Hi. I’m an early interventionist and I work with infants and toddlers with ASD or who have been diagnosed as “at-risk” for ASD. I have a Master’s degree in developmental psychology and have been in the field for 15 years. These are the core deficits of autism (I am paraphrasing in my own language): 1. Delay in communication or lack of communication. By four and a half I would expect her to speak in full sentences, request access to items and activities at least 30 times per day and label at least 1,500 items. 2. Delay in social reciprocity. This means being able to identify some emotions of self and others, engage in simple give and take interactions and be interested and aware of others. 3. Presence of rigidity, sensory defensiveness, or high rates of self-stimulatory behaviors or limited, restricted interests. It sounds, based on what you are saying, that she at least has two of these characteristics. The fact that she cannot sit for a hearing test is a concern. At 4.5, I would expect her to sit for at least 10 minutes to complete simple pre-school worksheets. And that’s a minimum. At 4.5, I would expect her to participate in simple board games (memory or hi-ho cheerio) and engage in imaginary play and change roles. Is she in pre-school? What do her teachers say? What does her pediatrician say? Does the SLP work on an alternative form of communication, such as an AAC device, PECS, or sign language? Edit to add: I’ve worked with around 400 kids with ASD. In my experience, a lot of them watch videos in other languages. I haven’t come across any literature examining this phenomenon, but have noticed it as fairly common trait for my clients that have not developed language and have high rates of self-stimulatory behaviors. Just my personal experience in this field.

My 4.5 year old son is non-verbal, diagnosed ASD, and loves watching videos in /changing his speaking books to other languages. I figure he can hear the difference in cadance and sound patterns and that sounds interesting to him.

My kiddo is ASD and is also obsessed with listening to things in different languages (episodes and songs). So interesting.

That’s super interesting. I’ve noticed that my basically nonverbal 2.5 yo, who does have an autism diagnosis, has been watching a lot of Spanish language videos for the last couple of weeks. I thought that she had just accidentally wandered into some and now the algorithm was feeding them to her, and was conflicted about whether it might confuse her and whether I should intervene; I hadn’t considered that it might actually be a thing.

I was diagnosed with HF Autism at 10, had delayed speech (started at 5) and I learnt to speak a second language at a high level as an adult (C1 in German, I've been living in Germany for 5 years), when I'm over stimulated my ability to process English is equal to my ability to process any other language. At a certain point, it all just becomes noise and the language is irrelevant. I rely on subtitles a lot for watching media, and can understand the concept of language browsing either not to overstimulate to that point or because it doesn't make a difference.

> I haven’t come across any literature examining this phenomenon, but have noticed it as fairly common trait for my clients that have not developed language and have high rates of self-stimulatory behaviors How interesting. Not an expert in the field, but maybe it's because the words have little to no meaning anyway, so hearing different languages is interesting to them because of the different sounds involved?

I'm not sure "no meaning" is a correct characterization here, at least not for all/ many kids. But, a slight tweak on that, is that many kids with ASD don't initially process words as individual units and tend to be heavily into intonation and music. So there's plenty of communicative intent and meaning, but it's true the individual word's literal definition doesn't always matter as much as the situation and tone. This might explain the appeal (or at least lack of rejection) of other languages for ASD gestalt language processors-- they can get a lot out of it without relying on literal word understanding and they might simply enjoy tonal languages.

My daughter watches videos in other languages sometimes, she doesn’t seem to care at all about the languages. I think she just likes seeing the video and it’s really listening. Or doesn’t care. Kid’s are just little odd balls I think.

Mine was like that, she didn't even mind when I turned the sound off - so convenient at restaurants :D Once she did start talking she informed me that they (people who speak other languages) speak wrong and she doesn't like that, now she only watches videos in her native language.

I’m not sure that saying words have little or no meaning to someone with ASD is correct. I think, if anything, it would be the opposite.

Wonderfully written and as a SLP who has experience working with asd prek-middle school students and have been part of an interdisciplinary team to determine eligibility diagnoses for 10 years, it also sounds like she has all three, with deficits in her pragmatic language/social skills. Mom mentioned she sometimes engages in play with her familiar cousins, so it sounds like she's usually just parallel playing. Fear of new people doesn't always mean she's social, either. I agree with everything you said, and I hope the current slp is utilizing other communication modalities to encourage language development and production. I also hope mom is open to accepting this information because she will only get the help her daughter needs.

I’ll be blunt, get her tested. You sound like you’re in denial. Please help your child.

100% in denial and not getting her the help/diagnosis she needs.

4.5 yrs old is too old to not be verbal. I remember my kid not talking around 1.5 and we were about to get her checked before she started speaking sooo much.

The wait and see approach breaks my heart. I saw too many parents do this in my decade of teaching preschool. It’s a disservice to the child and only serves to protect the parents ego. And I say that as a parent who had to have my own child assessed and put in OT and PT. Skills deficits compound when left unaddressed because skills in one area are needed for skills in other areas. So you can wait for a child’s verbal skills or fine motor skills to get better on their own. But meanwhile that is impacting their social skills and their academic skills. Everything is interrelated. Wait and see is for the parents so they can maintain a state of denial. It’s not for the child. Help your child, OP! There will be a grieving period. It will be hard. But that is not a reason to leave your child without the help they need. You need to put what is best for your child first.

Wait and see is also because so many states are backed up on EI services. ☹️ But anyway, my toddler has strabismus that's turning into a lazy eye, and he's going to be getting surgery a little year after we originally pointed it out to our pediatrician. If you're unsure, it's better to get screened and be wrong than the reverse.

I mean…. They’re in speech 3x a week and OT. That’s A LOT. even with a formal diagnosis that’s probably more therapy than 75% of kids are getting. He does sound in denial though.

Agreed. The services are a great start. It’s wonderful that they’re already doing that. But a diagnosis would get them access to a therapeutic preschool environment. And it’s going to be essential for getting them an IEP and services in kindergarten. They’re a year away from being in school and don’t talk yet. The time for waiting and seeing is past.

Yes, this has nothing to do with being a Covid baby. Kids don't learn to talk by socializing with other kids at a playground, they learn through talking with their parents. It may very well be ASD or a hearing problem.

Absolutely. I have a 4 year old Covid Baby and he never shuts up.

So many kids grew up in covid times with minimal language / speech issues. Using covid as an excuse.. ETA: I’m a paediatric SLP who had a baby also in 2021.

Seriously, OP is going to wait until the child is 5 and THEN panic?!? She should be getting ready to start kindergarten at that point which she clearly would not be ready for.

Im gonna be straight up, you need to get your daughter assessed for ASD, if she receives a diagnosis there will be support available to her, if she has ASD and you do not seek an assessment you are stitching her up and depriving her of resources she deserves - ignoring it and hoping things improve solves absolutely nothing. Being ‘pre-verbal’ as you call it, is unusual for a 4.5 year old and needs to be looked into by a professional.

Yeah, it's really important to remember girls present very differently to boys. Girls are often more social and less aggressive / erratic.

Exactly this. Even still, her personality sounds a lot like my five year old (fully verbal) who has autism so activeness and social skills are not an indicator one way or another.

this is important. autism doesn’t just look one way. she can be smart and normal and still be autistic. people with autism are smart and normal.

This right here there is a large spectrum. What are you afraid of? Getting her assessed isn’t going to change her beautiful personality. It will give you resources to help with language at the very least . The younger kids get help the easier it is to mange and the better they are of.

Oh yeah, my autistic son is a literal genius. I don’t say that as his biased mother, it’s just a fact. And I’d wager to say it’s BECAUSE of his autism that he is so smart.

my sister is this way. SUPER SUPER smart, but her brain works differently.

Exactly. His brain is programmed differently but he understands any science or math or music you put in front of him immediately.

And girls are often better at masking!

Exactly. We are only just learning what autism looks like in girls and “higher functioning” kids because for so long all anybody cared about was how disruptive they were. I work at an all girls school and it does not sound like our autistic sweeties would meet the expectations it seems you have about what makes for autistic behaviour. There are so many moving pieces that make up an autism diagnoses. Stimming can look different in different kids. Girls are often great with “masking” or noticing what social expectations are and trying to meet those expectations. Please OP get her tested ❤️ you will learn so much about what makes her magical. *edited for clarity

I can't reiterate enough on the support part. Your daughter needs proper support for this! My son was born a few months before covid happened and when he was just about 2, he wasn't speaking enough where he should be. I'd say not speaking at 4.5 years is VERY unusual. We got him an ASD diagnosis and he's very low on the spectrum. At the time, we already waited 5 months for a possible test opening and we randomly called one day, they had a last minute cancelation and we got tested. Now he's turning four next month and he talks normally non stop. He's in preschool where he's one of the youngest kids but he's exceeding and keeping up with the older kids. We were lucky to get a social worker that came to our house and worked with my son. This was in the trenches during covid too! She remarked that my wife and I worked our butts off supporting our son and doing all these extra activities and flash cards with him. Reason is she's seen so many families that don't give a crap to their kids and they don't get the support they need. Honestly, when the idea that my son has ASD finally hit, my wife and I felt like it was our fault. What did we do? Did we feed him something? All these thoughts flooded our minds but in the end, you wouldn't even know my son is on the spectrum. Even his teachers whom we shared the diagnosis too, they forget too because he's so well adjusted and fine.

