Many toddlers have speech delays, and sometimes a speech delay is a symptom of something bigger
like autism.
I know from experience that it's often confusing and overwhelming to parents who are on waiting
lists for autism evaluations when these waiting lists are growing longer and longer each day.
So today, I'm going to break down what I look for to possibly tell if it's autism or a speech
delay and what to do no matter if it's just a speech delay or early warning signs of autism.
Hi, I'm Dr. Mary Barbera, autism mom, behavior analyst, registered nurse, and best selling
author.
Each week, I provide you with some of my ideas about turning autism around.
So, if you haven't subscribed to my YouTube channel, you can do that now.
Like many children with autism, my son Lucas who got started with just a speech and language
delay.
He went to a typical two year old preschool and didn't cry or fuss mch.
He also went to weekly speech therapy when he was two and initially, the SOP seemed optimistic
that he would improve and everything would be fine.
As a first time mom with a nursing background, I didn't know much about typical milestones
and I knew nothing about the early warning signs of autism.
But in my defense, it was the late 1990s before Google searches or Facebook and the rate of
autism back then was 1 in 500, not 1 in 50 like it is today.
Once Lucas was diagnosed with autism one day before he turned three, I made it my mission
to learn the early warning signs and to train pediatricians around the state of Pennsylvania
through an early detection grant from First Signs.
I can't diagnose autism, but as a nurse, as a behavior analyst with a strong background
in autism, I do look for early warning signs of autism with a child, an 18 month old or
two year old who's not talking much or at all.
These are the things I look for, and if your child is having these early warning signs
of autism, please know not to panic, I'm going to tell you, no matter what it is, I'm going
to tell you some things that you can do today to start helping turn things around.
So, I assess an 18 month old or a two year old by looking first at pointing.
I never realized how important pointing is, but it's very important and by 18 months,
or at least by two, a child should be pointing.
Not just once a month pointing, but like pointing a decent amount.
They should be pointing for things that they want like juice or a toy.
But they should also be pointing to get your attention, for joint attention is what we
call it, by pointing things to show you things, like pointing to an airplane that's flying
up above, even if they don't have the language to say airplane, if they're pointing with
their index finger to show you the airplane, like, "oh, oh," that's a good sign that it
might not be autism because that pointing is such a critical red flag for autism.
The lack of pointing is.
In addition to pointing, I also look for a child, even a child that's not talking to
understand some language.
I remember when my boys were two years old and six months old, I had a photographer come
to the house to try to get some pictures.
This is back in the late 1990s, I remember the photography giving Lucas a film canister
and saying, "Here buddy, throw this away," and he had no idea what the guy was talking
about.
The guy looked at him like you should know this, you're old enough.
I just kind of brushed it off and thought, you know, I didn't know if he should or shouldn't
know it, but he didn't understand language.
It wasn't just an expressive language delay, it was also a receptive language delay, which
doesn't have to be autism.
A child can have both and not have autism.
But Lucas has a very severe expressive and receptive language delay.
So in addition to looking at pointing and language, I also wanna look for things like
playing.
Does the child play with some toys, sore than just one toy?
Or is he super focused on one object, or needs to carry it around all the time?
Or plays with things over and over again, like stacking blocks, not just for a couple
minutes while you do something quick, but like hours and hours they can be content not
using language, but like spinning things or living things up.
These are all red flags for autism.
And finally, a child of 18 months or two, should be naturally starting to imitate some
things, like waving or making an airplane fly.
So, it's not just if they're talking or not, we also really need to look at things like
play, imitation, and whether or not the child understands language.
It he doesn't have any imitation play, and he doesn't understand language, it may be
more than a speech delay.
But, I have some good news.
After working with hundreds, if not thousands of children, as a behavior analyst, I learned
that no matter if it is autism or just something like speech delay, putting the same proven
ABA strategies in place can help increase talking and decrease tantrums.
I've also worked with kids where I know we've prevented the diagnosis of autism, or turned
it around so quickly that they caught up before kindergarten.
So, here are the three things I'd recommend you do if you're concerned about your young
child, who is either speech delayed, showing some signs of autism, maybe they already have
a diagnosis of autism, but are waiting for treatment, or they could be waiting for an
autism evaluation.
And even if it is just a speech delay, learning these three things can help you and your child
get started today.
Step number one, I want you to learn typical milestones and compare them to your child's
development.
The CDC has a great index of milestones on their website that are expected at every age.
So if your child's 4 months old, 8 months old, 18 months old, 2 years old, you should
be able to look and see what the child should be doing physically, cognitively, language-wise,
when should they be putting two words together for instance, when should they be pointing,
when should they be feeding themselves.
And it's important not just to look at the language milestones, we wanna look at self
care, when can they feed themselves?
Drink out of an open cup?
Self regulation skills, do they get so upset that they can't calm themselves down?
Are they having frequent tantrums and problem behaviors because they don't understand the
world around them?
You'll also wanna compare the milestones of typically developing two year olds, and there's
gonna be a range.
It's not gonna be like, every two year needs to be doing this.
But if you look at the two year old milestones and your child is not doing any of them, but
you look back at the 18 month milestones and they're doing all of them, then it may just
be a little bit of a delay.
Either way, if there are delays between what your child is doing and the milestones, I'd
go on to step number two, which is make a sick appointment with your child's pediatrician.
This is something that I never thought of.
There was no well visits between two and three, and I had some concerns.
My husband had some concerns, and we just never thought about going to the doctor specifically
to discuss those concerns, and I would recommend that.
You want to get screening done by a professional and because as a parent, you just want everything
to be okay, but get a professional to help you screen the child, see if we can start
early intervention.
Also, in addition to contacting your pediatrician, if your child goes to daycare or preschool,
you may wanna talk to your child's teacher too, to see if they're falling behind in the
classroom.
She can give you input potentially on how he's doing with group responding, is he waiting
in line, is he getting into trouble at preschool?
And this can also give you an idea of what if happening.
Step number three is you need to learn all you can about the science of applied behavior
analysis, or ABA for short.
Because with intensive ABA therapy, when a child is very young, even some with severe
autism already diagnosed, children can recover from autism and lead normal lives.
But you have to get on it, and even if it's just speech delay, ABA is always gonna help
the situation, never hurt the situation.
Especially if you learn proactive strategies that you can do with your child right in your
own home.
ABA can help kids with any kind of disorder and speech delays, they can learn language
a lot more quickly.
So, in summary, if you are concerned about your child or any toddler that you know and
you can't tell if it's autism or just a speech delay, number one, learn typical milestones.
Google the CDC act early website, learn the milestones, compare them to what the child
is doing.
Step two, talk to your child's pediatrician and their preschool teacher, and get screening
done, and early intervention started as soon as possible.
And step number three is you need to learn about ABA and one of the best places to start
is by going to marybarbera.com/toddler, click the link right below to get more information
today.
And if you like this video blog, I would love it if you would leave me a comment, give me
a thumbs up, and share the video with others who might benefit.
Don't forget, you can download my free toddler guide called, "Is It Autism, ADHD, or Typical
Toddler Tantrums?
3 Steps You Can Take Today Instead of Worrying" at marybarbera.com/toddler, and I hope to
see you right here next week.