20:42 here. My oldest DS is now 8 and still has language delays and it's even more clear that he has ADHD (ASD was definitively ruled out by NIH researchers doing a study on ASD and other developmental delays and our dev ped). Although DS is at grade level in reading, he has slow processing speed and other indications of poor executive functioning which affects his comprehension and ability to re-tell. He's not hyperactive but he does take ADHD medication which does seem to help attention and executive function. In the smaller special ed classroom, he appears far more NT but in the general classroom his executive functioning challenges are more apparent. He gets ST through the school but we have not supplemented it privately.

I also have a younger DS with greater delays and apraxia of speech (ASD was also definitively ruled out in the same NIH ASD/dev delay study that my older DS participated in and by the dev ped). He's been in a special ed preschool for the last 2.5 years and receives both school based and private OT/ST. In describing him, one might think he is on the ASD but, again, it's the executive functioning deficit (especially working memory) that impact his language based interactions. It's hard to maintain an exchange when you can't hold the words in your memory long enough to process them all or when you have challenges getting the words that are in our mind to come out of your mouth.

My son's first diagnosis (at age 6) was Mixed Expressive Receptive Language Disorder. He was very bright, but really showed language delay in comparison to his peers. After about a year of speech therapy, his diagnosis was changed to high functioning autism. He became more obviously ASD, not less once he started talking more. His preservative interests are very strong. We just didn't see them as much when he talked less. Also, as he started to talk more, his problems with social communication and pragmatic language use became more evident.

Speech therapy helped tremendously. He's much more functional and happy now. To OP, I would say don't worry too much about the label and just treat the deficits. The intervention for a language disorder is speech therapy and opportunities to practice social skills (gymastics classes, playdates, preschool). These are also key interventions for an ASD. Start with treating the language delay and see where it leads. Many more kids have speech delays than have ASD.

These are all big red flags for ASDs. My son had these kinds of language issues and he definitely has an ASD. I read a lot of folks trying very hard to find some answer than an ASD but it really doesn't help if its not true. Get a full evaluation by a developmental pediatrician. Thats the only way to know.

My other DC has ADHD and never ever had these language issues. I'm not saying it couldn't be ADHD (which by the way is often co-morbid with ASDs), I have no idea what if any diagnosis your children will have. But don;t let a fear of an ASD diagnosis keep you from looking under that rock, cause there are some indications that you should look there.

PP Writes:


I can't say that all the kids on this thread have ADHD (as we all know it could be a lot of this, these symptoms can be just so similar for some many disorders) but it's just not the girls. I've got a girl (no ADHD) and boys (both with ADHD) and spend a lot of time in the classroom with DS. Girls seem to be so much more verbal and socially aware at a younger age than boys (yes, I'm stereotyping) that maybe you're just more aware of it at an earlier age. At 3.5, my DD was way ahead of her 5 year old brother in both communication and social skills - and as much as I'd like to think so, I'm sure it's not because she's so gifted.




I have a 6 yo boy also, with ADHD. He is currently at the Lindamood Bell Center because of his comprehension issues. Your post resonated with me because as I was picking him up yesterday, all I saw were boys. There must have been 10 boys leaving the center and 1 girl. I couldn't help but wonder what is going on with our boys that impedes their ability to verbalize and socialize at the same level as girls. I sure hope that they are able to catch up at some point.

Bumping this thread up.

My daughter (age 2.5) had her 1-year ST eval today. Expressive language scored normal (97), and receptive language scored well below normal (66). She showed good eye contact, good social interaction and good pretend play during the evaluation, and her dev ped does not think she is on the autism spectrum. Most arrows point to adhd, and this thread was just fascinating to read for me. In general, her impulsivity is VERY high and her attention span is VERY low.

On the eval, many of her receptive problems resulted from not being able to understand what the question was really asking. For example, they showed her a picture of a car and asked her to point to the tires on the car. She pointed to the car, not understanding what the question was asking her to do. Another picture showed a boy in pajamas holding a blanket sitting on a bed and they asked her to point to the blanket. She said "go night night!" instead.

Anyone from this thread still here and willing to give an update on your daughter (or son)?

Anyone try anything like this?

http://www.ncbi.nlm.nih.gov/pubmed/12213433

My MIL had some health issues and as part of that they did bloodwork. She was found to be slightly deficient in carnitine and her doctor put her on a supplement. She said that her memory and attention really improved, so I was wondering if there might be a link to ADD. Will definitely be talking with our doctor about the study linked above.

20:27 Interesting. I've heard Greenspan speak about this particular thing, learning to think abstractly and in more complex, less rote ways, more forest, less leaves. I have a friend who has done the Linda Moode Bell (sp?) program which was helpfufor her child, a lot of pairing reading with ideation. No $ for that at the moment but we keep plugging away. My kid would lose the thread of a story if we stopped and asked about the page, never mind what might happen next.

A little bit of this is developmentally normal, glad it is getting better for you. I have a few friends with older boys who have been diagnosed with ADD in 3rd or 4th grade, they are struggling with the same issue.