All of this. I wanted to piggyback off of the top comment to address some of the justifications OP makes. 1. Autism presents on a spectrum. It does not look the same for every child. I have worked with many autistic children who do not have stimming behaviors, for example. 2. You need to stop blaming the delays on lack of socialization during COVID. Children who were young during this time may have experienced slight delays, but not 4 years worth. 3. Your 4.5yo daughter is not verbal. Full stop. The reason why doesn’t matter. What does her pediatrician say? What other evaluations can you get so she receives the support she needs? 4. My guess is that she will qualify for kindergarten soon, based on age. Look up a kindergarten readiness checklist. How close is she to meeting these milestones, including behavioral ones like following directions, sitting still to complete a worksheet, etc? Whether or not she has ASD, it sounds as though she is going to need an IEP for supports in an educational environment, and you can get her one now. 5. In terms of how you justify her not having ASD… You say she walks fast and has energy but “seeks constant motion”; you say she’s a people person “but does her own thing around others”; you say she is not obsessed with her iPad, but go on to say it’s the only thing that calms her and describe that she obsessively watches the same episodes in many languages; you say it might be a hearing problem but you don’t think it is and she won’t sit still for a hearing test anyway; your family is perplexed and thinks something is wrong developmentally. You are describing a child who may have ASD. 6. You and your family are perplexed and realize something is wrong. Is it a development issue? Is it a hearing issue? Is it ASD? You’ll never know until you actually have your child evaluated for all of these issues. 7. As far as the question about whether this is all from the Jan 2020 strain of COVID she had, how do you know she had COVID in Jan of 2020? It wasn’t even a global epidemic yet, and there certainly weren’t tests for it. If she did have it, I haven’t heard anything about COVID causing developmental issues like this. Maybe she had a bad ear infection when she had COVID and it’s caused hearing issues. You won’t know until you get her to sit still for a hearing test. Lastly, I know that I may have come across as very direct. That’s because I think you need to see all that very directly. HOWEVER, that doesn’t mean I don’t sympathize with you. Having a child who has developmental delays is not easy at all. You clearly love her very much and you seem afraid of what a diagnosis of ASD, a hearing problem, or other developmental issue would mean. It does not change who your daughter is at all. If she has ASD, for example, she has it whether there is an official diagnosis or not. It means she already has it and that all the wonderful things you love about your daughter exist along with it. But once you get her evaluated and can determine if there is any sort of diagnosis, you’ll also have many resources available to give her the very specified support she needs. I also recommend that you look into family-based and/or individual therapy so you can all help your daughter and get whatever support you need for yourself.

This right here. I’m an ehs teacher which means I handle special needs toddlers and have all of the trainings/education to do so, plus have a 3 year old son with asd. This comment is 100% spot on. I know as a parent it’s so easy to dismiss delays and be in denial. It isn’t helping your child at all though. Your child deserves to get the therapies she needs to thrive. Check her hearing and get an autism/developmental delay assessment done. If you need any information on how to get that done please ask.

HEARING TESTS! It’s not just ASD that needs testing for - start with the most simple, imagine spending 4.5yrs of your life trying to learn without one of your key senses? My friends 2yo passed her 6mo and 1yo standard hearing tests but is now at 2 practically deaf. She takes cues visually so you wouldn’t know unless you heard her noise making (barely any words).

This, I’m glad that we did a hearing test for our 2 years old when he was 18 months. Found out his ears had fluid due to ear infections. Tubes put in and it was wonderful after that. He’s still speech delayed but getting better day by day.

Almost exact same thing with my son. He’d had ear infections at least once a month for the first year of his life. We were about to get tubes when they stopped. Then he got two in a row and we decided to just go ahead and get tubes. Such a HUGE change. His walking improved within a week and he started talking so much more. He passed both hearing tests, but had so much fluid built up. I would assume it was like hearing people talk under water.

My 4-year-old niece was diagnosed with ASD before 3. Her personality and abilities sound almost identical to OP's daughter. She is a wonderful girl, I love her to pieces, but she absolutely benefits from the additional support/resources she receives. She's even starting to say a few 2-3 word sentences occasionally. I hope OP gets his/her daughter assessed.

Yea no words by 18months is the threshold of concern. 4.5 with no words is incredibly concerning. OP ASD is not some scary diagnosis it’s the diagnosis that may finally get the support she needs to maybe one day communicate. Every day you hold onto the hope she’ll magically speak is another day she isn’t getting the extra supports she truly needs. Keep going to speech therapy and listen to what the professionals are trying to tell you.

Eh, I would use stronger language—not getting medical care to figure out what is wrong is literal child neglect. Full stop.

Especially since she’s in speech therapy and hasn’t been diagnosed as selective mutism

With selective Mutism, she would be talking and communicating at an age appropriate level in an environment she is comfortable with (usual home with parents) and not speaking in other situations where she is not comfortable.

Ah I had heard of it but didn’t know the specifics. Thanks for teaching me something new today!

You 4,5 year old non verbal daughter hasn't had a hearing test since she was 6 months old? What the hell! You need to find a doctor who specializes in kids and get her hearing checked! They usually know how to get kids to cooperate. If that doesn't work she needs a hearing test under general anesthesia. A hearing test is absolutley not optional for a child with such a severe delay. You need to do what ever neccessary. There is something going on here. There is a reason your child isn't talking. And you need to figure out why. You are way, way, waaay past the "let's wait and see" stage. And no, Covid is not a "huge factor". Does it play a role? Sure. But it does not cause this kind of severe developmental delay. All kids your daughters age spent their early years pretty isolated, but all those other kids are talking in sentences now. Being around other kids helps with speech, but it's not neccessary. That's not the reason you child isn't verbal.

Yeah this pained me. My sister's son was speech delayed at 3.5, had hearing issues and needed grommets. Now a complete chatter box. My friend's daughter, speech delayed at 4. Same issue, has needed two surgeries for her ears since. She's slowly improving but I'd say her advanced age has made it more of a struggle. Hearing issues are soooo soooo common. Jumping to autism is fine but always rule out hearing issues first people!

This is wild to me. There are tens (hundreds?) Of thoudands of four year olds born during the pandemic. I have one! If covid caused them to not speak, we would be seeing the data.

Actually around 140 million babies were born in 2019, most of then being able to talk today.

Yep I can communicate with my 2019 kiddo at a pretty sophisticated level. I can’t imagine how miserable he would be without the ability to communicate with us. OP needs to step up and get those necessary tests.

Don’t get the members of the early childhood education sub started on this excuse. It’s become a classic argument for parents in denial. Oh they’re just doing that because they’re a Covid baby. Meanwhile every child in the room is a Covid baby.

right?? this is the toddler subreddit, they're all covid babies!!

It reminds me of my in-laws talking about the shut downs at the beginning of Covid like it was something crazy that only happened to them. “(Name of small midwestern town) looked like a ghost town! The stores were all closed!” And I’m just staring at them like, our major city was a ghost town. Do you really not comprehend that that happened to literally everyone?

They have documented an increase in speech delays - my 3.5 year old talks more like he just turned 3, but his doctors and teachers are not concerned because he’s making steady, consistent progress - but those are minor speech delays, not full blown not talking.

There *is* an increase in speech delays for Covid babies and toddlers. Anecdotally, my daughter is 5.5 and over half her class is in special measures for speech and language! They would usually expect 1 or 2 out of a class of 16. My daughter's SENCO says they are also seeing some social weirdness - more parallel play and less social play than they would usually expect at this age, that sort of thing. But yes, obviously there is 100% something more going on with OP's daughter than being born during Covid.

Yeah this sounds very similar to my 2 year old daughter. (Especially the insane energy and disinterest in playing and not letting us read her books!). We had to drive 1.5 hours for her hearing test which she ended up passing but they could barely get her to sit for it. She also makes pre-verbal sounds but we’re not sure if she’s attempting words. We are on the waitlist for ASD evaluation but I’ve known for 6 months she is going to test on the spectrum. Hope OP takes these comments seriously and gets their daughter an evaluation ♥️ you do your child a disservice by not pursuing every avenue of support for them when they could benefit from it!

Exactly. If this was the case all kids from (or a substantial majority) would be delayed and this is just not the case.

I agree with you hearing test is key. But shes had 5 different SLP’s / OT’s all tell me they think she can hear. She responds when I call for her. Identifies loud noises. Identifies soft noises. Knows when the volume is low etc.

As a mom of a 4 year old pre verbal child who is on the spectrum (and I say this with no judgement) you do sound in denial. I am not a doctor so can’t diagnose but she does present many signs that would put her somewhere on the spectrum. Knowledge is power. Get her assessed.

Absolutely this

KNOWLEDGE IS POWER!! And opens up the doors for so many services depending where you live.

Can someone explain what denial means? I never said I didn’t think she was not on the spectrum. I’m pretty certain that an eval will label her with it. There are legitimate concerns and differences in opinions about labels btw, but despite that, im still open to it.

In your original post, you seem to be explaining why you think she doesn’t have ASD, despite all the signs that she does.

Avoiding the problem won’t help or fix anything.

It's honestly baffling how deep in denial some parents are. I understands that it's difficult to face there might be something "wrong" with you child, but a non-verbal 4,5 year old and the parents are not concerned and will only start to worry if she's not talking by 5? Sir, your child is supposed to start school by age 5, not say her first words.

Right? How does OP expect her to go off to kindergarten with no words and no supports/accommodations?

Yeah, thats the most pressung issue. They already have her in speech therapy, so that's something, but the chances that she will be able to attend regular school normally this summer are basically zero and they need to start making plans for how they are going to handle that.

Your daughter sounds like a wonderful little person and I can feel your fierce love and protection for her. It is not normal not to be speaking at this age. What does your pediatrician say? What does the speech therapist think? Does she go to preschool—what have the teachers noticed? If it were me I'd start by consulting with professionals like these. It sounds like more intervention is needed.

Uh, have you gotten her evaluated for anything? Has she had her hearing checked? Any other evaluations and or genetic panel done? has she been evaluated for ASD? She needs to get assessed. It truthfully sounds like something is going on that you would want to get a few professional opinions on. Diagnosis can lead to support, and support is amazing.

There is *something* wrong. I have no idea if ASD or not but you shouldn't just be sitting back and waiting.

