QUESTION: I have a grandson who will be four in March. His speech
development is very slow. To date he only says a few words, and does
not put short sentences together. He still utters "noises" a lot.
I am worried about autism. His parents say he is just slow, and I
am afraid to mention the problem to them. Any suggestions?
ANSWER: Hearing difficulty can be a
cause for delay in speech and can be ruled out by your grandson's
pediatrician. If this has already been addressed, it would definitely
be wise to have your grandson seen by a pediatric speech pathologist
for evaluating whether he is having difficulty taking in language,
or getting it out! If he understands what is said, he is processing
language, but simply not producing it. The question is, why?
Identifying speech delay before age six can be important,
as much learning can take place through speech therapy when a child
is still very young. The Speech, Language
and Hearing Association may prove helpful to you and your grandchild's
parents. Rest assured that speech delay is not in itself an indication
of low intelligence, but instead represents difficulty with either
forming sounds or articulating them. The sooner a problem can be identified,
the greater the advantages will be if your grandson is suffering from
this problem. If your grandson is not only showing speech delay, but
also appears underdeveloped in his social interaction or tends to
avoid social contact, he could be suffering from Asperger's syndrome.
This syndrome is a milder form of autism, a neuropsychiatric disorder
that also involves speech delay. Still, help is available for children
who suffer from this developmental disorder, and the earlier they
receive help, the greater their ability to learn the social cues they
are missing. An evaluation checklist is available through the Autism
Research Institute or through an evaluation with a pediatric neurologist.
Here's what you can do to help on your own:
1. Read, read, read! Regardless of any other factors,
you can read to your grandson. Reading and talking provide the stimuli
needed to trigger language association and recognition, whatever the
cause of his difficulty.
2. Tell him stories. Even if he does not respond,
continue to make the effort to be verbal in his presence. Tell him
stories about the cat next door, what the garbage men are doing when
they bring their big truck down the street, or what kinds of foods
you will eat for dinner and which are your favorites! Even if he does
not respond verbally, that does not mean he is not taking in part
or all of what you say.
3. Teach him social cues. For example, if he does
not wave good-bye, you might wave to him, and show him how he can
wave back with his hand when you are ready to leave, saying "bye-bye."
Patiently repeating this and other social gestures can help him develop
social skills, if these interactions are lacking.
Talk with your grandson's parents about your concerns,
by couching them not in predictions, but in preventive terms. Let
them know that while it may not be likely that he has any serious
disorder, evaluation at this age represents an ounce of prevention.
Give them the resources listed here, and let them know that you are
available to spend quality time focused on helping your grandson acquire
language skills, in any way they find helpful.
Be sure to comment on your grandson's strengths, too.
Acknowledge his intelligence, curiosity, or any other positive trait.
Let them know in no uncertain terms that you are here to help, not
to criticize. Although you do not wish to intrude in any way, you
want to express your grandmotherly concern. After all, you have been
through these stages of development. While it is true that you could
be overreacting, you do not want to be remiss in not telling them
what your experienced eye observes.
Come from a place of love and support, and do your
best to be heard. Do not be afraid to completely express your concern,
even if it is uncomfortable. But do not press the issue further once
you have clearly communicated. Allow your grandson's parents time
to consider your input. They will likely see the wisdom behind your
love, and be more likely to seek help sooner, than if you did not
say anything at all!
