AboutSharon Rosen Lopez Expertise I am happy to answer questions about speech and language development in children.
Experience I have close to 30 years experience working as a pediatric speech/language pathologist, and have worked with infants and children through 18 years of age.
Organizations NY Speech/Language/Hearing Assocation
The American Speech/Language/Hearing Association
The Westchester Speech/Language/Hearing Association
Education/Credentials BA University of Wisconsin, Madison, Wisc
MA University of Washington, Seattle, Wa.
My son Seth just turned 3 and developed speech slowly and differently from other children. Up until about 2 years and 7 months he only identified words by their beginning sounds and he would even say entire sentences this way. I understood his special language, but others struggled. At a young age he was interested in symbols and he knew the phonetic sound letters by 2. He can identify numbers to 20 as well. At 2.7 he started talking and it was an explosion of conversation. He talks a lot with key people in his life, but with other children he tends to talk at them, telling them things and he also seems to talk about himself in the third person (Seth wants that or Seth is getting his teddy bear). I should say that Seth had speech therapy in a child care center for the summer (we live overseas in Laplace that does not have access to this sort of thing, this program ran for two months). He had started speaking before he went to the program, but obviously every little bit helps.
I do know that pronoun reversal is linked to autism, but my question here is if PR is also normal for kids in the early stages of speech development and if there are any activities I can do with Seth to help him use correct pronouns. I try to model a lot (I noticed my husband and I were speaking to Seth in the way that he was speaking- okay its time for Seth to go to bed and brush his teeth, etc), so we have made a very distinct to choice to use as much proper pronoun modeling as possible. Regarding autism, I have looked a lot into it, but I will say that there has never been a decline in Seth's development and he really doesn't seem to exhibit many of the other ASD symptoms (he plays imaginitely, he enjoys close contact, hugs, kisses, no problem with eye contact, etc).
Should I let the pronoun reversal sort itself out or should I be doing something about it?
Answer Hi Amy,
Thanks so much for providing detail about Seth's speech and language development. That's helpful to me in being able to address your concerns.
Use of first name rather than "I" pronoun is often seen in children who are developing language, as -- just as you suggest -- they are mimicking what they hear their parents say. It's great that you've recognized that you and your husband have tended to use Seth's first name when speaking with him, and by your using pronouns instead, it will help him to become aware of pronoun use. You can definitely help to stimulate Seth's pronoun development by providing him with a model after the fact: whenever he says "Seth wants cookies," you'll imitate his request (or comment, or whatever it is that he says), but with the corrected form -- "I want cookies, Mommy," or "I like grapes," or "I'm all done." I've written about pronoun development once before on AllExperts, and you may want to check that out: http://en.allexperts.com/q/Pediatrics-1429/2009/6/pronoun-confusion.htm. Although it's addressing a 3-year old child's use of 'me' instead of 'I,' it might nonetheless be of interest to you.
As far as your concerns about autism, the fact that your son is able to develop imaginary play may in itself belie these concerns. I'm wondering what your son's creative play is like. Between the ages of 2 1/2 and 3, children start to assume roles in play, though they'll still rely on use of realistic props. For example, Seth might have a stethoscope and play at being a doctor as he listens to your heartbeat, be the daddy who picks up his crying baby, or put on a fireman's hat and pretend that he's putting out a fire. Between the ages of 3 and 4 years, we see children start to sequence play events as they start to explore new outcomes in play -- the fireman drives the fire engine to the house that is on fire, and then the fireman gets the hose and starts to direct it at the house, sees a dog in the house and goes inside to save it, etc. I'm glad to hear that Seth enjoys close plysical contact, sustains reciprocal eye contact, and looks for his teddy bear! These behaviors all reflect his sensory integrity, relatedness, and engagement, which are areas of difficulty for children with autism.
Still, I do hear that your son has difficulty with social language development with peers, and that is something you might want to help him with. You may want to read up on social skills, and if so, Jed Baker, PhD, and Carol Gray are worthwhile resources. Carol Gray has several Social Stories books which walk children though the unspoken but inherent nuances of social skills, and Dr. Baker has written the "Social Skills Picture Book" for young children. The idea is to make explicit the social rules that are generally implicit. You can demonstrate social skills explicitly during your own interactions with Seth as well. For example, you might say: "I see that you like to play with blocks. So I'll play with you. (pause to give Seth time to absorb what you are saying). We can build together, and we'll talk about what we're building;" or, "I'm listening to what you say! (pause) You're right! That is BIG!" or, "I want to play with you. Let's look together. (pause). I'm going to put one more block on top! (pause) Do you think it's going to fall over?" or "You have a great idea! Let's take turns! (pause) I can push you...and then you can push me." As you'll notice, you're explaining some of the behaviors it takes to be more 'other oriented' -- looking, listening, taking turns -- and using vocabulary that explains 'shared focus.' We might expect that Seth will need consistent repetition of these implicit rules to help him learn to be less self involved during social interactions with peers. And you can make him more 'other focused' too in his interactions with you and his dad -- again, through your verbalizations: "I'm happy, Seth. Do you see my happiness in my smile and my eyes?" or "Daddy's busy. We can see (pause) -- he's sitting quietly reading the newpaper now. That means we should wait to talk to him."
In addition to these specific cues that you give Seth at home, inviting a child over for a play date (one child at a time will work best) and helping him navigate his way through their interactions will be helpful. After the play date, you might want to talk about the ways that he and his friend were able to play together. You could even write a story about the playdate and he could draw pictures -- or write symbols if he prefers! When you go to the playground, you might take time to explain to Seth the interactions you are noticing: "That boy likes to run. I see that his friend is following him. They look like they're having fun together." And finally, if Seth enjoys stories, you might search out storybooks that are about social engagement, or make some simple ones yourself if you have the inclination. Your hands-on approach will really help him to 'see' and 'listen' in order to accommodate others.
As Seth has had a non-typical development of speech and language, with enduring difficulties in social language use, I would recommend that he be evaluated by a pediatric speech/language pathologist in order to be sure that his needs are being met. It is impossible for me to rule out his having a learning disability or autism spectrum disorder that might require professional intervention.
I hope this note is helpful to you. Best of luck in helping Seth's communication and social skills flourish!