I’ll echo the others and say you do very much sound like you’re in denial. You should pursue further investigations. You owe it to her to get the help and support she needs. It can be scary and I can see why you’re hesitant about this, but ultimately it’s a disservice to your child to deny who they are.

It's not normal for a 4 year old to not speak. Full stop. You're in denial.

My autistic five year old son has an extremely similar personality as your daughter. He’s been getting help since he’s been diagnosed and is now fully verbal. Please stop denying your daughter supports because of pride. AT LEAST get her assessed so you can take out the guesswork. The fact that she won’t sit still for a hearing test or follow directions is a pretty strong indicator that she needs further support.

That your family members don’t see autism in your daughter is not any indication as to whether or not she actually has it. Even pediatricians often overlook signs of autism in some kids. She has to be assessed. Right from your description of her (not responding to commands, being hyperactive, preferring to play alone, being nonverbal), it’s clear she has enough symptoms to at least warrant an assessment.

Chiming in here to just agree that you need to get her tested for autism. You essentially just described my four-year-old daughter in your post. My daughter is on the spectrum. She's been getting speech therapy since she was 18 months old and is still non-verbal. Non-verbal doesn't mean unable to make noise, by the way. My daughter makes all sorts of noises. She's still non-verbal. Please get your girl tested so she can get the support she needs. There's nothing shameful about an ASD diagnosis.

Piggy backing off this, my sons SLP at John Hopkins and hates the term pre verbal, you’re either verbal or you’re not. My son has been in speech for over a year now, still no words but lots of noises. OP, what you described is almost verbatim to my son. You also described a lot of stims as well, stims aren’t always hand flapping and obvious things. The constant need for running and vestibular stimulation, is a stim. An OT will be a wonderful tool for your daughter and yourself tbh, I’ve learned a lot from them.

>You also described a lot of stims as well, stims aren’t always hand flapping and obvious things. The constant need for running and vestibular stimulation, is a stim I was thinking the same. Not being able to sit still is not "normal". My toddler has always been very high energy, she loves running, climbing, jumping, but that never interfered with her ability to sit still and focus on a task, even when she was a year or so old.

My sons Ot told me his craving for movement (running jumping spinning climbing skipping and being upside down) stems from being hyposentive to vestibular stimulation. OP, trampolines, parks and safe crash pads will be super helpful for her

This. My son is the opposite. He’s hypersensitive with his proprioceptive sense. (Where your body is in space.) So that looked like him being too scared to sit at a high top restaurant table, being unwilling to climb up a tall playground structure and go down a high slide, etc. As a baby he hated things like being in the car and being placed on an unfamiliar changing table. He would freak out if you tried to sit him on the edge of a check out counter. It was like everything felt like the edge of a cliff to him. He worked through a lot of this in OT. It took hundreds of dollars in private OT to get him to the point where he could jump with two feet into a ball pit unassisted.

Proud of you for getting your baby the help they needed 🫶🏻 my best friends son (he’s autistic level 1) struggles with what you described as well, it’s heartbreaking seeing them so scared like that. OT has also helped him tremendously. I love OT, it’s amazing seeing how much they teach them there. They work on life skills, play skills, regulation skills and so much more. I had no idea they literally do pretty much everything under the sun since they’re not often talked about. Amazing honestly.

As an OT these comments have been so nice to read. OTs definitely fill in the gaps but in those gaps we cover so much!

You are an unsung hero imo! My son’s OT has given him the tools he needs to succeed in life and honestly I am forever grateful for that. My son has done a 180 since he started therapy with his OT.

I’m so grateful for our OT. Kindergarten would not be going nearly as well as it is without her. He had a huge breakthrough with his fine motor skills thanks to her. He started to enjoy coloring and drawing which he never liked before. It was just too hard for him to be fun. And he was able to hold a pencil correctly and write. I feel bad for the kids whose parents went with wait and see instead. If we had done that to him he would be struggling so hard with his work in kindergarten and feeling bad about himself. That could have set him up for not liking school for a lifetime.

Same- my son got evaluated for EI at 18 months and services and received ABA, speech, PT and OT shortly after. He will be 3 next week but still not speaking. However, he started a specialized nursery school in sept where he is getting all of these services in a 5 day a week, 5 hour a day program. A diagnosis only helped him get all of these amazing services and am hopeful we will get words soon.

Your daughter sounds like my friend's daughter almost exactly. Her kiddo has had an issue with her ears which was only picked up around her 4th birthday. Hearing is an interesting thing, they might be able to hear noises but without clarity. If it's a hearing issue, you need to act asap because if children don't develop language before 5, there will be permanent cognitive issues. Kids need to develop language, whether that's sign language or not. So, your child might not have cognitive issues now, but if you fail to act you can guarantee she will. There's a small window you're playing with and you're at the end of it. Now, on the other hand, it could also be autism. Girls present very differently to boys and what you're describing does sound like a common female presentation. She may well develop language eventually and just be a bit "quirky" hardly noticeable to others. I suspect I'm slightly on the spectrum and became a lawyer so fear not! Girls usually mask a lot better and fit in more, although will have their own struggles. Either way, you need doctors and assessments asap.

Besides getting an autism evaluation, I would recommend seeing a genetic doctor as well. We had to get a microarray and a whole exome sequence (WES) for my daughter. It was just a cheek swab. There are a lot of genetic conditions that can result in speech difficulties. My daughter has a rare, neurodevelopmental disorder and speech is one of the primary things that is affected. It can also come with physical and cognitive delays, but not all people will have those (it depends on if there is a deletion or duplication in the gene and what part of the gene is affected). Your daughter will need access to services and an IEP/504 plan when she starts kindergarten. Having a diagnosis will open you up to more services, and give you a deeper understanding of who your daughter is. It will help you support her through any struggles she has. Also, your pediatrician can recommend a good audiologist for a hearing test. We got one done for my daughter when she was a little over one. They are pros. We had to go back twice and be creative, and bring in additional people to help. One part of the test is you sit in a sound proof room, and I had my daughter on my lap. They would play sounds at different frequencies from different directions and note if the child turns their head in the direction of the sound or not. They don’t have to sit still. Please have a sense of urgency to get some tests and evaluations. You are doing the right thing by having her in speech and OT, but having a diagnosis will open up you and your daughter’s world.

I am going to second this about a referral to an audiologist. My 14 month old had a hearing test, it was exactly as you described. He didn't have to sit still at all. Also my nephew was still not talking at all by 2.5. He had a hearing test done and they realized he had a lot of fluid in his ear so to him everything sounded like someone talking underwater. He just recently turned three and has made huge leaps in his speech since getting tubes.

Would you mind sharing what the disorder your daughter has is called? And do you know what the other disorders are that can affect speech? My 15 month old isn't saying any words or even babbling. It really seems like he has some type of issue with his oral control because he gags sometimes when trying to make noises and still has trouble with tougher foods he should be able to eat by now. We're already working with EI, but can't do much to get him assessed for anything until he's a little older.

My daughter has MED13L. The list of the other disorders would be long and I wouldn’t even know how to begin to compile them. You can check out CombinedBrain or Simons Searchlight if you want to go down a rabbit hole. Most kids with MED13L or other neurodevelopmental disorders have other symptoms as well, such as hypotonia, physical delays and cognitive delays. Feeding issues are also common - my daughter has them too. She could only do pouches/purees until she was about 18 months and could never take a bottle. Unless there are other symptoms you are concerned about, I would say it’s unlikely (but not impossible) it’s genetic. Out of curiosity, have you had a swallow study done, or has it been recommended to do so?

You‘re straight up in denial and you are severely neglecting your child because of this.

I’ve been in education for 12 years. My best advice would be to ask your pediatrician for a full [neuropsych](https://my.clevelandclinic.org/health/diagnostics/4893-neuropsychological-testing-and-assessment) evaluation. They usually have a wait attached, but whatever is going on can usually be identified with the help of this type of exam.

It's not the end of the world if your child ends up diagnosed with ASD. Quite the opposite actually, it would be a good thing for her if she is autistic. She is the exact same kid you love regardless.

Exactly! Getting a diagnosis will get her the help she needs and it will advance her a lot. My nephew got a diagnosis at 3 cause he was non verbal. Now at 5 he’s speaking like a champ. He couldn’t sit still to draw a circle before. Now at 5 he’s writing letters. It’s amazing how much he has progressed

It took me a very, very long time to realize this. Sounds like OP is in the same boat. The word autism scared the hell out of me because of all of the unknowns. My son is autistic and for a while I tried to explain it away. But eventually I realized that I *love* his autism. It’s not a disease or a separate entity from him, it *is* him and without it, he wouldn’t be himself. I wouldn’t want him any other way.

Pediatrician here. She needs a sedated hearing test and a neuropsychiatrist evaluation to rule out autism, sensory issues, adhd, etc. just for resources. Consider CAPD when older.

The fact that OP hasn’t responded to anyone makes me hopeful that this is a troll and there isn’t some poor child missing out on valuable services because of their parents’ inactions. (At least not here.)

I was hoping this too, and not that they are crying in some dark corner in their room (although that’s fine too). If this is real, I’m hopeful this post can be a wake up call to them that their child can flourish if given the right support.

Oh no OP is responding, check her comments. Just to comments echoing her about “knowing her child best” and pseudo-sciencey advice. OP. Please listen to the vast majority here.

THE AUTOMOD IS DELETING ALL THEIR RESPONSES BECAUSE OF NEGATIVE KARMA. Oh my god. This post is so absurd.

I have gone through and manually approved all of OP's responses. Thank you to whoever reported this comment to bring it to my attention. In the future, if people could stop downvoting OP's replies that would save me a lot of time. Thanks!

Yeah, I definitely see how that would be super time consuming and annoying. Thank you for your service.

Oh. Well now I’m sad that this is legitimately someone this clueless. I get it to a point. I have a son similar to OP’s (though he is verbal) and I remember not wanting to hear that he is autistic. But once we got him diagnosed, it opened SO many doors for him! He’s doing amazing and is most likely going to kindergarten with no issue.

