Expert: Dr. Sharon A. Mitchell - 10/5/2011

Question
Hi my name is Sasha and i have a son who is 4 years old. He is very smart and independent but he still has alot of problems with his speech. He tries so hard to talk but everything comes out all jumbled. I do understand a few words that he says like mom, ball, and no. He has been getting better every now and then he will put together a whole sentence now, but i know he should not be having this kind of trouble.  Also He is very picky with eating he insists on only eating TYSON chicken nuggets and it can not be any other brand, he refuses to eat almost everything i give him except for a few things. He also is very particular with his toys he only really plays with one kind of toy and he is not happy until he has everyone piece that goes to it, he will throw a fit if he does not have all of it, he will actually tear apart our entire house until everything is together. to the point that he even moves furniture by himself. I have finally got him to the point that he is peeing on the potty but he still will not go number 2 on it and i don't know if that is a concern or not but i know other children who do not have this issue. i am afraid that these things are red flags that something is wrong, but he is very loving and funny so i feel that it cannot be autism, and people are telling me otherwise, please help me because if these are concerns then i would like to get my son help, im not sure where to even start. Thank you

Answer
Hello Sasha,

There are reasons apart from autism that a child has difficulty speaking. Just reading the first part of what you have written, I wonder about the possibility of a phonological processing disorder or verbal apraxia. These are both things to talk to a speech therapist about. Such therapists provide remediation and will also guide you in things you can do at home to help your little boy.

You are right. By age 4, it is not typical to be this unintelligible. I would suggest an assessment by a speech therapist. If you are unsure how to find one, call your local school district for suggestions.

It's positive that he is at least half way to being toilet trained. But yes, you are again right. Most kids are toileting themselves fairly reliably by age 4, at least during the day.

His pickiness about food is also seen in kids with autism spectrum disorders, but it's also seen in kids who do NOT have autism. His manner of playing with his toys could be a trait shared by children with autism, but is not exclusive to autism.

From what you have said, I feel you have reason to be concerned but not necessarily concerned about autism. There is something different about the way your little guy is developing. Although autism is prevalent in the news now and people are quick to assume that label, there could be other explanations for your son's difficulties.

I think it is important that you have him evaluated. Depending on where you live, the place to start would be your family physician, a public health nurse, a pediatrician, etc. Phone your local school district and ask to speak to someone in charge of special education. They will suggest where you can go for help and may even provide some support themselves. Many school districts offer early entrance services to preschoolers who seem to be showing some developmental delays. Since your son will be of regular school age in another year, now is definitely the time to find out what may be causing his delays and to get extra assistance for him.

Best wishes to you and your family,

Dr. Sharon Mitchell