Hi Dr Justin
My son is 2 years 8 months and he is not talking. He repeats some words when we ask him to say them – and only when he needs something or feels like saying it. He doesn’t have issues in hearing. We are taking him to speech therapy and going to play school as well. He was also diagnosed and doctors confirmed he is having mild autistic characteristics.
He also has behavioural issues. In particular, he bites a lot – especially us (his parents).
Please suggest what steps we can follow to get him to a better state where he can behave like a normal kid and can speak quickly.
Dr Justin responds:
Due to your son’s age and the lack of information regarding his autistic traits, I really can’t give much specific guidance to you. However, I can give some general suggestions for dealing with speech and language challenges, and his behavioural issues. Fore more specialised and specific ideas, please see relevant professionals.
You are right to be concerned about your son’s speech and language. In typically developing children, language ‘explodes’ from around the age of 18 months. Sometimes it may take a few months longer, but most children will have a relatively large and growing vocabulary – around 1000 to 3000 words – by around the age of 2 1/2 to 3 years. Speech and language is related to social and academic outcomes, as well as emotional and behavioural ones. Therefore, under the advice of your doctor, speech pathologist, or paediatrician, ensure that you continue to help him develop.
I suspect that he has speech and language ability. You’ve indicated he will talk and is able to repeat what you say. So I would focus on encouraging speech in the following ways:
Describe what you are doing as you interact with him. If he is watching you in the kitchen, walking with you at the shops, or playing with you in the park, talk about everything you can. Point things out to him. Describe the colours of his clothes as you dress him. And ask him lots of questions. You may be able to get him to respond. Ask him “What is that animal?” “Tell me what game we should play.” “What colour is that shirt?”
Remember, however, that your questions should not be manipulative. There shouldn’t be pressure to answer. It’s more of a conversation where he has the chance to respond if he wants. But don’t start demanding he answer you.
When we force our children to speak they often feel helpless and even unworthy. Rather than trying to make him speak, show you want to understand. Crouch beside him and tell him what you are seeing. “You look like you want to tell me something. You’re pointing to the kitchen. What is it you want? Can you help me by telling me?”
If he can tell you, he will. If he cannot, then tell him what you think he wants. If he says “yes”, then smile and ask, “Can you please say ‘I want a drink please mum’”.
When he tries to say something, let him know he’s getting it. Focus on encouragement and gratitude, but not praise. You might say “Thank you for trying so hard to tell me that.” Or “You just asked for help and I understood because you spoke so clearly.”
By pointing out what you notice (without the judgement and evaluation implicit in praise), your child will get the valuable feedback you want to give, and can feel positive and encouraged without worrying about whether he can do it again.
As challenging as it is for you and the other adults around you, it is infinitely more challenging for your little boy. Be patient and compassionate with him. Don’t force him to do things he can’t. Instead, work with him gently as he develops.
Your son’s non-verbal and aggressive behaviours may or may not be related to your suggestion that he has autistic traits. It might also be related to his language and communication challenges. Regardless, you will have the most success in dealing with his challenging behaviour by doing the following:
- Remember that young children typically have some propensity towards challenging and aggressive behaviour, particularly when they can’t speak or don’t feel understood
- Know that it is normal for children to act out at this age due to a lack of control over behaviours and emotions
- Be responsive to his needs. If he is hungry, tired, angry, lonely, or stressed he is more likely to act out, so be especially patient during those times
- Avoid getting angry, and instead seek to understand him
- Teach him what to do instead of lashing out when he is angry
- Redirect him to other activities when he gets mad
- Provide him with regular reminders about what behaviours are acceptable, and what behaviours are not
- Be consistent in limit setting so he knows clearly what the rules are
In your son’s situation I also strongly encourage you to continue to get appropriate medical and other professional help.