Yes, this is definitely a speech pathologist's job. I've got to know a lot more since becoming good friends with maybe the best speech pathologist I've ever known.
Speech pathologists deal with a lot more than speech. They also can help with people who have trouble swallowing (such as after a stroke or other brain injury, for example).
Dara, what you describe is a LANGUAGE issue, rather than speech. We had the same sort of thing with difficult child 3 - he could read aloud (accurately) but not have any understanding of what he was reading. However, when he was learning to read we found that once he could read a word we had a chance at teaching him what it meant and having this stick.
difficult child 3 also would sing along to the radio; he could sing an entire song and get all the words right. But he also would vocalise the more obvious sound effects/backing music AS IF IT HAD EQUAL IMPORTANCE to the words.
The reason for this - for difficult child 3, he had no concept of meaning. WHat he was reproducing was, to him, simply a random series of sounds. The fact that he was capable of remembering such a complex sequence but with no understanding of any meaning to help him remember was simply remarkable.
An interesting effect we noticed when difficult child 3 was reproducing lyrics or movie text like this - when he didn't understand it, the words had a 'blurred' sound. Have you ever heard a visiting children's choir singing in English when it's not their native language? You can get the same effect in how they 'mangle' the English text in the song. It's less obvious in singing (because accents often disappear in singing, it's the artificial way certain phonemes get lengthened).
All this was happening with difficult child 3 when he was about Sammy's age.
You need to distinguish between what you mean when you talk about "speech" and "language". Speech is when you vocalise. It doesn't have to mean anything, but we usually do speak with some degree of meaning. Language is not necessarily vocalised but is more complex in that it requires the brain to connect the sound (where it's vocalised) to the meaning. There needs to be some sort of abstract connection - the sound becomes a symbol.
A baby babbles. There is not necessarily any meaning to it. Even when a baby first begins to say, "ma, ma, ma" they're not saying "mother", they're simply making sounds. WE are the ones who put the connection there, to meaning. It doesn't take much longer, as a rule, for a baby to learn that "mama" means "mother".
But with difficult child 3, that connection didn't happen when it does with other babies.
Also, think how soon babies learn to respond to their own names. Think how quickly A DOG can recognise its own name. Well, difficult child 3 didn't. It was as if he had no understanding that the sounds we made had any meaning at all. He could mimic our sounds, but had no understanding at all. I could be searching for him, calling him, frantically turning the house upside down and finally running up and down the street looking for him, calling him, asking the neighbours - only to find him happily sitting playing under the table hidden by the tablecloth. This happened a few times. When I found him he looked up and smiled - not in any "aha! You found me at last!" sort of way, more along the lines of, "here is a face I like." Absolutely no sense of knowingly having hidden. Despite the noise and the turmoil he just hadn't realised I was looking for him.
Now, you know how well difficult child 3 is doing now. At the dinner husband & I went to last night, a man spoke to husband about difficult child 3. This man has been working a lot with difficult child 3, spends a lot of time with difficult child 3 filling buckets of coal and lugging them round the train track for the drivers. And he had only just been told that difficult child 3 is autistic. He simply hadn't realised. Yes, he noticed he was slightly odd in the way he interacted sometimes, but he's a good kid, willing to help and very clever.
difficult child 3 is now doing really well. He is studying a mainstream curriculum and doing well (in most subjects). He has an amazing vocabulary, sounds like a walking thesaurus. When he looks a word up in the dictionary, he also looks up and studies the etymology - the origin of the word. So there is a lot of hope for Sammy.
What is needed - a speech pathology assessment. This is needed NOW. Part of tis will be useful in determining a diagnosis. And a big part of it will be important in setting the benchmark against which you mark Sammy's progress.
Next - speech pathology intervention and support. We actually didn't get much of this because what was available was limited, for us. But we found difficult child 3 had his own ways of learning, of finding ways to function.
This may not work for you, but somewhere somehow, Sammy is already giving you clues of what he is interested in and what he is capable of. Use these as your key, like a key to get into a tin of sardines.
For difficult child 3 - because he was highly interested in letters and numbers, we used this. We encouraged him, we showed him numbers and letters and used them to help him.
1) I made him lots of little, disposable books. You fold a sheet of paper in half. Turn, fold in half again. Turn, fold in half again. This should give you a small book with 8 leaves in it - 16 pages. Staple down one side and put tape over the staples for safety. Now cut the folds open to make the pages. Get out your pencils and draw for him. I drew difficult child 3's face on the front and wrote his name underneath. Inside, I began with the words he most needed and also seemed most likely to use. Words like "stop", "go", "exit" (because there was an exit sign he always pointed to in the building where his babysitter lived). I also would draw a picture to match the word. For example, "stop" was a stop sign. I also had a standing stick figure under it. "Exit" was a stick figure disappearing round a door with an exit sign above it. "Car". "dog", "cat", "truck" are all fairly easy. As a book got chewed, or forgotten and put through the washing machine, I would make another. By then he might have new words to learn.