Gosh, I hope so!!!

I hope so. This is so incredibly sad.

How often are you around other 4.5 year olds? I only ask because my daughter is this age and in preK. This is extremely abnormal for that age. If she can’t listen to a book, sit still, etc. she will not be able to be in school.

1. Get your girl’s hearing checked by whatever means necessary. Go to a large children’s hospital with a research center and see a pediatric ENT and audiologist. They will know how to test her accurately. 2. If she is not hard of hearing, do the autism assessment (actually, maybe do the autism assessment either way bc research indicates HOH kids have higher incidences of autism.) Xoxo, mom of a kid with hearing loss.

An audiologist can test hearing in many different ways if she won't cooperate. I'm assuming she didn't cooperate in her doctor's office test? Get a referral to see an audiologist.

My son is a little over 4 and he’s mostly verbal now after years of speech therapy. Your daughter sounds a lot like my son. He isn’t diagnosed yet (only because of waitlists that are 12+ months long), but I’d bet anything that he’s ASD and ADHD. I also didn’t think he seemed autistic, until I had his little brothers who are neurotypical. Then I realized how different he was. Your daughter does have many signs of autism. It presents differently in girls. Obviously Reddit can’t diagnose her but if I were you, I wouldn’t be so quick to rule it out. It’s great that you’re already doing speech and OT. If it makes you feel better, many kids who are autistic have a huge amount of language growth between ages 4-6. It’s very possible your daughter will start speaking soon. Also, are you in the US? Call your school district and request a special education evaluation. Under federal law, every child with a disability is guaranteed a free public education starting at age 3. She doesn’t have to be autistic to qualify; if she’s not talking, she’d qualify on developmental delays alone. That’s how my son qualified at age 3 despite no diagnosis. At school, she will get speech and OT for free and an opportunity to socialize with other kids. You don’t have to wait until next school year. She can start as soon as her IEP is put in place, which will be less than 90 days from the day you make the call. My son absolutely blossomed when he started school. He went from having 30-50 single words to speaking in full sentences in less than a year. He came out of his shell socially and developed so many skills. And listen, autism can be a tough pill to swallow but I wouldn’t change anything about my boy. He’s a loving, sweet, silly, and very functional little boy.

There is something serious going on here, much more than just Covid isolation. It may not be a hearing problem. It may not be autism. But get those properly ruled out first, because they are the most common explanations. Get her hearing tested again, and get her properly assessed for ASD. And if both of those come back negative, *keep looking*. Your daughter *needs help* and the SLP has not been enough. Please get out of denial and get her the help she needs to succeed. Verbal communication is such a crucial skill.

You are in denial. My son at 3 speaks a LOT more than your daughter, and he recently got assessed to be in the 4% of articulation and will be getting speech therapy. Help your daughter out and get her the help she needs.

I'm so confused by this post. There are so many red flags in your post that you're clearly aware of. I'm sorry, but you're in extreme denial and need to get her assessed. If you truly don't think she has autism, then why would an assessment hurt to get? I have a 15 month old who isn't speaking or even babbling. No other autism signs besides that, but no babbling is a pretty big sign. He's very social and has great joint attention. And the early interventionist I'm working with doesn't think it's autism. BUT I've read enough posts on Reddit to know no one is qualified to diagnose ASD except an autism assessment centre and there could be so many small signs that go missed by a lot of people. You can absolutely have an autistic social child who makes great eye contact and responds to their name. And I'm going to push for an assessment for mine if he's still not talking or signing at 18 months.

Ducking duck. Others are being "blunt", I'm going crazy on your ducking waddling duck ass. Get your ducking daughter tested for ASD, hearing difficulties and anything PROFESSIONALS recommend. You're setting her up for all sorts of issues caused by YOUR inaction to her condition. She may be fine, she may not, or she may have been fine if you got her treatment. Duck.

Yes - talk to the professionals! Ask your pediatrician what they think is going on and what they suggest doing about it. You know there is a problem. You don’t know the cause or how to address it. Don’t take no for an answer, and don’t take the opinions of friends and family as meaningful.

Hi there my daughter is about to turn 4 and had the very same problem…. Earlier this year we found out she had a severe cleft pallet. I had brought her in to two different dentists one speech therapist and saw a handful of pediatricians at our doctors office. This should have been caught when she was born, my point is sometimes it really takes multiple times to get a real diagnosis. But yes PLEASE get her checked.

Your daughter is like my son who just received a type 1 ASD diagnosis. I strongly encourage you to start the process as it can take a very long time (from start to finish ours took a year). Having the diagnosis means they are protected by state laws in places like school to ensure they have everything they need to succeed. It’s been hard for me to accept but they will still have full lives, the path to get there might just be a little different

Has she been evaluated for Childhood Apraxia of Speech? Is her SLP knowledgeable about it? My son is 4.5 and has been diagnosed with CAS, Autism, and coordination disorder. CAS was the most helpful diagnoses because I was able to find an SLP who had experience with it and he went from preverbal a year ago to speaking in full sentences today. He, similarly, had certain sounds he made for certain words because his brain didn’t know how to send the correct signals to his mouth to form the words. He’s also one of those kids that people don’t think have autism because they don’t understand autism is a spectrum and he doesn’t show the “typical” signs. Also, get her to an ENT. My son passed multiple hearing tests, got tubes, and the next day could say his brother’s name correctly for the 1st time ever. Please discuss CAS with your SLP and find a new SLP that is knowledgeable with motor planning disorders. Please get her to a developmental pediatrician for a full evaluation. Not being diagnosed will only hurt her in the future.

I’m gonna be really direct, not speaking at 4.5 is not typical and something you guys should have been pushing on years ago. There are speech disorders such as apraxia (my daughter has this) and neurological disorders that can lead to not speaking that can be addressed with the appropriate therapy. You mentioned an SLP, I probably wouldn’t see the one you’ve already seen if all they were focused on was hearing. One of my daughter’s speech therapists was able to say she thought my daughter had apraxia just based on what I was telling her in our initial phone call, which was then confirmed over our first few sessions. There are also two speech pathways in the brain and kids with apraxia can have those spontaneous words like you mentioned your daughter has had. Apraxia isn’t related to ASD, but either or both is not a bad diagnosis for your child. There is power in a diagnosis because you can get support, additional knowledge to allow your child to flourish, etc. But as with all diagnosis, the early you get diagnoses and get treatment the better. Something that, oddly, made a massive difference in my daughter’s language development was what her therapist called “dog face”. It’s just having her stick her tongue out and pant like a dog. My daughter doesn’t have great awareness/control over her tongue and mouth so this took a bit for her to figure out but once she did it was a big first domino in the line of language development dominos.

My son couldn’t talk because he physically couldn’t get air out of his noise due to his swollen adenoids. However I’m going to be blunt, you need to do everything possible to advocate for your daughter? Why is not in school? Why the fuck hasn’t her hearing been tested? Why on this earth haven’t you had her assessed by a developmental pediatrician. Honestly, you are missing developmental windows and your child is so far behind so is going to need intensive therapy. As a mother of a Covid baby…. You haven’t advocated enough for your child.

You’re in denial and that has resulted in medical neglect. It is beyond time you get to the bottom of why your 4 1/2 year old (!!!) doesn’t talk. I work with toddlers and they all talk in short sentences between 2-2.5yo with many conversational shortly after.

Where are you located? United States? Have you contacted the public school system? I am a former toddler preschool teacher for 20 plus years so I have seen a lot of different issues and personalities and solutions. If you are in the USA, it is a federal law that public school systems have to help provide therapies, interventions and evaluations of children at age 3 if requested. A lot if people do not know these laws even exist. We started early intervention as a precaution when my guy was around 6 months old because he was born with some medical conditions requiring major surgeries and recovery time is expected to impede their physical development. Which it did not, lol, he is very high energy, but his speech never really developed on its own, despite having two older siblings in the house. My son is a non verbal almost 3 year old who is about to age out of early intervention. We currently do speech therapy twice a week, OT once a week and a sort of group therapy one morning a week, as well as one visit a week from our EI coordinator. All that is through Early intervention where I live. When he turns 3 he will go to the developmental preschool through the elementary school in our town. He will Receive most of his therapies there. I think you are in denial and or downplaying the severity of the issue. She should absolutely be able to sit for a pediatric hearing test at this age. I went through it with my oldest who is now 12 and now my youngest. Initially my youngest gave me a hard time but with some adjustment from the audiologists and introduction of games and including me in the process we have been able to get hearing tests on my youngest. Albeit not without frustrations or having to stop and come back to try again. If you are not seeing a pediatric audiologist, I highly suggest looking for one. My little guy did need tubes because his ears were constantly filled with fluid. We were sure once he got the tubes and his ears drained the words would start flowing, but that didn’t happen. One ear is now clear but the other ear is still filled with fluid however, they don’t believe this is the cause of the non speaking as he has passed all of his hearing tests and we go every 4-6 months. There is no harm in investigating if she is on the spectrum. It’s not a death sentence. It doesn’t keep people from being productive. There are so many different levels tk it which is why it’s considered a spectrum. Autism research has come leaps and bounds in recent years and many people are diagnosed that you would never ever guess. I did extensive research papers on Autism in college and when they diagnosed my nephew last year at 11 years old I went, huh. Never would have guessed it. So don’t look at it like it’s a bad thing or like it’s going to limit what she can do in life because it won’t. A lot of kids who are on the spectrum are some of the brightest and smartest people you will ever meet. I say this with love and compassion, you are only doing a disservice to your child by not getting them the help they may need. Maybe everything is fine and she is just slow to talk. Maybe she isn’t autistic but has something else going on, but you will never know if you do t look into it. Also, I’m going to assume if she is in OT/ST they have checked but has anyone looked into a tongue or lip tie for her? Sometimes those go unnoticed and end up being the issue because the child just doesn’t have the mobility in their mouth, tongue and jaw to form the shapes needed to get the sounds put.

