Which kind of assessment speech or for autism?


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My daughter is 2 years old and knows barely 20 single words. I went to see Dr. Trodd who apparently specializes in autistic kids. He told me that he does not assess but only treats autistic kids. However, he told me that he doesn't think that my daughter has autism and that it seems to be just speech delay. Upon his request, I took blood test which turned out all negative. He then recommended a child behavior assessment doctor at Sanatorium Hospital...Iris Lau. So my question is, do I see a doctor who assesses autism or should i see a speech therapist? Any recommendations? My gut feeling says she just has speech delay...but I'd just like to put my heart at ease.
hi nanzbier- i was in the same situation as you 2 years ago. my son then just turned 2 and he was barely speaking. so we went to a pedia to ask. we were told that he has mild autism. simply because his speech is late. my gut feel as a mother told me it was just speech delay versus autism. pedia recommended us to an autism therapist. i did extensive research regarding autism and speech delays and assessments relating to both. we took our son to a speech therapist over at adventist as well as a child psychologist. both gave him passing marks and said he was far from being autistic. he has speech delays because of the following reasons:

1) boys are generally late in speech
2) single child syndrome - no older brother/sister to "keep up with"
3) our apartment complex does not have a lot of kids his age so social interaction is very limited
4) being a first/only child - nanny and us parents were spoiling him --- giving before he even has a chance to ask (hence, no motivation to speak and express himself)

we were told to do the following:
1) encourage speech more in the house . do not give unless he asks.
2) engage him more in conversations - we bought visual dvds with objects and words that just keep repeating (vobulary builder)
3) we enrolled him in a nursery class where he spent a lot of time with kids his age

within 6 months, we saw marked development in him and we only had to do 1 follow-up check and both therapist and psychologist cleared him for any other delays.

he is now 4 years old and will go to K2 class in August. He also talks non-stop now.

Let me know if you need the name of the therapist and psychologist we went to.

most importantly, trust your instincts as a mother. i did despite what the pedia told me and im glad i trusted myself and my son.
hello mickey mom....thank you so much for your reply. i tried to make an appointment with Dr. Lau at Sanatorium but she is booked up until October! I would definitely appreciate your contact information!My daughter goes to gymboree twice a week and she has playgroups just about everyday. We take her swimming and to the indoor playground quite often, but she doesn't seem to like to play with kids her age. She likes older kids. She also is an only child and spoiled by me and the nanny. =) I will start not giving her things unless she asks for it. But how did you do that exactly? She will just try to grab for it. I just simply say, "Do you want.....or is ....what you want?" What DVD's do you recommend?
Thank you again for your time to repsond!!! I really appreciate it!
My first born had no real words, besides Mummy and Daddy before he was two. He lagged way behind in his speech until around 3. Now you can't stop him! His younger brother is turning two this week and he says even less, despite having an older brother. I did not see any specailists for either of them. They are just late talkers. They both also prefer the company of older kids and seem to be quite intelligent. Go and see someone to put your mind at rest.
Even our so who turned 8 month slast week said his first words last week. He is also only child , with no children his age in building complex. He doesnt like children his age we have tried taking him to the park but he doesnt have any reaction to kids age, he prefers older kids like 3-4 years old. We do talk to hima lot and always encourage him , but he seems to play with us as he knows that we want him to speak but he doesnt. We were freaked out also but mY MIL put us at ease said that boys take mor etime than girls and also as long as all his other milestones are ok then u dont have to worry
Hi Nanzbier,
We saw the following people:

1) Rainy Chan - Speech Therapist. Rehabilitation Centre, Hong Kong Adventist Hospital 2574-6211 or directly at 9654-8231

2) Dr. Tommy Chan - Child Psychologist. Dr. Susan Jamieson and Associates 16th Floor Hing Wai Bldg, Queen's Road Central 2526-5929

Normal for kids her age to want to play with older kids. Mine used to play a lot with the son of my good friend who is 4 years older than him. Also, was told that toddlers at this age will most likely play "along side" each other rather than play "with each other". I think they only start playing together beginning at age 4 or even 5.

As for the DVDs, we got the Baby Einstein series (HMV and Page One would have them). I also got VCDs of Baby Bumblebee. I think the shop in this site sells them. Otherwise, Dymocks or Bumps to Babes may have them.

Hope this is being helpful. Hang in there. Have faith in yourself as a mother and your child. I'm sure she's beautiful and bright. Read and research so you know your options and the questions to ask the doctors. I came prepared to the doctor consultations and it helped a lot.
thanks to all your responses. my daughter has always been late hitting her milestones. crawling at 11 months walking at 17 months....and now its talking. so in a way..i guess i shouldn't really worry until 6 months from now. =) i will definitely try the dvds. also, does dr. chan do childhood assesment evaluations? or should i go to a clinic like matilda or some other place that can assess?

thanks again for all your responses!
This chain has been really interesting for me to read as my paediatrician recently suggested we consider a speech therapist for our 25 month old if her speech doesn't improve.

