Questions on having a 4 year old tested

[Guest]

Hi! I've never posted on this board, but figured I may find a wealth of info. here.

 

My son is 4 and I was going to mention at our next dr's. apptm. some issues that I am not sure are of concern or not. I am hoping you guys can tell me to chill (or the opposite!).

 

Some of his characteristics:

 

Late talker (3 yrs. is when he became coherent to family; others still have difficult understanding him; he began his own systematic language around 2 - I always attributed this to having constant ear infections his first year of life.) He says /t/ when he pronounces /c/ (cat=tat) and /s/ when he pronounces /th/, (thirty=sirty) for example.

 

Very unsocial - he prefers to be alone. I've been planning increased social times with other kids his age and he is just not interested in playing with other kids, even with encouragement from me. He does not, however, have any problems playing with his sister, me or my dh. At home, he can spend the entire day outside playing in one dirt hole - by himself and be happy as a clam. He's not really interested in conversing with people outside our family unless it's on "his" terms, and then he'll talk your ear off. (People just look at me clueless, though, as to what he's saying.)

 

The post on the GB about inverting u & n has me freaked out now, also.

 

More background: he has extremely honed fine motor skills - has since practically birth, terrible gross motor skills (sports, running, etc.); he's very sharp (picked up counting by 10's in a day @ 3.5 - rote memory, doesn't understand the concept behind what he's doing) but not by any means a genius (not reading or doing math at a high level or anything.) My dh has severe dyslexia; I have no known ld. Both dh & I tend to be introverts. Dh says that he always stuck to himself as a child and that ds reminds him a lot of himself.

 

If I mention this to our pediatrician, I'm assuming he'll recommend testing (he told me last year that it was an option when I mentioned the speech delay but didn't feel it was necessary) so if we were to go through with that what would we expect? What is a test like? Is it covered by insurance (if not how much $$$ are we talking about)? Does this sound like the characteristics of any particular ld or just normal 4 year old stuff?

 

And to add one more question, (b/c I don't have enough already) how do you defend h/s-ing when people question your child's apparent lack of social skills?

 

I appreciate any feedback - I tend to get paranoid and don't want to if this all sounds normal. We're off to a park day, but I look forward to checking back later.

 

Thanks for taking the time to read/answer this. :)

 

ETA: I'm editing this b/c I am going to print it out and want the following for reference as well:

Sensitivity to hot and cold (weather, water, etc.)

Obsession with trash can/schedules

Edited March 27, 2009 by Guest

[Laurie4b]

The thing that is of most concern in your post is the issue of social skills. That deserves evaluation if nothing else.

 

The articulation issues sound within normal range. Late talking could indicate a problem, but maybe not. Does he actually converse within the family, or deliver monologues as you describe outside the family? Is he interested in what you, his dad, and his sister are doing, what you have to say, etc? Are the conversations reciprocal? If there are problems in conversing, then an evaluation by a speech and language therapist should be helpful.

 

Is all his learning "rote" or are there age-appropriate concepts that he understands?

 

Poor gross motor skills should also be evaluated. An occupational therapist can do that. The eval and treatment are covered by most insurance.

 

Probably the best option to evaluate social skills plus the rest would be a developmental pediatrician. They are kind of a generalist of the specialists.

 

Any time you question social skills, I think there is cause to check further. Nothing is more important than social skills to eventual success in life.

 

I don't know what post you're referring to about inverting n's and u's. Could you link it? However, it's normal at 4 to reverse thing. That's simply a vertical reversal rather than a horizontal reversal, like b/d.

[The Governess]

:grouphug::grouphug: I don't know if what you're describing is "normal" or not. And I have no idea about the social issues. But I don't think it would hurt to get an evaluation.

 

My dd2 has similar speech problems. She has been in speech therapy for a year and a half. She is much easier to understand now, but she still has a hard time with a lot of letter sounds (she says bup for cup, leaves ending sounds off, etc.). Her therapist does a lot of exercises with her to encourage her to move her tongue more and position it properly, etc. She will be re-evaluated when she turns 3 to see if she still qualifies at that point, and if so her therapy will be through the school district.