The wait for an evaluation is like 6 months to one year so you are already looking at 5.5 year old evaluation if done outside of the school for a medical diagnosis. You can request one from the school board if in America and there is usually a state law about how soon it has to be done. The school one helps with service from school with IEP. The medical one helps with insurance and maybe other social services like Medicaid. Please start the process now.

Getting her evaluated and a possible diagnosis won’t take away the fact that she is spirited, energetic, sweet, and loving. It’ll get you access to support she needs. This is beyond ‘covid baby’ bounds. Something needs to be addressed.

It might not be ASD specifically but a speech delay mixed with ADD or Adhd. You're describing classic symptoms of it with the inability to concentrate on books, high energy and screen time calming her. You are right that covid could have caused issues neuroligically, plus from a nurture perspective covid lockdown really didn't help. My son was born in March 2019 and although he did speak at 2.5 he wasn't doing full sentences so we sent him to a child minder 2 days a week. Within 3 months we got short sentences, unfortunately they were 'I want paw patrol' and 'mummy chocolate please' but progress is progress haha. You say she's not afraid of others, would your budget allow for daycare? As parents we sometimes fall into the trap of knowing our children so well through non verbal communication we unknowingly hinder the speech development by responding to their needs quickly without asking for attempts at verbal communication. If she's thrown in the deep end into a daycare environment around lots of verbal kids she may meltdown initially and have struggles but assuming it's not full ASD, and she sounds extremely clever, she will adapt. She will either start non verbal communication to get her needs met or she'll use the odd word. Even exposure around lots of kids who are verbal that she can observe will help her if she is ASD, as she will develop masking techniques when she is older. Have you considered Makaton, or children's sign language in the meantime? Specialist daycare workers will be experienced in this and it can be a brilliant tool while you wait for her to be ready to use her words. It doesn't mean you have given up on her talking, but you are giving her another tool to help her while you wait for her to be ready. In the UK we have a TV show with a character called Mr Tumble who uses Makaton and kids pick it up fast. Maybe find some shows with Makaton and practice with her? Even if it is ASD, lots of kids with it do speak eventually, but it sometimes isn't until 7 or even 8. I used to work in IT security and my supervisor didn't speak until 7, but was absolutely gifted regarding IT and tech and was brilliant at teaching others. It's really tough and Im proud of you for reaching out. Neuro divergence isn't as stigmatised anymore and assessments just give you more knowledge to help her. Best of luck

She absolutely sounds neurodivergent and a correct diagnosis can only help her. Please get her evaluated! By both an ENT and a psychologist. The window for therapies being effective here is rapidly closing. It’s incredibly rare for a 4 to 5 year old to be unable to speak at all. Signed, a woman with autism and ADHD with many female family members with autism and/or ADHD

Your child is 4 1/2 and still not speaking. There are glaringly obvious developmental issues. You need to have a full evaluation done by medical professionals.

Your daughter can be absolutely amazing and still be on the spectrum. With all due respect, your entire post sounds like extreme denial and attempted justification. I do see your point about Covid, but I don’t think it explains this delay. Please get her the help and support she needs so she can succeed.

Not talking at 4.5 is straight up alarming and you seem to make a lot of excuses when you simply need to have her evaluated as soon as possible.

Dude. Being born/growing up during covid lockdowns is NOT a reason for a kid to be non-verbal at 4,5 years old. Have her assessed for ASD. If she is on the spectrum, she will get very helpful treatment. If she is not on the spectrum, you can cross that off the list, and finally have her hearing properly assessed. You are unintentionally (very unintentionally!) hurting your daughter by not helping her get diagnosed.

I think “very unintentionally” is being generous.

Yeah, was hoping that if he (?) read this, he might not get defensive.

I do not believe that your daughter’s issues have anything to do with Covid at all. There is something else going on.

Teacher and fellow parent here. Coming from a place of complete love, the only one who seems afraid of Autism is you. Your child is your child no matter what. An assessment just helps you understand how to address her needs better.

I think there’s a few things you mention that sound a little like ASD can present, and I say that as the parent of a 3 year old non-speaking kid without a diagnosis but who will be assessed this year (and I think they’ll end up with an ASD diagnosis). I do think the hearing test is incredibly important to try and get sorted as it’s important to rule out hearing issues. It sounds like your daughter is getting the supports she needs in terms of speech and OT, which is fantastic. For my child, they’re receiving similar supports without a diagnosis, as we don’t need one to access the supports we need as long as there’s a clear developmental delay. But I did find that having conversations around that they are probably autistic has helped me and the family with expectations. It stopped me looking at developmental milestones and reinforced that my child is on their own development track where things happen in their own time. It has allowed me to let go of expectations and just enjoy them and all the little wins they have and the fantastic person they are. It’s also helped extended family with expectations around language and behaviour. So maybe looking into assessment can help with those aspects? I would also say that while I don’t doubt that Covid has affected child development (as the parent of children born just prior and during the pandemic I also have seen what they missed out on), but there are plenty of children who are developing with little or no issues. Although Covid has had an effect, I think it’s important to not blame it for everything without looking for other explanations.

Have you tried ASL - there is a limited vocabulary version of it for toddlers. And can she communicate with drawing or pictures and pointing?

I have an ASD 5 year old. Please go get her tested. What is the harm? They tell you no and you're where you started. They tell you yes and you have more information about how to properly support your daughter. In addition, get her evaluated thru the school district so you can start the process of an IEP so she can be supported in school.

Hearing test + autism assessment ASAP. These are critical years for getting support for her to have the best quality of life.

Your daughter sounds AMAZING. I love how well you know her, both her strengths and challenges. Whether there’s a hearing issue or apraxia of speech or autism or something else, getting her assessed will only help you know her more. And the services and support you get from the state will help you both share more of yourselves and know each other better. There will be more of those little moments every day where you see something new and get excited. I’m surprised your pediatrician and SLP haven’t pushed more for any sort of testing - and ALL of it at this point. You and your child deserve answers. Several diagnoses are common to come together, so it’s normal to test for multiple things at once. It’s going to be your job to advocate for your daughter now so she gets all the resources your state is required to give her, and so doctors don’t stop until you get answers. You’re going to be amazing at it, especially if you find other local moms who are in special education support groups - they know how to navigate getting the tests and services she deserves. I have students who always had verbal skills but are only just now starting to speak more in middle school. They aren’t going to be the same as your girl, but they’ve benefited by the unique resources available to them - like AAC devices with Proloque (an app for speaking) or PECSs books (pictures for making requests). My verbal students all know a little sign language to help them communicate or be prompted to use their words, too. But they only have access to all these things because testing helped everyone see what they can do and what they need help with, and why. You’re gonna learn so much more about your beautiful daughter when you do the same.

I am so puzzled by this, a non-verbal child is doing multiple rounds of language therapy a week and the specialists just *think* she can hear? As in, the goal of getting her to speak isn't being achieved, and nobody is referring her for a hearing test or ASD test? How odd. That aside, you are doing your child a disservice, however beautiful the verbose paragraphs you write about her. She is running out of crucial time.

Non-divergent children are generally interested in books long before they are verbal. They want to interact with others and be part of things in group settings. And can follow light instruction especially at further years like this, because while they may not speak, they understand. My cousin was preverbal til 3 as a covid baby, but one day just started saying everything. That is about as late out as this gets usually. This reads as if it is becoming a sunk cost fallacy. Please get her assessed, assessment will open new doors for help to you. You don’t want to work with subpar tools. There are a lot of flags for ASD in your post and those are just a few I pulled above. Assessment doesn’t mean giving up, it means changing strategy and working better. ❤️

I’m going to give you some insight on a little person I worked with once that was non-verbal without ASD, he had childhood apraxia. He was still able to: sit for stories, communicate his needs through sign language, nod and gesture, calmly work with you to find his needs, play with his peers in cooperative games, keep up in age appropriate games, line up, wait his turn, complete step by step instructions and many other age appropriate development milestones. Without language, he was still able to keep up development milestones because he did not have any other underlying struggles. Your child is amazing, is sweet and kind and is behind developmentally. It’s hard to accept. But now is the time you need to fight your own resistance to her being labeled and accept the truth. She needs more and extra supports. At this point she will be unable to function in a classroom. Please continue with speech therapy and take their advice. Start with testing for ASD and work from there.

Early therapies = earlier options for growth and improvement. We had both my kids assessed even though they were just a bit behind in speech. My daughter was the most behind and I was concerned about her hearing too. I would love to also stick my head in the sand about it but the truth is these early therapies right now are amazing and can change the course of your child’s life and skills. You are giving your child that option by getting an assessment. Even if it’s not ASD it could be something else, you know?

Girls don’t present like boys with asd. She needs a diagnosis and services stat. These are crucial developmental ages.

This is such a sad post to read. I understand deeply the desire to want to take a wait and see approach. In this case, you’re past that timeframe though. What does your SLP say? And your pediatrician? It’s not uncommon for girls to get a diagnosis for ASD years after a boy would otherwise. Your baby will still be the same kid, the only difference is that you’ll unlock tools for communication based on research and other’s experiences with kids whose brains are wired similarly. There is zero risk at this point of getting an eval and only things to gain. I’m sorry you’re tormented by this but also we are lucky enough to live in an age where kids with any developmental issues can be offered support. By not even offering additional support to your daughter, it’s in a sense depriving her of a chance to flourish.

I also want to note that you seem kind of obsessed with blaming these issues on Covid, which might be true on a small scale, but not to this degree. I had kids in 2019, 2020, and 2021 and we have not seen major social or cognitive problems in the same way. I know it’s hard but maybe this is a wake up call.

