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

[Anonymous]

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.

[Anonymous]

What does the pediatrician say? Ask your pediatrician to refer you to a developmental pediatrician and Childfind. A 2.5 yr old who does not say a single word needs a through evaluation.

Childfind will give you services including speech therapy at no cost to you. You can always supplement with private services too.

[Anonymous]

Well, it's not the two year old in him. sorry to be harsh op but I've been on this path and it's important to be realistic even if it's hard. The normal range, from 5-100 percentile, is to combine words at this point and they're well on their way to sentries usually. So I'd get a thorough eval also and go from there.

[Anonymous]

If you're a DC resident you can get free therapy through Early Intervention.
http://osse.dc.gov/publication/strong-start-dc-early-intervention-program-dc-eip-road-map

This program really helped us to get our son the therapy he needed, because our insurance didn't cover it either.

Your county government (if you're in VA or MD) may have a similar program that can get you free or reduced price therapy.

[Anonymous]

Its MERLD, its not a official diagnosis anymore but many of us still use it. There are a few Facebook groups that are far more supportive than here.

Receptive language is how much your child understands - can he follow simple commands, does he answer his name, etc.

Expressive is the talking part - how much is he talking.

Insurance sometimes covers it, they covered ours after about a year but it was a huge fight and finding the right doctor in our system who could get it pushed through.

Receptive language is much harder than expressive language. At least our experience.

There are several lower cost places - three local universities and Scottish Rite that have sliding fee services. U of MD has a preschool for 3-5 year olds as well called LEAP. And, you can do Infant and toddler but given his age they may make you wait till 3 and then it is child find.

What is going on with the language? What specific questions can we answer for you?

[Anonymous]

I agree with the PPs that you should have a developmental pediatrician evaluate your DC. It may take a while so contact Child Find in your jurisdiction. Give them the results of your speech therapist's evaluation. They should an OT/PT consult. The result of those assesments will be helpful to the dev ped.

[Anonymous]

Anonymous wrote:Its MERLD, its not a official diagnosis anymore but many of us still use it. There are a few Facebook groups that are far more supportive than here.

Receptive language is how much your child understands - can he follow simple commands, does he answer his name, etc.

Expressive is the talking part - how much is he talking.

Insurance sometimes covers it, they covered ours after about a year but it was a huge fight and finding the right doctor in our system who could get it pushed through.

Receptive language is much harder than expressive language. At least our experience.

There are several lower cost places - three local universities and Scottish Rite that have sliding fee services. U of MD has a preschool for 3-5 year olds as well called LEAP. And, you can do Infant and toddler but given his age they may make you wait till 3 and then it is child find.

What is going on with the language? What specific questions can we answer for you?

If he's 2.5 and hasn't spoken a word, no early intervention (EI) service will make you wait 6 months. OP, call EI for your state. Infant & Toddlers is in MD and other PP mentioned DC. EI services generally run when schools are in session, so call tomorrow morning. This will be less expensive than paying for private. Schedule an evaluation.

Ask EI about Hanen classes. You can also order the book, "It takes two to talk," from Amazon. GMU and GW also have speech clinics associated with their Universities. Sometimes insurance will let you submit after the fact if they don't cover services.

Check with ASHA for accurate information on speech issues: http://www.asha.org/public/speech/disorders/Preschool-Language-Disorders/

Lastly, make an appointment with an ENT and have his hearing check with an audiologist. Preferably one who has a sound proof booth. The kid will sit on your lap.

[Anonymous]

OP, children younger than 5 or 6 may still be referred to as having "mixed receptive expressive language disorder." When children are younger than preschool age, they can have what are called developmental delays. Meaning that they may need therapy to bring them up to their peers, but eventually, they outgrow the delay with no long term issues.

When children who are 5/6 or older and still have lingering issues, psycho-educational or neuropsychological evaluations are comprehensive testing that determines various diagnoses. What 15:01 was referring to is that MERLD is no longer a current diagnosis in the DSM. The DSM is the Diagnostic and Statistical Manual published by the American Psychiatric Association every several years based on review of clinical research. You'll hear terms like "evidence based." That's what the evidence is based on--clinical research. The DSM is one of those big fat books you'll see in doctor offices. We're on version 5 that was published in 2013.

Essentially, prior to 2013, when an older child was diagnosed with MERLD, it indicated that a child was not on the autism spectrum. Parents who were obsessed by this and equally obsessed that school designations provided by IDEA and FAPE for IEPs did not necessarily reflect the diagnostic nuances, banded together to form Facebook groups. However, you won't need to worry about this alphabet soup for a couple of years (if at all). The DSM is a really fat book and there are literally only a baker's dozen IEP designations.

However, kids who were diagnosed under the DSM with MERLD prior to 2013, have different diagnoses--some still mean that kids are not on the autism spectrum. Still some people weirdly cling to the "MERLD" terminology even though it's woefully out of date. Why I know this is that I had a kid diagnosed with MERLD and now has various different diagnoses--none of which is autism. Why I'm bothering to write this post is that you are obviously new to this arena, and cryptic, rambling comments about support can only confuse the situation. Basically what the formerly-known-as MERLD parents want you to know is that their kids aren't autistic. (So yeah, we get it "MERLD" parents, you don't need to send a slew of responses that will only further confuse the OP. I am not writing any opinion, just facts.)

Seeking out a developmental pediatrician is a good idea. It will take several months to get an appointment. Make an appointment with Children's and Kennedy Krieger (KKI) and take which ever appointment that comes up first and cancel the other.

[Anonymous]

FYI....a lot of time they give this diagnosis when young because they are now sure what the real cause is and want to give them a little more time to see how they do. They did his for my child. Turned out later to be apraxia and asd.

[Anonymous]

OP, come join some of us on the Facebook groups for Merld and speech delays. The parents are very helpful and will give you much more information, help and support than those here who push their own agenda like the last two posters. There are several (or one) poster who insists MERLD is not relevant, when it is, and everything is asd or adhd or both along with complex learning disorders. If we discuss receptive and expressive issues here, they insert their own agenda and often give misinformation or spew very unhelpful facts.

[Anonymous]

Anonymous wrote:OP, come join some of us on the Facebook groups for Merld and speech delays. The parents are very helpful and will give you much more information, help and support than those here who push their own agenda like the last two posters. There are several (or one) poster who insists MERLD is not relevant, when it is, and everything is asd or adhd or both along with complex learning disorders. If we discuss receptive and expressive issues here, they insert their own agenda and often give misinformation or spew very unhelpful facts.

Or the OP could just rely on actual facts from the American Speech Language Association (ASHA).

[Anonymous]

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.

[Anonymous]

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.

[Anonymous]

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.

[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.

And my child does not have autism. Not was he ever suspected of having it because he is not borderline as the children on the facebook group all clearly are not all the way over. The professionals in this area are well capable of recognizing autism.