When It’s Not Your Child

Dear Amy,

My nephew, a darling little boy of four-and-a-half, isn’t quite developing on track. He’s still in diapers, which, by itself, wouldn’t terrify me, except for the fact that he can’t communicate much at all. He’s growing up in a bilingual household, so I’ve been told that we’re to expect some delay in his speech skills. But four years old seems to me long enough to at least learn to string together a few words on his own. The few phrases he repeats are copied from his mom and dad; the rest of his animated babble makes no sense at all, in either of his parents’ languages.

He’s willful and stubborn and won’t be told what to do because he often doesn’t seem to notice you exist, let alone pay attention to your call or command. Reading a book with him is a joke. He doesn’t care for the story, just concentrates on leafing through the pages, back and forth, looking at the pictures.

Is he merely willful and stubborn? Does he just not like to be told what to do, and so ignores many comments directed toward him? His parents took him to a child psychologist when he was three, but they were told then that he was just fine and that he would start speaking late because of language confusion or some such. Well, it’s late now, and I’m worried. Isn’t it true that in cases of actual communication disorders, the longer the wait to therapy, the harder it will always be to communicate?

~ Thinking Worried Thoughts…

Confession: the question queue is littered with more than small handful of questions similar to yours — of the “I suspect a delay in a child who is not mine, do I say something?” variety. And I haven’t really tackled them because I don’t know what the right answer is.

No one needed to tell me that my child was falling behind developmentally. I knew. My husband knew. And we were very fortunate that the first “experts” we turned to agreed, instead of telling us to “wait and see” and “boys just talk late” and “it’s just his personality.” If that had happened…even waiting six months or a year…yeah, we would have lost vital time and crucial therapy windows to identify Noah’s primary issues and close the gap as best we could.

But even though I KNEW, concerns or unsolicited advice from people? Weren’t exactly welcome. My mother-in-law randomly sent books about child development that had NOTHING to do with what we were facing, and I greeted them with little more than an eyeroll. My blog comments were either a fount of awesome knowledge and ideas…or something I couldn’t even read some days because WAIT NO YOU DON’T ACTUALLY KNOW HIM LIKE I DO STOP TALKING. Noah’s first preschool teacher told me she thought he had Pervasive Developmental Disorder (PDD-NOS) and/or Attention Deficit Disorder. Those are (OH THE  IRONY) precisely the diagnoses we’re currently facing, but damn, at the time we were just trying to sort through a speech delay, and she still had no right or place to say that to me, who the hell did she think she was, grumble bitter grrrraaaawwwrrrr. It just made me angry and defensive…and didn’t exactly make me rush home to pick up the phone and schedule a new evaluation that afternoon.

So if I, a parent who KNEW that my child likely needed intervention of some kind, still had a gut reaction like that to a well-meaning (if unqualified) concerns, I hesitate to tell a stranger over the Internet to “go ahead! speak up! say something! it’s in the best interest of the child!”  Because I feel like the odds of the parent who refuses to acknowledge any problem at all being any more receptive and non-offended are pretty low. I have definitely bit my tongue on multiple occasions with other parents — ones who are clearly ignoring something, or going gung-ho about a treatment option that’s been proven questionable or sketchy. ONE TIME, I actually sort-of half mentioned the idea of getting a second opinion when an acquaintance’s son “passed” a cursory evaluation by Early Intervention despite showing signs of an Autism Spectrum Disorder. Eventually, they got one. A year later. When they decided to get one.

However, you’re family. And it sounds like your nephew’s parents were at least at one time aware enough that something was up to take him to a child psychologist, so perhaps raising your continued concerns (“sooooo, you guys planning to take him to see something different this time? what’s the plan for kindergarten?”) wouldn’t be completely out of left field.

That said, I kind of want to smack that child psychologist. Because while it’s true, children in bilingual households do tend to talk later…four-and-a-half is LATE. LATE-LATE. And you know what? Noah’s been in Early Intervention programs since his second birthday, and every single one (every! single! one!) was also attended and utilized by similar-aged “late talkers” from bilingual households. Just because it’s a general sort-of “expected” thing doesn’t mean those kids won’t benefit from some extra help, or should be ignored completely until they eventually catch up on their own.

And I’m curious as to how long the child psychologist advised his parents to wait it out. Because in local math, in six-ish months,  your nephew will be considered old enough for kindergarten, depending on when his birthday is. I don’t know where he lives — if he’s even in the States at all — but…is he in preschool? Daycare? Haven’t concerns been raised there, at some point? What does his pediatrician say? Has he had his hearing checked? Have they tried sign language? Can his parents call the school district for an evaluation? See a developmental pede? Take him for a full receptive/expressive language evaluation somewhere that sees regularly sees bilingual families? Take him…well, ANYWHERE other than that child psych who put them on a “wait-and-see” track without any backup plan for a follow-up in six months or a year, much less a full year and half?

While I’m sure there ARE four-and-a-half year olds out there who still wear diapers and have no patience for books because they’re just that stubborn, and there ARE bilingual kids who catch up verbally overnight with no other underlying issues, your question is literally exploding with red flags when you take them all together. I can’t even imagine how frustrating it must be to be four-and-a-half years old and still be unable to communicate effectively. I’d probably get pretty damn stubborn and willful too. Yes, he really should be talking more than a few echolalic phrases and baby talk. He should be paying attention to what other people say and have more advanced social and play skills. Yes, every kid is different and unique and march to their own drummer and some just sort of develop in explosions and spurts and catch up mysteriously on their own, but…plenty don’t.

As a not-exactly-super-relevant point of reference: Noah is just one year older than your nephew. I’m guessing you read my blog and know where he currently stands developmentally, which is no where near the level of delay your nephew seems to be stuck at. And yet there’s still so much room for improvement and need for accommodation, enough to qualify him for special education and continued private therapy. Not necessarily for a communication disorder or language delay anymore, but…likely because once we already tackled that one, and moved on to the next layer, like a developmental onion.

All this to say: I think your worry is completely justified. I wish I had advice on how to bring it up with his parents, how to phrase it so they’d be both motivated to action AND not defensive or angry at you for trying to “diagnose” their child, or just something else you could DO, but I don’t. It’s hard when it’s your own kid. It’s hard when it’s NOT your own kid, and not your choice or call. Good luck, and know that we’re all rooting for your nephew.

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