 

She used to get OT as well. She was a baby when she had her evaluation, but she gets a re-assessment every six months. If you get your son evaluated, it will probably be in a room with a lot of toys, they will watch him play with things, they may show him some cards or objects and ask him to name them, talk about them, or do something with them. They may ask him some basic questions. At this age, a lot of the questions will be directed at you. They will want to know about developmental milestones - can he throw a ball, skip, jump with two feet, hold a pencil properly, etc. They will also probably ask about behavior - is he sleeping well, eating well, socializing, etc. But they will probably rely on your reported observations more than on how he behaves at that particular visit.

 

If they feel there is a social issue, they will probably recommend a group therapy class. The group classes help teach cooperative play, taking turns, etc. while they work on speech, OT, or other underlying issues.

 

If you go through the school district, everything is covered. Your insurance may also cover private party speech therapy, but it varies. Ours doesn't cover it.

 

My dd loves her therapy classes. It's playtime to her. She doesn't know she's working on any skills. :D

[Guest]

The thing that is of most concern in your post is the issue of social skills. That deserves evaluation if nothing else.

 

The articulation issues sound within normal range. Late talking could indicate a problem, but maybe not. Does he actually converse within the family, or deliver monologues as you describe outside the family? Is he interested in what you, his dad, and his sister are doing, what you have to say, etc? Are the conversations reciprocal? If there are problems in conversing, then an evaluation by a speech and language therapist should be helpful. He has no problems conversing within our immediate family. I would consider us very normal when we talk and reciprocate with him. It's when we go out in public.

 

Is all his learning "rote" or are there age-appropriate concepts that he understands? He very easily memorizes things. I'm not sure what would be age-appropriate concepts - sharing? Yes. Imagination - Yes. He's not big into animals, which I expected at his age, but enjoys cars, trucks, legos. He loves to be read to - all different kinds of stories... not sure if that answers what you are asking...

 

Poor gross motor skills should also be evaluated. An occupational therapist can do that. The eval and treatment are covered by most insurance.

 

Probably the best option to evaluate social skills plus the rest would be a developmental pediatrician. They are kind of a generalist of the specialists.

Okay I will look into this...

 

Any time you question social skills, I think there is cause to check further. Nothing is more important than social skills to eventual success in life. And this, too...

 

I don't know what post you're referring to about inverting n's and u's. Could you link it? However, it's normal at 4 to reverse thing. That's simply a vertical reversal rather than a horizontal reversal, like b/d. Here's the thread; it may be more that I've been concerned about a few things lately and this just magnified everything.

 

Thank you for your answers, Laurie, at least I can go in to the dr. and have an idea of what I'm asking for in re: to types of therapists. And you've helped me clarify what I'm concerned about the most: social & gross motor skills.

[Guest]

:grouphug::grouphug: I don't know if what you're describing is "normal" or not. And I have no idea about the social issues. But I don't think it would hurt to get an evaluation.

 

My dd2 has similar speech problems. She has been in speech therapy for a year and a half. She is much easier to understand now, but she still has a hard time with a lot of letter sounds (she says bup for cup, leaves ending sounds off, etc.). Her therapist does a lot of exercises with her to encourage her to move her tongue more and position it properly, etc. She will be re-evaluated when she turns 3 to see if she still qualifies at that point, and if so her therapy will be through the school district.

 

She used to get OT as well. She was a baby when she had her evaluation, but she gets a re-assessment every six months. If you get your son evaluated, it will probably be in a room with a lot of toys, they will watch him play with things, they may show him some cards or objects and ask him to name them, talk about them, or do something with them. They may ask him some basic questions. At this age, a lot of the questions will be directed at you. They will want to know about developmental milestones - can he throw a ball, skip, jump with two feet, hold a pencil properly, etc. They will also probably ask about behavior - is he sleeping well, eating well, socializing, etc. But they will probably rely on your reported observations more than on how he behaves at that particular visit.

 

If they feel there is a social issue, they will probably recommend a group therapy class. The group classes help teach cooperative play, taking turns, etc. while they work on speech, OT, or other underlying issues.

 

If you go through the school district, everything is covered. Your insurance may also cover private party speech therapy, but it varies. Ours doesn't cover it.

 

My dd loves her therapy classes. It's playtime to her. She doesn't know she's working on any skills. :D

 

Thank you for your input - I just hear therapy and get really concerned with the mental images that pop into my head. Good info...

[JudoMom]

Thank you for your answers, Laurie, at least I can go in to the dr. and have an idea of what I'm asking for in re: to types of therapists. And you've helped me clarify what I'm concerned about the most: social & gross motor skills.

