2 1/2 year old with possible mixed receptive expressive language disorder

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

[Anonymous]

Anonymous wrote:So my 2.5 year old hasnt said a single word. We got him evaluated by a speech therapist and is now in speech therapy twice a week. Today i asked her what his official diagnosis was and she was a little iffy and said mixed receptive expressive language disorder/delay. I really dont know what that is exactly and ive done some research to learn more about it. But what I want to know is how can a 2 year old be diagnosed so early with this? While i know they are professionals, sometimes i just wonder if its the 2 year old in him.
What upsets me more is insurance wont even cover it.

I'm a different "MERLD" mom. Back to OP's issues:

--Child Find can be a good resource to get therapies. I'd call them now to get slated for an evaluation. They should also check his hearing to rule out issues there.

--When children are really young, under 3, it can be hard to tease out the issues. Also, it may be just a receptive delay. On our MERLD boards, we see many, many parents whose children aren't talking by 2.5 but are caught up by 3.5 with little intervention. But we also see that some children continue to have issues through early elementary, and for a smaller percentage, for the rest of their lives.

--I second the Hanen recommendation, you can also look up Dr. Jim McDonald's Communicating Partners website. You by far spend the most time with your child, and you can be modeling speech and doing "therapy" with him on a daily basis.

--Drop down to the child's utterance level plus one word. Since your child is not using any words, I would go with one word. Concrete words are best, things you can show him and hear the word, like ball, doll, cup, etc. One way to do this is to have a small box of new toys that you only bring down a couple of times a day to work with, containing concrete items of words you want to work on. Pictures are good too, to start the labeling process.


How is your child's social communication? Does he point, look at you to share interests, etc.? Does he recognize his name?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

Quote the post where it turned into a rant about Merld versus autism and paste it. You're the one who brought it up like you do every time. Nobody gives a duck about meeting your kid. Don't be such a raging narcissist. Other people's problems are not an excuse for you to talk about yourself endlessly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

Quote the post where it turned into a rant about Merld versus autism and paste it. You're the one who brought it up like you do every time. Nobody gives a duck about meeting your kid. Don't be such a raging narcissist. Other people's problems are not an excuse for you to talk about yourself endlessly.

Are you done derailing the thread, being nasty and diagnosing kids differently as you see fit? How about giving a little help and support instead.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

Quote the post where it turned into a rant about Merld versus autism and paste it. You're the one who brought it up like you do every time. Nobody gives a duck about meeting your kid. Don't be such a raging narcissist. Other people's problems are not an excuse for you to talk about yourself endlessly.

Are you done derailing the thread, being nasty and diagnosing kids differently as you see fit? How about giving a little help and support instead.

1. You derailed the thread, as you well know, given that the only posts about autism versus merld were authored by you and so you cannot post one, or quote.

2. I am actually the one suggesting that you and your Facebook group do not diagnose her child, but that she go to a developmental pediatrician, and go from there. I have no idea, and nor do you, what is going on, nor would I purport to do so and refer her to, say, my son's epilepsy page because that sounds a lot like what my son with epilepsy looked like.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op do not go on the Merld boards. If you're in the DMV you can get real legitimate help here easily. The Merld boards and groups are parents that are essentially avoiding an autism label at all costs, and often the cost is getting the child therapy. It is truly crazy. Some of the kids have no words at 4 plus and are not in therapy. Steer clear.

OP, this is absolutely NOT true, which is why we cannot discuss things here. Several posters insist that kids who are late talkers have autism, learning concerns (some do but not all, etc). Most of our kids are in speech therapy (those of us who can afford it). This is why we can't talk about language disorders on this board. You have one or more people derailing the conversation pushing autism as their child has it as well as other disorders.

Some of our kids who don't start talking till 4-5 are doing great.

Why on earth would you need to afford it. It's covered by insurance if you actually go to a dev ped and child find covers it also. This is also absolutely true. I've visited several and been horrified by the denial and refusal to actually put aside he parental ego and help the child. It's horrifying and honestly borders on abuse. Sorry, pp, but it's truly awful.[/uote]

What a bitch. You really have no idea what you are talking about.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

Quote the post where it turned into a rant about Merld versus autism and paste it. You're the one who brought it up like you do every time. Nobody gives a duck about meeting your kid. Don't be such a raging narcissist. Other people's problems are not an excuse for you to talk about yourself endlessly.

Are you done derailing the thread, being nasty and diagnosing kids differently as you see fit? How about giving a little help and support instead.

1. You derailed the thread, as you well know, given that the only posts about autism versus merld were authored by you and so you cannot post one, or quote.

2. I am actually the one suggesting that you and your Facebook group do not diagnose her child, but that she go to a developmental pediatrician, and go from there. I have no idea, and nor do you, what is going on, nor would I purport to do so and refer her to, say, my son's epilepsy page because that sounds a lot like what my son with epilepsy looked like.

Facebook MERLD groups -- the good ones -- don't "diagnose" children. Get off your high horse. They are a support group for those of us faced with people like you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

Quote the post where it turned into a rant about Merld versus autism and paste it. You're the one who brought it up like you do every time. Nobody gives a duck about meeting your kid. Don't be such a raging narcissist. Other people's problems are not an excuse for you to talk about yourself endlessly.

Are you done derailing the thread, being nasty and diagnosing kids differently as you see fit? How about giving a little help and support instead.

1. You derailed the thread, as you well know, given that the only posts about autism versus merld were authored by you and so you cannot post one, or quote.

2. I am actually the one suggesting that you and your Facebook group do not diagnose her child, but that she go to a developmental pediatrician, and go from there. I have no idea, and nor do you, what is going on, nor would I purport to do so and refer her to, say, my son's epilepsy page because that sounds a lot like what my son with epilepsy looked like.