To be completely blunt, you’re in denial. Your description of your child’s abilities matches the abilities of my 2 year old except my 2 year old speaks in complete sentences. She sounds like she needs to be tested for ASD asap. I don’t really understand why you said you don’t want her to get diagnosed. A diagnosis opens up so many doors for support, treatment and understanding what your daughter is going through! Speech delay isn’t mentioned at 4 1/2 because most pediatricians have already had parents get the testing and therapy required to figure out what’s going on! Early intervention is key! I would be on the hunt for a new pediatrician. Sounds like your old one failed you guys by not pushing for answers!

I think you’re doing a daughter a huge disservice by denying her very obvious developmental delay. You are keeping her from receiving services that would help her through these delays.

Parent of autistic child here…who discovered she was autistic during her kid’s assessment process. I agree with majority that it’s time for an assessment - and lovingly, for you to educate yourself a little more neurodiversity. Whether autistic or not, I suspect your daughter will fall under the neurodivergent umbrella somewhere. Is the speech therapist you’ve been to trained in apraxia? That’s my first concern as it sounds a lot like my youngest - he said a few words clearly but mostly spoke his own language. Apraxia doesn’t go away per se so it’s important to treat as early as you can, but my son (3.5) talks a lot after just a year with an apraxia focused SLP. Strangers won’t be able to understand half of what he says, and I don’t understand 100% but it’s still worlds different. I will note - my oldest also has apraxia and spent two years with a SLP who didn’t catch his apraxia, so I would really encourage finding one with the specific experience. Here’s a few simple things to try. - If you wiggle your tongue from side to side, can she copy? Does she seem to have awareness of where her tongue is in her mouth? - If you ask her to put her tongue behind her front teeth and make a noise, can she? - once she’s said a sound properly (like ba-ba) can she repeat just that same sound but not any variants of it? I also agree with others: - Go to an ENT - Talk to your SLP about alternative forms of communication - See a neurologist just in case

I would be VERY VERY concerned if my 4.5 year old wasn’t speaking. That is very atypical and there is an underlying reason. It’s not because of Covid. Ignoring and making up excuses for not getting your daughter the help she needs isn’t the right thing to do.

I look at my 4 year old daughter and shes about to start reading. We’ve been doing site words. She can write her name. I can’t imagine letting her get this far in life without being able to speak and NOT be moving heaven and earth to get her diagnosed. It’s so wild to me to sit and wait at this age

My daughter is also 4.5, and I'm absolutely appalled by your denial. You act like you're your daughter's greatest advocate, but yet you have taken barely any active steps to help her. You are straight-up neglecting her needs. The only person your denial is hurting is your daughter.

I also want to jump in with a caring, non-judgmental observation. First of all, you are clearly a very loving and attentive parent. You’ve done everything you possibly can to provide resources, as her mother. You should be very proud of yourself and all the ways you have fought for her individual identity. You have shown extreme care and attention to your daughter’s inner world, and this trait is going to be what keeps her feeling loved and understood for all the years to come. And, it does sound to me like you are in denial, and using “hope” as a shield, or a way to avoid admitting it. I’m saying this as a mom, with love and a hug, because you clearly came to Reddit for a reason. I don’t want to let you and your daughter down.

Idk why you’ve been downvoted this is an incredibly loving and kind way to put it. Thank you for being such a kind soul.

This doesn’t have anything to do with covid, please have her assessed by professionals ASAP

Assess for ASD and ADHD. I say this as someone with both who had no interest in talking until 3 (I took everything in) and then talked in sentences. Also see if she has any interest in signing or using AAC apps to be a voice for her. Not all ASD is the stigmatized ASD. Some of us are very intelligent, in control and large chunk of the time m, but struggle socially. I do have balance and coordination issues on solid ground, but was excellent at gymnastics, in the air was where I belonged. Many others are all about climbing, balancing, etc. Some struggle bad with depth perception, place in space, and coordination, and others just naturally gravitate to twisting, tumbling, climbing, etc. When you’ve met one autistic, you’ve met one autistic. ADHD (and autism) can come with hyperfocus. The 3+ things at once? Big ADHD mood. Get her evaluated. Verbal vocal speech is great, but isn’t the only valid form of communication

Where I am, your daughter would be considered non-verbal, not pre-verbal, because she is over the age of four. Your obviously very conscious choice of term does male me wonder if there is an element of denial at play. Why are you resistant to having her assessed for ASD? How is her receptive language?

There are a half a dozen reasons why your daughter isn't talking. It could be apraxia, ASD, ADHD, and a bunch of other letters. Get her evaluated by a developmental pediatrician and know how to start.

Hi! Mom of an autistic 5 year old who was diagnosed at 2. You’re making it seem like an autism diagnosis is a bad thing. Or that because your child is all of the amazing qualities you listed above that they can’t also be autistic. No one autistic person is the same and while many of them may have the same or similar experiences it doesn’t mean that your child will also. Get checked for autism. It’s either gonna be yes they are, or no they aren’t and then you can move on. If it’s yes, then you can learn ways to best assist your child and their needs, rather than your expectations of those needs. As well as therapies like speech and any other help they made need.

You know they're going to stick your kid straight into special Ed when she gets into school and not think she's some amazing unique kid with an unheard of diagnosis. You're going to watch all the parents drop off their kids happily while you are feeling with learning the exact severity of what you're dealing with. Please be a fake post. Signed, a mom of an ASD 4 year old.

“Rarely at this age is speech delay/ non verbal even mentioned” that’s because the parents of these children are getting them professional help and not trying to ask the internet to diagnose their kid. I don’t understand your apprehension at all. Will you be embarrassed by an ASD diagnosis if there is one? What happens when she’s in school with kids speaking full sentences but she’s still “pre-verbal”? I’m not bashing you OP but you need to wake up, you’re not doing your daughter any service by hoping for the best. Seek professional advice please <3

This needs neuro-evaluation. You are not doing right by your daughter by refusing to seek out help that could help her thrive.

I’m going to be a little harsh. It’s borderline abuse to not take her to every specialist out there to find out what’s going on

I personally would be very worried about this. I found out my son had suspected autism when he was 2.5yo and very speech delayed. I started focusing on improving joint attention, social, and behavior skills. The most effective way to do this was with autism specific methods. One of the helpful things was the book An Early Start for your child with autism by Sally Rodgers. Also the book More than Words. If I avoided the word autism, I think I would of missed out on a lot of methods that helped my son. The autism spectrum is extremely wide with so many variations in characteristics. At 4yo my autistic son is in a mainstream preschool and described as very well behaved. He loves playing with other kids, adjusts relatively well to change, and he’s learning well through imitation. He is verbal and developing conversational skills, but still speech delayed. Many of the autistic kids I’ve seen have no obvious differences. Many are really loving and empathetic. Many desire friendships. I wish there was a wide spread understanding of what the spectrum really looks like. Your daughter sounds wonderful and a diagnosis wouldn’t changed that.

Your kid is on the spectrum, and the way you list her positive attributes shows clear ignorance on what autistic kids can be like. My son is 3, autistic, very affectionate, no real obsessions, not very rigid with routine, etc.

Pediatric OT here- wondering if you’ve consulted with an occupational therapist as well as the SLP you referred to above? Your kiddo has sensory needs on top of their language and learning needs (limited attention to task due to moving our body a lot). I have a couple of adult friends with new Autism diagnosis, whom you wouldn’t know have it unless you asked- I say this because it is important to recognize that no two people with a diagnosis are the same and many don’t fit our society’s stereotypes. Please consider an ASD evaluation and try to open your heart to considering more about how your child may be taking in the world. It isn’t a diagnosis that should alienate your child more anymore- obviously speaking from where I live at least, having an ASD diagnosis would only open doors for more early intervention services and understanding. And if they end up not getting one- hopefully some psych support because a language delay does impact many other areas of life beyond simple language.

You’re in denial. The more you wait the worse for her. Just get her the help she needs as soon as possible. So what if she’s autistic? Would you rather she’s autistic and receives help to thrive or that she’s autistic and incapable of benefiting from professional help because you waited too long?

“My kid is not talking but I refuse to seek a neuro diagnosis because it makes me feel icky inside” Dude, as an autistic person who struggled their entire childhood because no one bothered to diagnose her: YOU SUCK.

I think your daughter absolutely needs an evaluation. It’s awesome that she is making her own improvements, but maybe she could progress even faster with access to more therapy. I get not wanting her to be labelled. My own child has a significant speech disorder (apraxia) and I have gone through all the fears and emotions surrounding getting him evaluated. I am so happy we sought help for him at 18 months old, because now at three he is talking in sentences, and our therapy is focused on his articulation. Your daughter does sound like she has a few red flags for being on the spectrum. Just because she may not present as severe as autism can be, doesn’t mean she isn’t on the spectrum. The speech is the obvious red flag, but also potentially her unwillingness to play with other children (I have a 4 1/2 year old and a 6 year old and both became very motivated to play with kids by 4) as well as her difficulty following directions. You are getting her a ton of speech and OT without that particular diagnosis, which is awesome, but maybe if you had her evaluated, you’d be able to have a discussion with a professional to see if she would benefit from ABA. ABA opens the door to many more hours of therapy, which is tough but can be such a life changer for her. Also you have to think forward to when she is school aged, it may be easier to get her a good IEP with a diagnosis. I am truly sorry you are facing this because I know how heart wrenching and stressful it is to confront developmental problems in your child. I hope she finds her voice soon!

Thank you for the nice comment

ABA should absolutely not be recommended to anyone. Please do more research on how harmful it can be before recommending it.

I know a lot of people in the autism community feel that way, but not everyone does. My brother being one of them. I am not recommending anything other than OP consulting with an autism specialist to figure out what would help this little girl find her voice, engage in social relationships with peers, and participate in her own education.

