Expert: Dr. Sharon A. Mitchell - 10/17/2008

Question
My four year old Melody was diagnosed with auditory processing disorder when she was 2. My wife and i went through extensive in home care specialist, and doctors to try and help her progress through it. Melody is now 4 and has a little sister Ella who is 2. Ella is starting to express her self by following the way Melody expresses her self. Ella has shown no signs of any disorder. I now am recently divorced and Melody seems to be regressing back to age two by only completing two and three word sentences. The girls mother is not in thier life very much anymore and I think that is taking a toll on the girls. I guess my question is how can i help melody start girlhood and be her own person with her constantly falling back? please help,
kenny

Answer
A divorce is a stressful thing for kids (and adults too!). Just like adults, individual children react differently. For many, they show signs of regression, reverting to behaviors they showed at a younger age. With some this affects their toilet training, others behave as if they're back in the "terrible two" years, others become clingy or withdrawn while some kids may seem to lose their more advanced talking skills.

If the marital separation occurred within the last year and this Melody's expressive language skills are the only regression you see in her, I'd guess that this may be due to the stress of all the changes in her young life and will resolve with time and reassurance.

The girls may be helped by seeing a counselor, someone experienced in play therapy or working with preschool children.

I'm a strong believer in visuals, particularly for children with a history of receptive language difficulties. If using a visual (a picture) makes it easier for her to understand directions, what's expected of her and what will be happening, then they're a great tool for helping Melody (and Ella) make sense of their world. And they're not that much work to use.

A visual schedule on the bedroom wall can show the girls in which order they are to put on their clothes. One in the bathroom can tell them to wash hands, their face, brush their teeth, etc. Pictures by the back door can show what they need to put into their back pack before leaving for day care. Pictures can show where to hang coats, put shoes, store certain toys, etc.

Using pictures removes the onus from the adult to constantly remind or nag. They give the child more independence.

A visual schedule on the fridge can let the girls know what's going to happen that day. For free pictures and a good explanation of how/why to use visuals, check out www.do2learn.com.

Here is some information about what is within the expected speech and language skills for a four year old:

http://www.asha.org/public/speech/development/34.htm

http://www.investinkids.ca/Docbase/BrowseTopic.aspx?Portal=a0380b3a-4520-4d09-ba...

http://www.med.umich.edu/1libr/yourchild/devmile.htm

If you believe that she has regressed language-wise and this lasts longer than a couple months, I would be worthwhile getting in touch with her former therapists to get their take on the situation.

Are you wondering if Melody has autism? Kids with autism spectrum disorders do exhibit difficulties with auditory processing but kids with just auditory processing weaknesses don't show other signs of autism. If this possibility concerns you, there are some at-home screening tests you can take a look at.

Here is some information on how autism spectrum disorders are diagnosed: http://autism.about.com/od/whatisautism/a/DMVautism.htm

At this link you'll find a free, online checklist screener for autism that you can do: http://www.childbrain.com/pddassess.html

And if your concern is more specifically about Asperger's, take a look at this: http://www.udel.edu/bkirby/asperger/aspergerscaleAttwood.html

Below are two versions of a Checklist for Autism in Toddlers that a physician might use. It may be useful for you to look them over to get an idea of what sorts of things a diagnostician may look for. The first link explains a bit more about the CHAT:

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=128&a=2226

http://depts.washington.edu/dataproj/chat.html

http://www.utmem.edu/pediatrics/general/clinical/m-chat.pdf

None of the above are definitive tests as to whether or not your child has autism. The diagnosis is much more involved. But if after looking at these links, you're still worried you could print off the checklist results to show your doctor.

Sharon A. Mitchell, B.A., B.Ed., M.A.
www.autismsite.ca