 

 

I wouldn't be terribly concerned. I think it's a good idea to bring this up with your regular pediatrician, but nothing in your post stood out to me as abnormal. Some kids are more introverted than others, and that's okay. My older 2 have always been more introverted, my middle son has been fairly balanced, and my younger 2 are (especially my 5 year old) are way more extroverted than I've ever been. Seriously, I still have to coach my 8 & 9 year olds to answer people when they've been asked a question by someone they don't know, although I see drastic improvment over when they were 4 & 5 (my 8 year old held a completely uncoached conversation with our neighbor last weekend, and even went back to ask him a specific question).

 

One of my boys was born with superb motor skills, and another would trip when he was crawling. However, as he's grown we've seen steady improvement and our pediatrician has never been concerned.

 

As I said, I wouldn't worry too much. Since you're concerned, bring it up with your ped., but everything you listed sounded within the normal range of behavior to me.

[Misty]

I think he definitely needs evaluated. Type up all that you see that you feel is an indication of something, and hand it to the evaluator sometime during the course of your conversation with him.

 

As far as insurance, ours paid every penny, but we are military and have excellent insurance through them. Call your insurance company and ask specific questions. You may need a referral from your pediatrician first.

 

To answer your question "What is the test like?".. That depends on the Dr. and the issues your child is having. Generally you and your dh will have to fill out some forms concerning his behavior. You will talk with the Dr. a little, and then he will take your child to do some tests... Maybe an IQ test, an achievment test, and maybe some other little things like an ADHD assessment, etc.. Not sure because mine went back alone without me. But they did get an IQ test and achievment tests. Our testing sessions were spread out over two days and were about 3-4 hours each day.

 

As far as defending social skills and homeschooling... I usually just say that I was the exact same way when I was a kid and I went to public school my entire life..... I was very delayed with social skills (um.. still waiting on 'em ;-) and I also had speech delay. Public school didn't fix me one bit... Just made it worse as far as I'm concerned. So much for public school being the "social skills depot"!! I have Asperger's and all of my children also have Asperger's (Generally with Asperger's there is no speech delay, but I did have speech delay... It's rare, but it happens.. I also had lots of ear infections so it could have been what they call a "coincidental speech delay").

 

Definitely get him evaluated... The social skills issues, your dh being dyslexic, the obsession with garbage truck schedules, speech delay, etc... RED FLAGS!!

 

Good luck!

[Guest]

I appreciate all of your input. I did bring this up to dh last night and he said no way on the testing. He thinks it's a waste of time and a waste of money. He doesn't see what good it will do to have him tested at this age and thinks that everything I described here sounds like a normal child (and like himself as a child.) :001_huh:

 

Suggestions? He did say if he is the same way in a year or two he would consider the testing/evaluating then. WWYD?

[Terabith]

I'm concerned about the speech issues and the gross motor skills. If he's not understandable outside the family, then that's a problem. It's going to majorly affect social skills too, bc other kids can't understand him!

 

Quite frankly, I would tell dh that this needs to be done and it needs to be done sooner rather than later. I would make an appointment with the pediatrician and ask for input on all these issues, and I would call the local school district and ask for an evaluation. You don't have to use the services they provide, but they will do a free developmental assessment. At four, you can still utilize their services even with no intention on enrolling in public school, and I would categorize the special ed preschools (regular preschools that add in speech and occupational/ physical therapy), as different than "real school." But they would give a free assessment that you can hand your dh, with results, and the testing is usually pretty fun for the kids, and speech and occupational or physical therapy can make a HUGE difference, but it's more effective at younger ages. It doesn't have to take a lot of time or a lot of money. It might not take ANY money. But if you don't try, you won't know.

[Mandamom]

I had my 4.5 year old tested and she had a great time. It was play time -- blocks and letters, etc.

 

I tend to get my kids's speech problems evaluated early so my kids started therapy around 18 months old. For them it was playtime with toys that we didn't own and they both looked forward to it.

 

I have also used our school system for developmental testing, speech services and now my kids are in public school and we have had great help. Sometimes they have found no need for services while other times we have found that problems exist and they have provided a lot of help and support.

 

That being said, the therapy and testing is generally fun for the kids and if done by an experienced psychologist.