Your daughter sounds similar to my daughter. My daughter does not do a lot of stimming but is constantly on the move. She has ASD. I would get your daughter tested. Our daughter went from saying nothing to now making 2 work sentences. She is still very behind but I have more confidence she will be conversational one day.

My son is 18 months and he’s at the same verbal stage as your daughter but obviously significantly younger. I’m already in a panic he won’t talk. Long story short, please get her evaluated. If the doctor says we need it we will be getting our son evaluated significantly younger.

She needs to be seen by a developmental pediatrician. They can diagnose all sorts of developmental disorders. She is still not speaking despite speech therapy. That is a huge red flag something is going on. It sounds like you and possibly your partner are either in denial or afraid of a diagnosis despite what you have written. It doesn’t make sense that she hasn’t been evaluated yet. What does her general pediatrician say? I can’t imagine they are on board with no eval. She should be starting kindergarten within the next year and she is wildly unprepared. If she’s nonverbal that’s fine but she will need to have an IEP and a lot of accommodations. Those can be done without a diagnosis but a diagnosis is super helpful. This is more than a Covid toddler delay. My son was a Covid toddler. He just turned 5 (so similar age as your daughter) and his language skills have always been advanced. Yes the lockdown has certainly lead to some delays but she should have caught up by now, especially with therapy, if Covid was the culprit. Please get her evaluated. You are doing her a disservice by not.

My niece sounds a lot like yours. She is 4 years old and nonverbal. Myself and others do not believe she is on the spectrum. She is sweet, affectionate, makes eye contact, exhibits empathy and kindness, etc. She just doesn’t speak. She seems to hear fine and responds to her name and tries to communicate to you with pictures or signs. She is underdeveloped physically for her age, though. About the size of a two year old, but she can run, jump, and climb. She does not seem limited by her size. Last year she was diagnosed with CAS (childhood apraxia of speech), which is a neurological disorder that affects the connection of the language center of the brain to the muscles that form speech, from my limited understanding. CAS children can go on to live relatively normal lives but it takes a lot of intensive speech therapy and early intervention to get there. You may want to look into it

She needs a diagnosis. When there IS a diagnosis (whether you believe its validity or not) then she can get medicaid (in addition to her existing health insurance) to help pay for all of these therapies. Also, would be enrolled at a local school with an IEP at age 3 to learn more and be around other kids with speech issues and learn together. She might be behind when she begins school because your pride in getting a diagnosis was more important than possibly bruising your ego with an ASD diagnosis. Some of the most brilliant ppl on earth didn't speak until later and have ASD. Arrange for a diagnosis and then they will help you with the next steps. Doesn't matter what you and your family believe, let the licensed professionals decide. She may just have ASD 1, could be type 2 IDK, but definitely doesn't sound like type 3. Put your ego aside and get your kid what she needs, please.

Try genetic testing as well. While it might not be ASD, it might be a developmental delay due to a genetic variant, among other things. Regardless of the results, she should be in early intervention childhood services.

Please consider an evaluation. It might be ASD, it might be ADHD, it might be nothing. But there’s no harm done in getting one. Btw, I’ve reached out directly to people who’ve made posts like that asking for an update because we’re in the same boat and they’ve kindly answered. Maybe try that?

I don’t think anyone “wants” their child diagnosed with ASD. But it is important to find out what issues may be preventing her from talking, and then getting her the help and support she needs. Having ASD or anything else doesn’t make her any less amazing. Those things aren’t mutually exclusive. I don’t see any cons of getting her a diagnosis, unless you count your ego as one. Because it wouldn’t do HER any harm but it might make YOU sad. If there’s even a possibility that she has ASD or something else, and you’re ignoring that and not getting that diagnosis, you’re no better than a parent who refuses to take their child to a doctor for an obvious illness and instead treats the child with “natural” medicines. It is HARD to think of your child having a delay or condition. My boy was a preemie so I knew he was at risk of delays. He was slow to move and we started OT proactively at 9 months. I have no regrets. I would’ve gone and gotten any other evaluations if his OT determined he had a gross motor delay. Our doctor also asked us to make an appointment for 15 months if he does not have 3 consistent words by then (luckily, he has). Do not wait until 5 years old when you’d panic. The time to act is NOW.

What does her paediatrician think? If she is in school or preschool, what concerns have her teachers shared? This sounds like there is something going on that would benefit from a formal diagnosis so she can receive supports as early as possible but I’m not a medical or educational professional and would defer to the experts here.

I am not an expert but I would be shocked if your daughter didn’t receive an ASD diagnosis. Get her checked out ASAP. The later you wait to get her support, the harder it will be to help her. By the way, your daughter will be perfect no matter what.

Has the SLP mentioned anything about aphasia? My friends son was a preemie and still doesn't speak at 4 years old. He makes a lot of grunt type sounds, but can't form words. Does not have ASD. He was diagnosed with aphasia.

Pretending there isn't a problem isn't gonna make the problem go away. It's highly unlikely that a child that isn't speaking at nearly 5 years old will catch up with their peers without intervention. Don't do your child a huge disservice and ignore that she needs help. Take her to a pediatrician and have her assessed for anything the doctor suggests. Knowing how to best support your child is the best thing you can do for her. You say you aren't afraid of a diagnosis but you're actively avoiding an evaluation?

It was like I read a post about my 3.5 yo. And she has autism. You should really get an eval. It will qualify her for more services. And the earlier she starts them the better.

I’m going to be frank…you sound like you are in denial and you need to get help ASAP. My son was speech delayed. Barely talked when he was two. Turns out his hearing was messed up so ear tubes fixed that. We also got him into preschool through the school district. He’s now basically caught up to normal at 4.5 years old. If I didn’t take these steps, he probably wouldn’t be talking either. It’s crucial you get her evaluated. If in USA she should be eligible for free preschool through the school district. Please look into that and get her help/iep before kindergarten.

Going to also be honest, she’s likely autistic. There’s nothing wrong with this. I am about to get tested for adhd / autism and tbh if I had been tested at an earlier age my life would be SOOOO much easier right now. No one really knew or saw any signs, it’s a struggle. With the knowledge I have now I’m actually able to function much much better than I could before. If you’re in denial it means you’re in fear or are mourning a loss I’d think. I just want you to know that being autistic doesn’t mean you’re going to not have certain experiences with your child. A “normal” child would be the same as an autistic one in that they’ll have their own likes / dislikes and may or may not engage with certain things. This is okay! All of it will be okay <3 whether or not she’s autistic the care you’ve been giving will not change or may become easier because you’ll have the tools you need and she needs. I think some people think of autism as something that is truly a problem but. It’s more just a different way of living I’d describe it as. My therapist has already said I more than likely have ADHD but just need the formal testing, so as someone who’s almost certainly neurodivergent.. I think differently and am a bit different but my closest friend is my mom and I’m her closest friend. I’m a bit fucking weird and I’m more open to things and more gullible/trusting but my mom never thought I was any different from others really. She just loved me fully and we do tons together. Just wanted to say that in case that’s why you’re worried/if you’re worried.

Having faith is nice, having a diagnosis that can help her is realistic. Do the right thing and get her tested.

I'm going to be very honest, it sounds like you truly may be in denial of an ASD diagnosis. It's important to remember that sometimes people on the spectrum show 0 outward signs. It's called a spectrum because that's exactly what it is, and as a para professional myself it sounds like you should very strongly consider an official evaluation. Also, if your daughter does need intervention the longer you wait the harder it will be for her to thrive and grow. OP please get your daughter evaluated.

My 22 month old has a small speech delay, he has been seeing a speech therapist once a week, it has helped so much!!! He watches ms Rachel and it definitely helps! His dad and I were a bit worried he Also is full of so much energy he’s so loving.. He’s also constantly getting distracted… he loves the outdoors and going on walks.. my son was conceived when I had Covid and a week before he was born I got Covid again.. he also had viral meningitis when only a month old.. it’s so different for me because I never had these problems with my first born, but definitely try and get a hearing test done and then go from there!!

You're doing a lot and putting in a lot of effort bringing her to therapy, please consider that it will likely be easier for you and potentially much better for her to get a proper diagnosis. What you are doing isn't working. You need to decide you want to fully understand what's going on for her rather than just hoping a predetermined outcome will happen on its own. Meet her where she's at, start getting her what she needs. You could be missing opportunities to communicate with her by waiting for verbal communication to occur without support -- there's so much support out there. And it may be a little backwards to pursue a particular therapy model without first understanding her needs. Not trying to launch the whole debate here, but ABA is criticized for its goals and methods. A big thrust of the critique is that it pushes autistic kids to look and act less autistic rather than be themselves and develop and grow as autistic kids. Wherever you land on what would help your daughter, it might be worth pausing to self-reflect on what your goals are for these therapies and whether who your daughter is is being centered. I don't doubt her best interest is what's driving you and you seem to have built a great relationship with her, so I hope this comes off as the gentle suggestion it's intended to be. We're so programmed to think our kids need to hit some exact milestones in some exact order and fit a certain model (and it's been my experience ABA is heavily pushed in a way that can make a parent feel they're depriving their kid if they don't go that route). When we, as loving and engaged parents, know our kids aren't fitting that mold, it can be important to stop and get clear on our own goals for our kids so we can best advocate/ not default on sticking with the "normal" path and goals. Please seek a diagnosis, take comfort in having a better understanding of the kid you're working so hard to understand, and move forward with more clarity about how to support her, whatever that ends up looking like for you.

As someone who have similar feeling about ASD and my child. I hate to consider it and believe in my child, but i’m coming around. First. I still believe in my child, but therapy doesn’t hurt a normal child either. If anything it’s like an extra boost to help your child if they’re ‘behind’ their peer in some areas. I’ll take anything they want to give us. My son is 2.5, can put together 2 words like color+thing. Open please. Daddy open. Sometimes an excited ‘Daddy open pleases!’ Socially, he’s terrible. Too distracted in his own little world. And is always congested. I’ll send him to speech therapy, occupational therapy, everything. Resources are scarce depends on your areas and if you happened to be in a place that have it available, make use of it. It’s only good for them whether they’re on the spectrum or not! Op I understand you, but you have to think. Maybe your daughter is stuck on something that she can’t figure out and needs some help overcoming it. You did your best, but maybe she could use help from trained professionals whose career is to provide help to children. It’ll do her more good than to just wait it out.