2) I used photo albums. You can also use those plastic folders with clear sleeves for displaying a kid's school assignment. Write a story about Sammy. Put in photos of Sammy doing whatever the story says he is doing. For example, with difficult child 3 I wrote his story - "My name is.. I am a boy [because he had trouble understanding what is a boy, what is a girl]. I live at ... I like to climb trees." and so on. I had a photo of him up a tree, I put in a photo of him standing outside our house and so on. As the story progressed to outline his daily routine (which the book helped to nail in place) we would have photos of difficult child 3 cleaning his teeth, eating his meals, having his bath, getting dressed for school and so on. Also, any special days (such as our steam train trip on the Cockatoo Run) we took lots of photos and then wrote a special story for him to put in a folder. We would then read the story with him, sticking to the same words, and showing him the words as we read. Because it had happened to him and he remembered, it made it easier for him to memorise the sequence but to also understand the connection between what we read, and what he remembered of the experience. This also helped put language in place (ie understanding) as distinct from just speech.
3) We let him watch DVDs with subtitles on. He would watch them over and over, often zipping it back to re-watch a scene. difficult child 3's best friend's father commented on HIS son (also autistic), "He just watched them, over and over. There's nothing going on in his head, it's like he's just not there." I pointed out tat he definitely WAS there and working very hard to put it all together into one big bundle - the words, the meaning and the social context (gleaned from the action itself). Because they watch DVDs like this, they will often quote large slabs of text (often totally out of context). You should let them, because they seem to know instinctively what they need.
4) He got involved with watching TV shows aimed at teaching adult migrants to speak English. This one worked especially well, because it fitted difficult child 3's love of reading (hyperlexia). It also didn't 'talk down' to him - difficult child 3 has always hated being patronised. The TV shows for adult migrants were wonderful - they were strictly to a formula, very predictable in what segment came next. First there was a short dramatisation - a serial telling the story of an Aussie family. In this dramatisation a certain phrase would get used by different characters which would be the lesson for the day. Next came the two presenters, each using the phrase and showing by their actions what it meant. For example, "Is he playing golf today? Yes, he is playing golf today. Is SHE playing gold today? Yes, she is playing golf today. Are THEY playing golf today?..." and so on. For "it" they had a dog. It was funny seeing the dog with golf clubs! Then they had "Professor Say-It" who would focus on pronounciation of a particularly difficult word (for some people). All of this was subtitled, of course. They would do a short quiz on the serial - "Did Andy play golf today?" and the whole thing went for about half an hour. Another really good one was for teaching English-speaking people to read. Now, these programs wouldn't be suitable for you unless you wanted him to speak with an Aussie accent! Besides, probably unavailable now. But this is what worked for difficult child 3. Unusual, but darned effective.
We had to teach him the things most other kids learn by osmosis. And you need to keep remembering this - there is a tendency to think, especially with really bright kids, that "they're doing OK now, we can let him go on by himself from here," and this is a mistake. Even difficult child 1, now 24 and working full-time, needs my help in getting some vital paperwork completed and solving bureaucratic bungles. He's smart enough to know what to do (you would think) but couldn't organise his way out of a wet paper bag.
Sammy is only 3. He should have some fairly obvious language skills by now but clearly does not. You can't let the grass grow under your feet with language issues. But while you should get a speech therapist involved, there are also things you can do. I can't tell you specifically what you should do, but if you stand back and watch him for a bit, see what he really plugs into, and then see what you can piggyback to that to link him in with some good language skills, then go for it. You will need to schedule regular time with him to sit and work with him (let him think it is play) and use every spare minute you have to help him link these connections in his brain.
Compics are small cards with simple pictures on them, like stylised symbols. They represent different things. He needs to learn to use them to communicate with you instead of shouting random syllables. Once he gets the connection between a picture and its meaning, you can then teach him the word that connects in as well.
For example - Sammy wants a drink. He might come and grab your hand to drag you to the fridge, so you stop. "Do you want a drink, Sammy?" You get the compics (usually kept threaded on a string, like keys). "Show me the picture for drink, Sammy. Show me drink."
Sammy might be too impatient to do this, but the aim is to get him to use the card that shows a drink, to let you know he wants a drink. You reward him by giving him success - he shows you the right card, you immediately get him what he wants.
Next step - keep telling him it means "drink". Let him use his compics, but if he is in a hurry and just asks by name, reward him with praise.
If he is still struggling and you're fairly sure the methods I suggested won't work for Sammy (maybe he's not into reading at all) then a fairly high priority is to look for Compics. You should be able to find examples online that you can print out. A speech pathologist should give you some too, because although compics are a non-speech alternative, they ARE communication. Language. Grab some examples online, print them out on paper, and stick them to cardboard. Cut them out, put a hole in them with a hole punch and thread them onto string. Use them when you are trying to communicate with Sammy about something ("bathtime, Sammy" - show him the compic for "bath").
It may seem slow and tedious, but the hardest step is the first - that first link between something and its symbol. Once a person grasps the idea that something can be represented symbolically, that's the big step done. The next is much easier.
From there it begins to snowball.
Some concepts may take longer. difficult child 3 started school (age 5) finally understanding the meaning of "who" and "where" but not comprehending "why" and "how".
A few weeks ago he was discussing more complex words with his English teacher; words like "metaphorical".
We are dealing with other problems connected to the language delay, but we are finding our own ways there too. Again, certain games can help a great deal.
I hope this can help, Dara.
Marg