[The Governess]

I agree with Terabith - if he does end up needing therapy, he will most likely respond faster and need less overall if he is started earlier rather than later. If the evaluation was free would he be ok with it (I'm pretty sure it would be)?

[Mom22ns]

Suggestions? He did say if he is the same way in a year or two he would consider the testing/evaluating then. WWYD?

 

I would tell him that the brain is the most elastic before the age of 6. If you wait a year or two, that window has already closed. Testing may do nothing more than soothe your nerves. That alone can be worth it. If there is a problem, one year of therapy before 5 is worth many years of intervention after 5. You will save money and struggles for your child by helping him now not later.

 

The brain never completely loses its elasticity as it was once thought to. Stroke and other brain injury victims relearn motor skills and speech, but at a slow rate compared to what your 4 year old learns them. He can always be helped, but right now is the time he can make the most progress, quickly and with the least effort and cost.

[The Governess]

I would tell him that the brain is the most elastic before the age of 6. If you wait a year or two, that window has already closed. Testing may do nothing more than soothe your nerves. That alone can be worth it. If there is a problem, one year of therapy before 5 is worth many years of intervention after 5. You will save money and struggles for your child by helping him now not later.

 

The brain never completely loses its elasticity as it was once thought to. Stroke and other brain injury victims relearn motor skills and speech, but at a slow rate compared to what your 4 year old learns them. He can always be helped, but right now is the time he can make the most progress, quickly and with the least effort and cost.

 

:iagree::iagree: Very, very well said.

[*~Tina~*]

I'm only going on what little you have shared, so forgive me if this is too big of a leap, but have you ever read anything on Asperger Syndrome? Even if you and your husband opt for no evaluation at this time, I'd encourage you to read up on some of your concerns and try to do some things at home for your son. (The Complete Book of Aspergers by Tony Attwood is a great resource to start with.)

 

Personally, from one parent to another, I'd encourage you toward evaluation, because the sooner you know what (if anything) you are dealing with, the sooner you can figure out what works and get moving in that direction. Early intervention and remediation can often make a huge difference.

 

 

My husband and I are both introverts as well, however, I also have a child officially diagnosed with Asperger's and I can seen how fitting that might be to our family as a whole :grouphug: My dd always played "near" people, but not "with" people. She had no interest and saw no value in "interacting. She also had her own way of playing and if *you* didn't do it right, well. . . .

 

Children with AS also have a tendancy to talk "above" others and/or to focus and carry on conversations only to the extent that it interest them - in which case they can talk your ears off and not "hear" you otherwise. :)

 

There's much more to it that this tidbit, but I just wanted to give you something else to consider.

 

I sure wish I had caught on earlier in her life. It would have given us more understanding and direction for dealing with the quirky behavior and confusion of it all.

 

Blessings,

Tina

[Dobela]

I worked as an evaluator in early childhood special education. Yet when my son showed signs of possible delays I did not pursue testing. Now I regret it. Some of the issues we are dealing with now could have been worked on earlier - before my son realized he was not performing the same as his peers.

 

In our state, speical developmental centers provide testing before age 5. Tests are fun and engaging to children. There will be one broad eval used to screen other areas. If you have specific concerns in fine motor, or gross motor, or language, those are different fun evals. Almost all children I have worked with have enjoyed the evaluation process. It involves games and objects they may not have seen before - or they are asked to use familiar objects in new ways. After it is over, you will receive all scores and can make a decision then. My 9 yr old LOVES therapy. OT for him is fun and games and lots of 1-1 attention from a delightful person who always has some new challenge that is just right. My 2 yr old loves therapy for the same reasons. I like therapy because they are trained in areas I am not familiar with and can teach me to be a better parent and how to interact with my kids in the way they need most.

 

The worst thing that can happen is that your child will qualify for services. The best thing could be that you will have a much better understanding of your child's strengths and weaknesses.

 

I also want to say that when I was working, many of the boarderline kids we treated eventually stopped needing therapy of any type after a year or 2 of intervention. Also, in my state, a child cannot be "labeled" until after age 6 beyond the generic description of developmental delay unless a medical diagnosis of something else is known (like Down Syndrome, Autism, etc). It was not a label or experience that followed them.

 

I waied until my son was 7 to seek help and that created other problems - the insurance didn't want to pay because they did not see it as developmental and when we couldn't name a specific incident (like an accident) that caused the difficulty all claims were denied. If we had just acted at age 6 or 5 (when I first really began suspecting problems), our insurance would have paid.