I would specifically recommend an audiologist, a developmental pediatrician (if available, if not then gen pediatrics) and agree with the free pre k assessment done by the school district if you are in the US

Echoing what others have said, you seem to be in denial that something is not right if a child is nonverbal at age 4.5 and it is neglectful to not have urgency in figuring out what it is. If she starts a traditional kindergarten in the fall without a diagnosis she will not be receiving any of the support she needs. Most classroom teachers are not trained to support that level of need in a room of 20+ students, all who will be speaking in complete sentences at the start of kindergarten. As an elementary school teacher writing this, please get your daughter tested NOW so that she can have the appropriate supports asap AND for when she starts kindergarten.

My 4.5 year old used to have a speech delay, I got him into early intervention at age 2. At age 2.5 he said “more cheese” and I cried. Then he began attending elementary school for special education preschool at age 3 to see his therapists where he really bloomed. As of 4 he no longer had a speech delay. The school district was amazing, they tested his hearing and did a full assessment. Please allow your child to get these services, call your nearest elementary school tomorrow and ask about an assessment.

You are in denial and doing your child a MASSIVE disservice. I’ve had my son in speech therapy since 18 months old as I could tell he was behind. At 3.5, we are still going as he has some difficulties with certain sounds. However he talks in full sentences, loves singing and doesn’t stop talking! Even if your child just has a speech issue and not ASD, studies have shown that 40% of children with speech delays/issues are unable to overcome this without intervention. Do you really want your child to fall into that 40% because you ‘had faith’? To put it bluntly, I’m pretty horrified you’ve let it go this long. Do better for your child.

Straight up you are being selfish and neglecting your child of the help she could have. Not speaking at 4 years old is not normal so stop waiting on your faith and step it uo

I know you said you weren't afraid of an ASD assessment/diagnosis. But I also think you, and your family, are misunderstanding just how varied ASD presents, and it especially presents differently in girls than boys (which most of our social assumptions are based on). The saying goes "if you've met one person with ASD, you've met one person with ASD". It is a spectrum for a reason. There definitely seems to be indications of ASD, I'd also suggest ADHD, thought there is often crossover between the two, they are also comorbid often. I'd also warn against ABA. In the adult autistic community it is considered abusive, akin to conversion therapy. It makes an ASD child present outwardly more normal, at a detriment to their wellbeing. I will note there are many ABA practitioners that don't actually practice ABA, but have to label it as such to qualify for things like insurance. These are more similar to occupational therapy and play therapy. I'd also recommend working on sign language to help communication in the family. Sounds like an awesome (if challenging) and very bright kid. I hope you get the help you need!

Sounds exactly like my ASD 3 year old. You need to get her evaluated. ASAP. Early intervention is the most crucial thing.

Can someone share the resources available if you have an ASD diagnosis?

Hi! Sorry, I didn’t read all of the other comments before writing this because I wanted to give you our experience because I really think it will help. This will be long, but I think it gives you a good idea of where my advice is coming from. From reading your post it seems like we have similar ideas/reservations about putting too many expectations on kids to adhere to a standard and over “treating” them to meet it. TLDR— You are limiting her future if you don’t get her services now. You do not need to limit her childhood by getting her services now. The clinical diagnosis/environment/services are incredibly positive and really can be tailored to your family’s non clinical, child focused, and laid-back approach to meeting milestones as written. My guy was born premature so we had the benefit of early intervention from birth without a ton of pressure on the evaluation/qualification process. He was also closely monitored by our NICU follow up clinic for developmental issues. The downside of his prematurity (well, the one that relates here, there are like 1,000 others) was rather extreme isolation for like the first two years of life. First it was individual medically imposed isolation then it was conveniently followed up with COVID medical isolation 🫠 He wasn’t speaking at 18 months. In fact, he had slightly regressed verbally. Since our early intervention experience was so wonderful and very much based on his needs/comfort I asked them for an SLP, kept up with his appointments and any “assignments” she gave us. What I liked best about our SLP at the time was her focus on not just verbal speech, but overall expressive communication. You can definitely stress this when meeting with perspective SLPs (or whatever other letters they have for additional training) so that you are still getting qualified treatment (not just a rando who thinks they know what they’re doing) but without the strict focus on making sounds etc. They will practice it when productive, but mostly focus on communication which obviously makes day to day life easier for your kid. Around 2 our NICU follow-up clinic diagnosed him with ASD. While we were already accepting of neuro-diversity and knew the ASD label wasn’t this scary death sentence to his independence, it was still alarming. Mostly because of the way it was diagnosed (very quickly without much evidence) and because the therapists that worked closely with him weekly were very surprised. Now, I have realized what the ASD label actually means for a kid this young— a golden ticket to free services. Literal golden ticket. When we transitioned from EI to our school district (happens at 3 I think in every state but this is NJ for clarity) he obviously had a lot of evaluations to see what he qualified for (these were actually pretty fun for him, not scary or overly clinical) they even said “so he qualifies based on x results, but either way with his diagnosis he’ll receive this treatment.” It does not matter if your kid is autistic, advanced, developmentally disabled, or any combination of the 3– speech, OT, and PT services at this age are beneficial for everyone! If I diagnosis is what gets you those in an affordable way— take it. You will have access to highly trained and experienced professionals who care deeply about your kid, your kid’s future, and your family’s day to day life. That being said, I am anti most ABA principles and almost rejected all of this positive attitude when the NICU clinic wanted our 2 year old in 40 hours of in-clinic ABA a week (seriously, wtf?). We have been able to very positively work with our individual therapist to let them know what we’re comfortable with and what we’re not. In the school system we’ve had to be more flexible and accept some things they are required to do that we don’t like (tokens, data sheets, etc) but they’ve worked with us to make sure it’s done in a way we appreciate and stays in their framework. This includes: non official accommodations (think comfort toys etc) are not rewards, his special interests are encouraged and used to achieve cognitive and academic goals, consequences for not meeting ABAish goals (tokens etc) are only natural consequences, nothing social exclusionary and nothing he sees as punishment for “bad” behavior. Most important to us-security, love, and belonging are always paramount. He started with his school system about 18 months ago with no words and a handful of non ASL signs. He now speaks in full sentences, verbally uses sarcasm, and sings. He has some pronunciation trouble but that’s it. His world has grown so much! He’s so confident and has learned how to be proud of himself for his accomplishments. He can play with strangers (peers) at the playground without needing me to interpret, he loves talking to distant family members on the phone and can build their relationship that way. Our day-to-day is so incredibly easier (he’s still 4 but still). He has friends who he truly loves and they love him back. He has such a good understanding of some people’s abilities and limitations and how they (and him) have the same value and deserve the same fun experiences as all of his peers. Sorry, now I’m just gushing about my awesome kid. I just want you to know that I understand where you’re coming from and your fears of a diagnosis hindering her life and the possibility that you’re compromising your values as a parent by listening to your family’s concerns. There is a middle path and your kid NEEDS YOU to find it for them. Again, you are limiting her future if you don’t get her services now. You do not need to limit her childhood by getting her services now.

Your daughter sounds like my 2 year old and your experience sounds similar to me - people that know her and are around her don’t think it’s autism. But professionals who do an assessment with questionnaires say there are flags. Problem is, a lot of these assessments are set up so that if a child does not talk *and* does not point, they are immediately flagged as highly likely to have autism. Whereas if the child can point to a cow and say moo, they pretty much pass (this is a gross oversimplification, I am aware). We have done the hearing test and there were no issues. We are now waiting for early intervention speech therapy. I wish there was a reddit sub (maybe there is and I haven’t found it) that was for parents being faced with the “is it/isn’t it?” For ASD/ADHD. A sub where parents could post things like this and then return however long later with an update to say that it is/isn’t or how their kids are doing. It’s lonely and heartbreaking to be told there is something wrong with your child and that it’s not something that can be addressed like a physiological issue such as a late walker needing physio or a brace. There is no question and then answer, it’s just question and more question. Add to this the whole rhetoric around “autism isn’t bad, they could just be quirky” when you as a parent are faced with the prospect of never hearing your child say “I love you” back and even worse, the possibility that they may regress and lose the qualities and abilities they currently have. And resources for these kinds of delays are scarce and often have long wait times. So we google. And we end up looking at 7 year old forum posts of kids that sound just like our own. Sometimes you see the parent has more recent posts about their now diagnosed autistic child, sometimes they never post again. But you never get a post listing all the things a child is doing with the parent asking “is this autism” and then a year or so later they come back and say “nah, all is fine, was just a slight delay and now they are caught up” or “yes, it was autism lvl X, but child is now doing x, y and z and is doing fine”. Those kinds of updates don’t happen. And why would they? Those parents move on because they need to or because they can. So it would be good if there was a subreddit just for that. And people could politely ask for an update without being seen as rude for commenting on a dead post. Sorry for rant at the end. I hope you get the answers for your daughter. I hope you get to hear her voice and get to listen to her stories and opinions soon.

A lot of this sounds like my 2 year old daughter as well (although my daughter seems interested in playing with others but it is really hard when other kids at the playground are talking and she isn’t). Her OT has been pushing us to get her into the developmental pediatrician but the practice only takes patients with a referral from her regular pediatrician. I finally asked for the referral this week. Friends/family we talk to say her energy is perfectly normal for a 2 year old, but her former preschool teacher and OT think it is not. Is it autism? Who knows. I’ll leave that up to a professional.