Expert: Trey McGowan - 12/19/2009

Question
Hi,
I'm rachael, 25yr old mum of 3, my youngest son James is 31month's he has a lot of undiagnosed problems but im getting desperate now.
James has NO speech, (not a single word, or near word sounding sound) just the babbling you would expect from a 6-12 month old, James also shows NO understanding of language and as a result i am getting soo desperate, desperate to help my son and desperate for some reason for whats causing his no speech, he cannot follow commands, and his development is at 12-18 months,
Ive tried signing and also picture cards, but he doesnt seem to show any understanding of any language,
He has been assesd by a Speech and lanuage therapist and all she said is

"James communication skills are severly impaired, he shows no understanding of words" his play is simple and he held and mouthed a toy car, he showed no interest in me or communicating with me, James could not understand simple words, he does know know the meaning of ball, or toast, or drink.
The recomdation is that James be refered for a Multi-Disciplinary assesment, James will be seen again in 8 weeks

OK so sorry for being stupid, what is a muti-disciplinary assesment? what can i expect?
secondly, can you please help me think of a way to communicate with my son, we communicate purely by touch, rubbing patting, rocking, tapping, but obvously this is limited as to what he can tell me, (only if happy) and his needs are becoming more difficult to guess, i am desperate to comunicate with him but it seems we are getting no-where, James will not point or follow a pointing finger so pointing does not work!

He has small amount of hearing loss (allthough a contrubtory factor not enough to cause no speech) and also some vision loss allthough we dont know the extent of this yet,
If anyone has any advice i appreciate it thank you. his play is very simple, mouthing or holding objects, turning wheels on cars and trikes, he repeatedly opens and closes his toy cuboard door or spins the blades of a helicopter,
Because he cant communicates his needs he gets very upset and frustrated and this then becomes a fight to calm him down, he is 2 and a half but the size of a much smaller child so i get some very rude and dissaproving looks when he is kicking screaming and biting because he looks like a baby (12-18 months are his clothes). While i love him so much im getting desperate both for his sake or mine, no one seems to be telling me anything,
Thanks, hope you can help me, Even i am in uk i know things are a lot different but any advice you can give me would be very appreciated

Answer
Hi there, Rachael!

First off, while I wish I could be of more specific help with the multidisciplinary assessment, I don't know if there is a single specific way to do these. Essentially what this means is that he will be assessed by a number of doctors with different specialties who will look at the data and draw conclusions. Essentially, the main thing is that they don't have an idea of what is causing your son's speech difficulties, so they, too, are getting aggressive with their tactics. I don't know in specific what people will be there or what tests they will do, unfortunately; the best you can do in this case is to speak with the doctor who actually did the recommending. However, the good news is, while it sounds intimidating (and might well be!) it means that they are stepping up to try and identify the problem with more eyes than just theirs.

Secondly, the degree of communication disability here seems to be pretty severe. It's not just a matter of speech difficulty, but an actual 'breakdown' of *all* the communication skills. I wish I could give you an easy way to try and communicate with him, but unfortunately I have a feeling that if both understanding and speech are as impaired as it seems, there may not be a single aid that will make everything all better. To me, it seems as if the judgment of his development may be correct. I.E. that his language skills may be at the same development level as the rest of him, and that means that deep communication is potentially just not formed. The best suggestion I have for a situation like this, until you have gotten the multi-assessment and gotten a better idea of just what level of impairment there is and why, is to start at the basics. Try simple 'baby language' syllables to start. See if you can get some recognition and understanding with those.

If touch language is an option (i.e. he actually follows a pattern with touch), see if you can teach him different levels of it. When Hellen Keller was taught to 'speak', it was through the writing of letters on her hand. While I understand your son is not totally blind or totally deaf, if he seems to be 'understanding' the language of touch, maybe something like this would be an issue. Tapping morse, perhaps, would be a bit much for someone this young, but blind have used this as well.

http://www.deafblind.com/card.html
This is a 'manual alphabet' for the deafblind (those who are, d'uh, both deaf and blind). The signs are done on the person's hand, so they can feel the motions. In this way, words can be spelled out even if the person can't hear or see. Again, I know your son's sense development may not be total, but if touch seems to be working, here's an option to try.

I'm not sure if that will help out, but it's a suggestion I've got! Here's hoping that you will manage to discover the key and unlock your son's capability. And make sure that you ask about that assessment. They will likely be able to give much more detailed info than me!

Questions? Comments? Feedback? Follow-ups? Feel free to ask!

Trey