No one is diagnosing on those pages. No one even talks about diagnosing. Everyone generally recommends regular evaluations and frequent therapy (multiple times a week). But, you wouldn't know as you'd rather criticize than support and actually see what is going on. There are many bad groups, but there are a few that are really helpful.


If you had a helpful group established for epilepsy, then why not share it? Why not try to help a parent who thinks their kid may be having seizures from someone whose been there/done that. If my kid was having seizures, is one of the first places I'd go. Just like people share about developmental ped's, neuropsych practices, schools, activities etc. on here.

I find it much easier talking to parents of older kids similar to mine as they have helpful advice for IEP goals, speech therapy goals, activities that are successful for kids similar to mine, etc. I've gotten a lot of help that way and very thankful for it. One mom on here early on was a huge help to get me started and think through the therapy choices (I think she's still here but not sure). (one I'm sure you heavily bash as well). What may not be of value to you, may be of value to someone else.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There's no "sticking to the topic" for neuro disordered. They categorically do not work that way. Your kid isn't talking at almost three, there is likely a reason and it isn't likely to be limited. That's the scientific truth.

Whose scientific truth are you referring to? Your's? I know many kids with just language disorders. Its not autism. But, back to the original post, what do you have useful for OP?

To get an eval and not join your cracked out Facebook group.

The child had an evaluation. Read the post. Why do you always have to be so nasty? Do you really think its helpful?

He saw a speech therapist. That's not an evaluation and that's your problem right there.

Speech pathologist do language evaluations. Should she get a more global assessment, yes, but speech pathologists are qualified to do language testing. There is absolutely no need to be so nasty. Why can't you be supportive and helpful? She (or he) is just starting the process and trying to figure it out. You are in a very different place. I feel bad for you that you feel the need to behave as you do.

It's not more compassionate somehow to make every post about a speech delay about you, and your agenda of autism versus "language children," which is an entirely made up, self serving thing. You dominate all of these threads with your nonsense and it is maddening. Quit owning yourself as some great language crusader.

It never started out about me or any of the other MERLD parents or kids on here. It started out as offering support, which then you turned into a rant about MERLD vs. Autism. OP asked what it was. You derailed it. You do not have a language kid, so why do you have to come on every language thread and derail it with your attacks. If you want to offer support, great, but instead of support, every thread is a tangent with misinformation that you make up about our kids, without even meeting them. No one is going on an autism vs. language disorder. OP topic was about MERLD. It was not about autism. And, yet, pages later you still rant about the debate you created without offering anything of substance. Or, did you create this thread to start a debate? Makes me start to wonder.

Quote the post where it turned into a rant about Merld versus autism and paste it. You're the one who brought it up like you do every time. Nobody gives a duck about meeting your kid. Don't be such a raging narcissist. Other people's problems are not an excuse for you to talk about yourself endlessly.

Are you done derailing the thread, being nasty and diagnosing kids differently as you see fit? How about giving a little help and support instead.

1. You derailed the thread, as you well know, given that the only posts about autism versus merld were authored by you and so you cannot post one, or quote.

2. I am actually the one suggesting that you and your Facebook group do not diagnose her child, but that she go to a developmental pediatrician, and go from there. I have no idea, and nor do you, what is going on, nor would I purport to do so and refer her to, say, my son's epilepsy page because that sounds a lot like what my son with epilepsy looked like.

Facebook MERLD groups -- the good ones -- don't "diagnose" children. Get off your high horse. They are a support group for those of us faced with people like you.

Protect from people like me? People who think you should not act like autism is the third rail and make sure to ram your autism versus "language kids" down everyone's throat? people like me who think that people with serious developmental concerns should have their children evaluated by developmental experts regardless of whether they are afraid or unwilling to hear the results of such evaluations? I am not who you need protecting from, PP. You are such a victim and suffer from so much projection it is impossible to get through to you - I have seen so many try and fail on this forum. Why don't you just stick to your group where you can limit your world to like minded people and continue believing its your "language kids" up against the horrible cruel world insisting that they all have autism. There is no such conspiracy out there other than in your own mind.

[Anonymous]

Is Verbal Behavior approach a good program for young kids with MERLD? Is MERLD similar to the new DSM diagnosis of Social Communication Disorder?

[Anonymous]

Anonymous wrote:Is Verbal Behavior approach a good program for young kids with MERLD? Is MERLD similar to the new DSM diagnosis of Social Communication Disorder?

Yes. I have a kid who was initially diagnosed with MERLD and Social Communication Pragmatics Disorder is the diagnosis we ended up with when he went for neuropsych evaluation. MERLD falls under several diagnoses, but this is one. Kids are not considered on the spectrum but they may have similar communication issues to kids who are.

[Anonymous]

NP here. My DS was dx'ed with MERLD back in the day when it was in the DSM and autism was a very infrequent dx. There was PDD and Aspergers as well at that time. There was no insurance coverage for any of these.

My suggestion to OP is to start language therapy, as much as you can pack in when your child is younger. You get more advancement in shorter time at younger ages and you are not faced with trying to get a recalcitrant 9 year old to go with therapy.

Get in line at at a developmental ped. That wasn't a thing back when I faced this and no one suggested it. But even if you child has ASD, he clearly will need language therapy and best IME to start as early as possible.

The closest we got to a cause was the suggestion that multiple ear infections had impaired his auditory processing (tested at GW), so his receptive language was very low. He did eke out somewhat better on expressive language because he apparently was able to exploit pretty much all of the receptive language he had. After a few years of language therapy we found a lot of success with Fast Forward that was offered at our SLP and which can be very helpful for auditory processing.