be a good idea, but you need a diagnosis and big picture from a dev. ped and/or clinical psychologist. |
Anonymous
Small price to pay for early intervention. You don’t get those early years back. |
Anonymous
| I think your plan of private OT and speech and PEP preschool is good and just try as best you can to move up the developmental ped appointment in order to hopefully get a formal diagnosis of autism. Call often and see if there are any cancellations or even try to get in elsewhere. The wait for my regular developmental pediatrician was also almost a year, but I know people who got in with Kennedy Krieger in Baltimore within about 3 months. |
Anonymous
| If you do ABA you can learn to implement many programs yourself with assistance of a good BCBA, thus limiting overall costs if that’s a concern. You can hire a nanny that can become an RBT or a company can provide one. You do not need a diagnosis to start ABA, many young children start well before a diagnosis. Providers should do a thorough interview, review history, and conduct various assessments as part of the intake process. Parent training will be part of the protocol, home based is encouraged for this reason but services can also be carried over to daycare, community outings, play dates, overlap with other providers, etc. If cost is a concern talk to providers about ways you can minimize those, there are many ways to do this. Generally speaking, the more time you can commit the less financial impact you will see. ABA EI programs are hours and hours of work to get going as most require materials to be bought or made (not difficult to make, just time intensive) but run pretty smoothly after you get a system in place (first 6-12 months are hardest). Find someone with experience in verbal behavior if functional language is a primary concern- ABA providers will address other areas as well, not just language. |
Anonymous
|
Yes to the speech therapy! OT if there are motor delays. OT can also help focus on daily living skills like getting dressed, using a fork, etc.
|
Anonymous
ABA may or may not be helpful - but OP IS getting early intervention. She’s enrolling her child in PEP and figuring out other services. No need to panic. |
Anonymous
Most parents panic over hearing 1-2 months from intake phone call to assessment date because they realize how valuable time is for early intervention. I know this stress well because I’m usually the first person in a home, sometimes with almost zero information just to get services started ASAP. You do whatever services you want, however you want, but best practices is definitely not sitting around waiting on evals and IEPs. |
Anonymous
That’s a very privileged statement. |
Anonymous
I’ve worked with homeless people to billionaires and every walk of life in between- hardly sounds like an intervention based on “privilege”. |
Anonymous
There are parents at my kid’s daycare who can’t afford even the insurance copays for ABA. |