[aliya]

Hi Monica,

I never post here, and rarely even lurk, but I feel like I have to post in response to your concerns.

Your little viking played wonderfully with my boys in December. Yes, shy at first, but he warmed up pretty quickly.

Right now I would listen to your DH and wait on the testing. He (your dh) has always been very shy - I don't see that as a bad thing. You said he sees himself in your ds, and I totally believe it.

I would never tell you to ignore your instinct, but I would definitely wait for now. I only get to see the little guy on occasion, but he's never struck me as "off" in any way, shape or form.

You are doing an INCREDIBLE job with both your kids. They are so fortunate to have such wonderful, loving parents. Keep doing everything you're doing!!

Debbie (SIL to Krazzymommy) :)

[tamcnghton]

I understand your concerns for your child and your husband's response. I don't want to expose myself too much but I have some experience in both areas. I had red flags something was different about my daughter since the day she was born. My pediatrician said she was just immature. By age 6 he got overuled by a psycologist, who he himself referred us to, after she got really scared at night and kept waking us, after a burglary happened. At age 6 I finally got the conformation that she had issues (for which we got help) But....the road to getting help was bumpy and hubby was not on board at all times. I would highly recommend a book by Dr. Willard Harley called His Needs Her Needs for Parents.

 

My daughter is now an 11 yr old who is thriving and overcome most of her obstacles (with a lot of hard work and support on my part). I did not get the help when I thought I should have....but it all worked out in the end...even the burglar helped us to get the help, albeit 3 yrs later than i would have wished it.

 

Getting your husband on board may be more important than getting an evaluation ASAP. If you feel you can back off and bring up the book I mentioned above (not relating it to your son) than I think this could be very beneficial for your whole family. One very important rule of the book to follow (not just agree with, but really carry out) is Joint Policy of Agreement. Don't tell hubby that rule....because then you will be "fixing him" ...there is always plenty to fix on both sides. What I would recommend is reading a few chapters yourself to see if you agree this is a great book....then tell your husband you found this great book...that it has a survey and ask if he would mind filling it out. Tell him that you want to find out if you are meeting his needs. You also will fill one out for him to read. Either of you may be surprised at the others responses. You may not like some responses. But don't sweep them under the rug. The bump under the rug will just get bigger and someday it will trip you up and you will have wished you had taken care of it when it was a small problem. Kids with special needs (even just personality needs that don't show up on any test) are a challenge. Actually all children are a challenge. Parenting is a challenge ! Being on the same page is so important I can't begin to tell you .....

Edited March 30, 2009 by tamcnghton
spelling

[CherylG]

I appreciate all of your input. I did bring this up to dh last night and he said no way on the testing. He thinks it's a waste of time and a waste of money. He doesn't see what good it will do to have him tested at this age and thinks that everything I described here sounds like a normal child (and like himself as a child.) :001_huh:

 

Suggestions? He did say if he is the same way in a year or two he would consider the testing/evaluating then. WWYD?

 

When we pulled him out of public school I was totally paranoid. I wanted to know what I was "dealing" with. To make a really long story short...we paid for a private tutor for the first year of homeschooling because I was sure that I was going to get it all wrong.

 

When this learning specialist kept asking me what I was using with our son and then she would buy the program to implement it in his weekly routine; that gave me enough confidence to pull him out of that program and fly solo. This is the same son that I had to pull out of P.E.P. (Postpartum Education for Parents) when all the other children developed so much quicker than him and he would become their target as they learned to walk and crawl and he was just happy sitting and looking at a kitchen spoon. (literally)

 

He has grown up, finished college, is a very good example to his younger brother and sisters, and is in a sweet relationship with a young lady that we all love. But as in the days of old where he only wanted to put the Lego pieces together and then leave them, he is very content taking a book (Crime and Punishment at the moment) and reading while we are all at the beach.

He isn't anti-social-he just likes his own thoughts. He does have dyslexia but I never let him know that until one of his City College teacher told him while he was in High School. I had always just read to him.

 

I would go with your husband on this one. There are plenty of public school kids that are shy-I am shy...I am totally public schooled. Don't let those labels hinder you, if you and your husband think this is the best for your family. We have 4 late bloomers...hope that gives you encouragement.

God bless you!

Cheryl