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I was surprised to read 9:57's response because it is so different from what I have been told by STs. Mine has HFA and does interactive play, but does not do nearly the amount of back and forths as NT peers. Mine also parallel plays quite well and I have always been told that 5 y.os rarely do that anymore. When it was happening still at 3 with some interactions here and there I was told that is within the realm of normal for boys, but by the 4s and beyond there should be lots of interactive play and conversation (though not as much conversation as with girls). Mine was also dxed with APD early, by a clinician who has a lot of experience with it and who knows it when she sees it-not by evaluation.
Re:autism. A lot of what 9:57 wrote is what other professionals told me is a myth. My spectrum child has great eye contact, rarely perseverates and has lots of interest in other kids. Pragmatic weakesses are his issue not interest. I was also told you rarely see kids with receptive delay who aren't on the spectrum. Mine now has caught up receptively, but not expressively, but we still consider the HFA dx fitting due to pragmatic issues and motor planning weaknesses as well as huge scatter in strengths in weaknesses. |
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I agree with 16:57. Some kids with ASDs make great eye contact. My DS does not and I remember meeting another child with whom he was in a group and thinking that child must be higher functioning then mine because he made great eye contact, but once I got to know him it was clear that his impairments were just different, and actually more serious.
Most kids I know on the high end of the autistic spectrum are interested in other kids, they just don't interact with them in typical ways. |
| Funny, what 9:57 wrote is right in line with what I was told by the professionals we work with. Also, I have to strongly disagree with the statement "rarely see kids with receptive delay who aren't on the spectrum". Receptive speech delays are not the exclusive domain of ASD. It's well documented that with ADHD, a developmental disorder of the brain, there can be as much as a 30% delay in brain maturation. This certainly can show up as a receptive speech delay. Executive functioning impairment (common in ADHD but not exclusive to it or to ASD) can also result in receptive delays. Going back to the devleopmental delays of ADHD, if a child has a 30% delay, he may be 5 years old chronologically, he's only 3.5 developmentally. When he's 6 chronologically, he's only 4.2 developmentally. There's a reason these disorders are 'spectrum' disorders and why it's important to track development over time to better identify what's going on and what areas to target. |
I'm bumping this thread b/c this describes my son exactly. Wondering how everyone is doing. |
"On the spectrum" is not the same as being diagnosed with an ASD. Language disorders are within the broad autism phenotype, but are not autism. They're related disorders, but they're not the same thing. http://www.psychologytoday.com/blog/making-sense-autistic-spectrum-disorders/201006/006-not-quite-autism-the-borderland-asd |
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The DSM sayd that in order to receive a MERLD (mixed expressive-receptive language disorder) diagnosis, autism spectrum disorder must be ruled out.
If the DSM says it is possible for a receptive language delay to occur without an autism spectrum disorder, then we have our answer. The new DSM coming out next year also requires autism to be ruled out before diagnosing one of several language disorder categories, so the answer is not changing. |
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And not only that, the DSM V is taking out the language component from the ASD description, because so many parents and doctors and school districts were getting this wrong. Instead, it will be social communication and perseveration. |
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Over on our late talkers board, we find many, many, many children who have receptive delays, but not autism. At young ages, it can be hard to tell the difference. Late Talkers often don't make good great eye contact, have trouble in group settings, have trouble paying attention, tantruming from frustration, etc. As their language comes in, their autistic-like symptoms fade out. School is still sometimes an issue, as the heavy auditory load can overwhelm them. I have friends with LTing children....and no one can tell they ever had a late-talking issue. |
Got any friends whose kids had apraxia of speech? My 5 yo DS has it (and mixed expressive/receptive language disorder) and while we see improvements, I don't know any big kids or adults who have it. I'm wondering what lies in store for us. |
| Like PP, my son also has apraxia of speech and mixed expressive receptive language disorder. Would be interested as well in responises to the question she posed. |
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I taught a severely apraxic 12-year-old boy a few years back. He was doing great.
At that point, he had what I would call a small speech issue. Some of his sounds were a bit distorted, but nothing that would really cause you to raise your eyebrows. He was in advanced math, had tons of friends, played sports, etc. Could you still tell there was a speech issue -- yes, but nothing that will affect his quality of life in any significant way.
I do not know if he also had MERLD in addition to his apraxia. |
When my son was first diagnosed with MERLD, I did a ton of research on outcomes. Most young adults continued to have some impairments as they entered adulthood. Fucntionality seems to be tied to general IQ, with higher IQs being tied to better outcomes. |
My child was "Dxed" by our speech therapist as having childhood apraxia of speech. But that wasn't his issue. MERLD is. Apraxia is technically the ability to make speech sounds sometimes, but not others. But speech therapists tend to give it out for many speech disorders. As he's gotten older (he's now 9), his "apraxia" is gone. What's clear is that he has expressive and receptive issues, language processing issues, and auditory comprehension issues. Children with MERLD can have auditory weaknesses even as adults. One father described his son as getting A's in hands-on lab classes, but having more trouble in lecture classes in college. But another dad says his son is getting mostly As and is doing well in college with no signs of his earlier difficulties. |
| Thanks for the follow up posts on older kids with apraxia and their outcomes. I'm the one with the 5 yo with apraxia and MERLD (diagnosed by audiologist/SLP and dev ped). He doesn't seem to have cognitive deficits so I'm hopeful. At least we see progress. Thanks! |
| My daughter has a receptive language delay that was diagnosed at the age of 12, after being diagnosed for ADD, she has difficulty following conversations and reading comprehension difficulties. she was diagnosed late per the therapist because she had great coping skills. She currently has a IEP receives Speech Therapy at school, goes through cognitive retraining, has a writing specialist that works with her and I'm currently trying to find a reading specialist. This is a hard disability to treat because it quite rare per her therapy, so I had to personally investigate this myself. And the treatment facilities are limited state to state. |