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Thursday, December 5, 2013
Has my nephew been misdiagnosed or misled?
My nephew is 6 years old. He did not speak a single word until he was 4.5 years old. He does speak now, but speaks as though a person who is deaf speaks. He is not very coordinated or athletic. He is rather slow and clumsy. He usually has a snotty nose and doesn`t care. He just seems to behave like a gentle giant, very aloof and simple and speaks. He almost speaks like he isn`t moving his tongue at all. He does interact with people and family, but he seems different than any of his siblings. He attends regular public school and they say that he is basically "normal"--but I have serious doubts that this ignoring pattern is delaying help that we could be gettting him. I have been told there is a form of autism where the person interacts, but has severe speech issues. What should a person ask/request in order to determine if this is in fact that form of autism and what is this form called.
I’m glad that your nephew is in school and doing well. Based on your description of his characteristics: very late to talk, speaks like a person who is deaf, slow and clumsy, aloof and simple, does interact with people - I would also be concerned about your nephew’s development.
To identify any underlying medical or developmental disorders I would recommend a neurodevelopmental assessment by a developmental team that includes an assessment of his motor skills, cognitive skills, hearing, and speech and language skills in addition to a medical assessment.
You are describing several developmental features that are not typically associated with an autism spectrum disorder (although children with autism can have motor problems, hearing impairments, or language impairments these would be in addition to the autism).
There is no form of autism where a person interacts typically with others but has severe speech issues. All forms of autism present with interaction difficulties. You might be thinking of Childhood Apraxia of Speech where a child wants to interact with others but cannot coordinate the speech muscles to make clear combinations of sounds.
I encourage you to have your nephew’s parents’ talk to their physician to get a referral for a comprehensive developmental assessment. Best of luck.
Paula C Rabidoux, PhD/CCC-SLP
Clinical Associate Professor of Psychiatry
Clinical Associate Professor of Speech & Hearing
College of Social and Behavioral Sciences
The Ohio State University