17:34 again. Sorry to be so slow about responding ... I forgot to check back on this thread. Yes, my child did exhibit difficulty with reading comprehension ... he could tell you every detail of a story in the correct order, but he could only see the trees and not the forest! So understanding the moral or lesson or overall meanings from stories is tricky for him, but he is gradually improving. And trying to "guess what might happen next" just drives him nuts ... he is very literal and cannot imagine why you would want to guess when the answer is right on the next page!! Again, this is improving fairly quickly ... his progress from first to second grade was quite good and a relief. I don't know that it is related to his ADD ... that had never occurred to me and I had never heard of such a connection. Isn't the brain interesting?!

Anonymous wrote:At what age can you effectively assess for an auditory processing disorder? Is this related to nonverbal LD in any way? thanks

I'm no speech therapist but the Audiologist/SLP who evaluated our DS said testing could be done at younger ages than what is generally quoted (usually age 6 or 7). He said there hadn't been good research done on what the lowest age cutoff should be and that the rationale given for using age 6/7 as the cut off was because of the brain maturity. He said the brain's speech/language capabilities continue to develop into the pre-teen years and using "brain maturity" as a rationale wasn't well supported. Our DS was evaluated at age 5 and from what I saw, he was capable of being assessed at a much younger age.

speech therapist here. That is a difficult age since kids range so widely in their abilities. According to research & best practice, we don't usually assess for auditory processing prior to age 7. Your child may have such a large vocabulary that she is unable to use all her words in conversation. Also if the vast majority of her vocabulary is nouns then it would be easy to answer factual questions, but not participate in conversation. Make sure she knows a lot of verbs & adjectives. Also at this age, the best thing to do is have lots of interaction with peers. You can spend a ton of money on speech therapy or just schedule lots of play dates & maybe enroll her in some kind of class: art/dance/gym/music. At this age many kids still parallel play as opposed to playing together. You can give dialogue while the kids are playing to model conversation. This is what would happen during therapy. Good luck. And no receptive language delay does not mean spectrum disorder. It is sometimes a component, but there are many more things to look for with spectrum disorders (eye contact, perseveration on one topic or item, no interest what so ever with interacting with peers).

Anonymous wrote:pp, would you be willing to share your SLP's name at Lab? or how you went about finding them? i have a friend looking for this very same type of help. thanks.

DD's SLP for Pragmatics at the lab school is Eden Springer. I called the SLP department and sent along the neuropsych testing and they told me what they thought we needed and the best persons to work with.

At what age can you effectively assess for an auditory processing disorder? Is this related to nonverbal LD in any way? thanks

Anonymous wrote:17:34 Sounds like we have similar kids. Did yours have an issue with reading comprehension at all? Mine only seems to be able to answer questions when the language tracks pretty closely to the story.

I have a 6 yo boy who sounds a lot like 17:34 and, apparently, 18:04. We had an auditory processing evaluation because his OT (plus the one we had before she moved) thought he had an APD. He is receiving OT because of SPD, in particular he's got a hypersensitive vestibular system (he loves swinging) and hypotonia. The evaluation showed he definitely did not have APD. For a variety of reasons, the evaluator thought he presented as a child with ADHD - many that people are talking about on this thread. We had yet another evaluation and, sure enough, it's ADHD. He had about 6 months of speech therapy and his therapist (before she took another job) thought his communication problems were a result of the ADHD (as 17:34 has described) rather than a speech/language disorder.

I can't say that all the kids on this thread have ADHD (as we all know it could be a lot of this, these symptoms can be just so similar for some many disorders) but it's just not the girls. I've got a girl (no ADHD) and boys (both with ADHD) and spend a lot of time in the classroom with DS. Girls seem to be so much more verbal and socially aware at a younger age than boys (yes, I'm stereotyping) that maybe you're just more aware of it at an earlier age. At 3.5, my DD was way ahead of her 5 year old brother in both communication and social skills - and as much as I'd like to think so, I'm sure it's not because she's so gifted.

I was the first responder on this thread and I cannot believe how many people have this same problem..with 5 year old girls. If anyone was interested in getting together I would be too.

Anonymous wrote:

Anonymous wrote:This was hard for me to understand for a long time, and still is frankly. My DD was completely verbal at 2, had an amazing vocabulary at 2-3, great enunciation but I realized when she started school at 3 she wasn't interacting at all with peers. We've learned its not an issue with speech, and traditional speech therapy doesn't really help at all. My DD learns by ROTE and learns conversation patterns. She is great when answering a factual question and can communication anything she wants to but can't follow a conversation. Its not necessarily a spectrum disorder, but its hard to "treat." Modeling conversation helps and scaffolding conversations will help when she's older -- you literally have to spell out, 'when someone says this, you can say this or that." i keep hoping it will come naturally, and it does a little bit but SLOWLY.

OP here...wow, PP, your DD sounds so much like mine. Have you determined what's at the root of her issues? Does she have a dx of SPD or PPD? My DD will interact with her peers but can only go so far because her classmates are having conversations and my DD can't follow them. I have a hunch she has auditory processing issues but I know that can't truly diagnosed until she's older.

Yes, we finally at age five just this year had her evaluated for auditory processing and she does test as having a problem with interpreting things with background noise. So we'll treat this year. But yes, its a tricky issue to understand. I have found after two years of painful, forced playdates that they do help if you stick with them...but there was many a day when I was crying after the playdate (not good for mom or daughter, I know!).