At 18 months old, Noah only had 5 words and I started to become concerned. However, I quickly brushed it off as many children take a little more time to develop language. When adults spoke to Noah or asked questions and he did not respond, I found myself quickly explaining that he was still learning to talk. At 20 months, he still only had 10-15 words and so we had him evaluated by San Diego Regional Center. When the evaluators came to our house, Noah was thrilled. He quickly warmed up to them, showing the ladies all of his books and toys. As a standard question, they asked if we had concerns with Autism and I said no, citing numerous examples of his social nature. The evaluators also commented that he made good eye contact, engaged in play with them and was proud of his accomplishments. He did demonstrate delays with both his receptive and expressive language and qualified for an IFSP for speech and infant education. Noah was just beginning his services in March 2020 when COVID hit. We attempted speech therapy through Zoom which was a disaster. Noah did not understand he was supposed to interact with the person on the screen and just walked away from the computer. Ultimately, we decided not to continue with speech therapy via Zoom. Having 20 years of experience with kids with disabilities, I thought I could handle his needs on my own. Scotty and I did weekly trainings online to help Noah with his communication and implemented these strategies at home. Despite all of our best efforts, Noah was making very limited progress with speech. At 2 ½ years old, growing increasingly concerned about his communication, we decided it was worth the risk for Noah to start seeing a speech therapist in person. This speech therapist had come highly recommended by two friends and was implementing a ton of safety measures. I hoped that she would meet Noah, reassure me that he was going to be ok and we would start to see more progress. During our first session with the speech therapist, she expressed significant concerns with his communication and play skills. As one example, while playing with toy animals, he named the animals, made a few animal sounds and then mouthed the toys. As the evaluation went on, it became clear she was suggesting that he might possibly have Autism. Of course, the “A” word was never used but as a psychologist, I knew exactly what she was saying. I cried the entire car ride home as it was such a huge step for me to bring him to see a professional in the middle of a pandemic and the feedback I received was so negative and hard to hear.
It’s true that his play skills with toys were lacking. Noah has always preferred more physical play and social routine games (chase, ready-set-go, ball play, tickles, etc..). He almost always chooses constructive play with puzzles and blocks rather than pretend play. I had noticed that his pretend play wasn’t developing beyond very simple pretend play. For example, Noah would pretend to sweep and mop with his pretend cleaning set but wasn’t able to combine activities to create more complex household routines. He also would pretend to feed the baby doll with a bottle but wasn’t able to combine actions for a play scenario such as putting the baby to sleep. He also still mouthed his toys all the time, a behavior that by 2 ½ should mostly be going away. I also had this gut feeling that something was off and felt like Noah was regressing in some areas. Noah seemed in a “funk” which I initially attributed to being stuck at home during the pandemic and adjusting to a new baby sister. He wasn’t as responsive when I called his name as he used to be and was having a harder time following basic directions (e.g. “Go get me the Brown Bear Book”). It wasn’t just the words he lacked but I also questioned how much of what I was saying he actually understood.
Even though I didn’t see Autism yet, I knew that if another professional thought there was something off about Noah’s development, then I should take it seriously. Even though I didn’t like what the speech therapist said, I sprang into action. I called Noah’s regional center coordinator that same day and asked for ABA and I’m so thankful she listened and started services for him right away. I also got on the waitlist at the UCSD, Autism Center for Excellence to have Noah evaluated for Autism.
The Noah Connection 