She probably says about 50 words, some of which are not particularly clear and are shortenings of words ('wawa' for shower, for example). She doesn't use sentences and rarely has two intelligible words together. But she has always had a way of communicating her needs to you so isn't frustrated by lack of speech. And she understands you perfectly when you ask her to do something.

I am reluctant to take her to a speech therapist as she chatters away all the time in her own language, throwing in the odd word for good measure. And she can actually count to 10 in English and Mandarin, knows various parts of her body (some in Mandarin as well as English) and can tell you various animals and the sounds they make.

I will trust my instinct as a mother that she is just a late talker and will soon be chattering away to us in a way we can understand. However, the contacts mentioned above will be a good reference if we do need to find a speech therapist.
The book Out of Sync may help you assess if your child has global development delay or autistism (which I hate labelling kids) or just speech delay. I will suggest caution if the child hits all/most milestones late. It is always easier to intercept at an early age than later.

Creeping and crawling and vestibular exercises are good in developing the brain, to help cross the mid-line and develop the cerebellum which governs learning.


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thanks cemily! i'll look into that book.
does it sound right to get an assessment for $2000 USD? thats how much someone is charging in america.
Yes, USD2000 sounds right. That'sthe charge for something similar back in 2005.


Hi Mickey Mom,

How long was your child in therapy for? How frequent was it? I'm in China and would have to go in to HK for therapy.

hi nanzbier,
my son did not need to go to therapy sessions. he was cleared by both specialists and was not required to do so. we were just advised to put him in an environment with more children (hence, the pre-school), and observe for 6 months. fortunately for us, he showed marked improvement in that 6 months time frame and did not have to follow through with anything because now he talks like there's no tomorrow
autism/speech delay assessment

My kid has been assessed by the govt center for autism but I would like to get a second opinion. Any advice on Doctors? What has been your experience with Dr. Tommy Chan? I've read the book "Einstein Syndrome, Late-taking Children" by Thomas Sowell, which is very informative about late talking kids, and the problem of misdiagnosis. I've seen Dr Trodd already, but I would like views on experiences with other doctors. Much appreciated.
Dear TSKN,

Of course you are aware that late talker is NOT equivalent to autism. Late talking is fine. Encouragement + other speech therapy early interception will yield results, eventually. Autism calls for totally different measures. Nutrition and neurological development are absolutely necessary. Speech therapy will not be much help until much later.

www.familyhopecenter.org and www.handle.org are helpful.


my daughter doesn't talk much too - she is 2 end of mth - and i never think there is anything wrong with her except she is a late talker. Sometimes i think as parents, we become so paranoid and so imaginative! Do we realise the norm is more that 2 year olds don;'t talk than they do? In my daughter's playgroup classes, I observed every child closely and realise 9 out of 10 either babble or say 1-2 words. The one exception was a little girl who not just talks but utter 10-word sentences politely and succintly - I told her mother she ahs a genius in her hands. haha.

Another thing I find abt HK doctors in my 4 years here is they are GREAT in scaring people. Once a doctor said my friend's boy has acute bronchitis (and he wasn't even bothered by his minor cough!) and another said her child has a rare bacteria infection bla bla bla. Then the blood tests come in, the speech therapists come in, the expert this expert that - all costing thousands of dollars. I fell into that trap before but never again! My daughter has prearicular pits (ear holes) and doctors ran a million tests to conclude: she can hear afterall. Then she has umbilical hernia - poking here and there, many discussions of surgeries. Then they said she had premature breasts - so she has this syndrome that syndrome. I became smart and fed up frankly about the trend of HK doctors so we went back to Australia for a special medical trip and the conclusion: all is well, her breast tissue is normal cos of hormones she got from me (and in fact has diminished now 6 months later); she can hear perfectly, not just sounds but even subtle language tones/clicks (the PD who saw her has the exact same prearciular pits too!!! and he is smart right?) ; and her hernia? the hole has closed completely by that time. I have spent more than 20,000 in HK just to hear bullshit!

In my simple mind, surely autism cannot be diagnosed based on one parameter of speech capability? There must be other symptoms such as shying from eye contact, anti-social behaviour, actions that go beyond normal naughtiness? I heard from some current affaris programs before that autisim is a very very complex syndrome and hard to diagnose until they are 4-5 years old.

Just my two cents....
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I completely agree with mummybee.

In fact, when I was researching about Autism before, speech delay is just one of the parameters and is not the most obvious one. Also, there are several types and degrees of Autism too. From that extensive research I did, I even came across the very comprehensive tests clinical psychologists administer to give a conclusive YES or NO. Therefore, when I took my son for consultation, I was able to handle the questions and interact with the experts without being paranoid/scared. Key really is to educate yourself as I found out that doctors in HK do not like to offer information more than what is asked of them. And this can lead to doubts on your part which eventually evolve into paranoia and even panic attacks.
Thank you guys so much for all your comments. I completely agree about the paranoia! I've been there! The meeting with Karen at SLC was great. She thinks its language delay and not autism...although she said that it is difficult to assess this early.