Expert: James Michael Roan - 5/22/2006

Question
Thank you for your reply to my question.  We had her tested through the school, and has  social language delay, expressive and receptive delay.  Starting speech therapy on 6/6,  1x/wk for 6 weeks, when school begins, will receive it 2x/wk. IQ was performed by a psychologist, WPPSI. Scored above average, in non-verbal, verbal considerably lower, but noted that she was very impulsive.  He recommended Pre-K in the fall, but we are reluctant. She will still get 2 times per week speech therapy whether in school or not. She would be in a special ed. class. Does point and gesture; attempts to share with others (other kids and family) toys, food, etc.  Very good social smiles. Plays alongside mostly. Has a hard time communicating and appears to just give up  and play by herself, which totally breaks my heart. Attempts to join in the fun, but can t keep up socially; can be physically aggressive when kids attempt to exclude her because she doesn't play exactly how they want her to; example:  girls playing Barbies, have them set up the way they are playing...a certain scenario, she comes/attempts to play, but does not do what they are doing, they get mad, so she gets aggressive.  Vicious circle. Then, they do not want her to play at all.  She gets time out (I cannot justify physical punishment/spanking for pinching or swatting at someone.)  She plays functionally with toys, doesn't spin tires,etc.  She can't do a pretend scenario; doctor, tea party, etc.  She can if there are props (dress up clothes, toys)but doesn t seem to know what words to use/doesn t have them in her vocab. There is some chatting, but mostly with a purpose.   See...    Hey look at that    See that..  are usually her ways to engage in conversation, but she cannot seem to maintain; doesn t seem to know what to say, runs out of words.  We did M-Chat; scored in the non-Autistic realm.  I tend to believe that this is all stemming from her language disability and generally immaturity, but I could be wrong.

Answer
Hi Amy;

I suspect you are right on all accounts. Language and social development are intensely intertwined: one influences the other. You want her in an environment where she has good social, behavioral, and communication models her age and who do not have autism predominately. Place her where you feel she is best suited, but where she can be supported by an adult knowledgeable about social development. Speech and language services should be held in small groups with other peers and not just be a therapy session between an adult and your daughter.

If your daughter has actually has been diagnosed with a pragmatic language disorder by a test and/or observation conducted by a speech and language pathologist, then keep your eye out for the future possibility of mild Asperger's Syndrome. These folks have a fundamental difficulty with social competence and can start showing difficulties as early as Kindergarten. Good luck.

Kind Regards,
James