Developmental Delays in 3-Year-Olds?

This is hill worth dying on, in my opinion, for the sake of this child. His behavior is bad because of his frustration at not being able to communicate. He desperately needs speech and language therapy.

Beg them to get him evaluated.

See if you can look for opportunities to talk to them about this. You say “understandably” sensitive, and there some parents are afraid of anything being “wrong” with their child, but some parents are quick to seek help if anything seems even slightly off what is considered “normal.”

When these parents tell you that the pediatrician has recommended a specialist, try to normalize it for them. See if you can see what their worry is. It can be scary going to a specialist or school district to seek an assessment, but maybe you could normalize it for them by sharing a story of a friend who found the process really helpful. School districts will give a free assessment, and you could offer to go with them if they feel uncomfortable.

At what age are they considering sending him to school? If preschool seems possible once they get settled, you could be supportive of that, and let the school address his needs for help.

This child does sound like he has some delays, especially in the area of communication. There can be many reasons for this, including poor hearing, autism, various speech disorders, etc. The sooner he gets help, the better, as the window for developing speech is not open forever.

I work in early childhood education and what they have now discovered is that the sooner you intervene, even as early as infancy, the less intervention will be needed overall so it is so important to get evaluated as soon as possible. Maybe find a gentle way for your husband to bring up the topic with his sibling. But in the end he is their child.

it's a pity they don't want to get him evaluated (or do much of anything else competent and useful it seems) although i think it's great that they're super loving and accepting of him.

but ultimately this is not yours to fix. unless they've directly asked for your input, zip it.

they'll just think you're being mean about them drastically overstaying their welcome. don't give them any excuses to make you the villain.

khairete
S.

"I haven’t mentioned anything to his parents because they are (understandably) very sensitive about this subject." This is the problem - they are sensitive about it? Why is that "understandable"? Are we sensitive when a child appears to have a broken bone or a least the question of one? Strep? Why is there a huge difference when it's behavioral or a neuro delay? That frustrates me no end - it's as if certain infections or disease are "acceptable" and others indicate a parental failing or a genetic flaw.

I don't think you have much sway over them, except to say that "in our state...." and put in something you know to be true about your town - like "Toddlers are evaluated for free by the school system so they can get extra help and not be behind when it's time for school." You can also document what you see and send that info to the pediatrician, who will not discuss it with you or respond, but also will not inform the parents. Then, at the next check-up, the doctor can use your info to guide questions and recommendations. Is it possible for the doctor to request evaluation and then have the school system contact the parents directly with their own experience in dealing with other reticent parents?

I wouldn't worry about bedtimes, food, and routines so much, but I do think you can implement some boundaries with them - "Hey, we're all living under one room and we need to find ways to accommodate to the others. We're willing to share space, the kitchen, the laundry and so on, but what's your suggestion of how to handle late night screaming fits that keep us up on before a work/school day, or my kids being hit and bitten?" If they are loving and patient with him, you may not have much to critique, and perhaps you should not. Not your kid, and they aren't going to take it well since they aren't even listening to the doctor.

Then I'd do everything I can to help them look for their own place. You can also help them find a pediatrician they trust, since this one isn't it.

I'm sorry your family is in this situation. I know from your latest post, these arrangements are becoming burdensome for your family.

I have a couple of thoughts - First, your loyalty/protection has to be for your family first. Period. If your nephew is biting/hitting your children, it is completely fine for you to address it. I would NOT allow my kids to be held captive by a child who is misbehaving - whether or not this child is on the spectrum or not.

Unfortunately, you really can't offer much at this point. You could ask her if she wanted the name of some pediatricians in the area for continuity of care. I would think that would be one of the first things she would want established in her new location. Secondly, when the child isn't misbehaving, you might could mention that you're concerned how her son will do in pre-k, daycare or whatever and wondered if she thought it might be a good idea to have him evaluated from a place of concern over future successes.

I have a friend and all 4 of her kids are on the spectrum. My kids suffered at get togethers because of hitting/biting/pulling hair/throwing toys, etc. I finally decided I wanted to remain friends with her, but my children did not deserve to be the receivers of their aggression. I listened to my friend at her wits end many, many times. Each time I would try to compliment her on at least one positive I could see. I would then ask her if she had thought about getting them evaluated. I would reiterate that trying to parent kids when there might be more mitigating circumstances is like trying to treat a kid who has diabetes the same as one who doesn't - just didn't make sense. After MANY years she finally decided she was ready (when 2 kids hit puberty and it really came to a head). I think it's sad, because the kids could've received help much earlier if she would've had them evaluated. I don't understand it, and I know I haven't walked the path, so I don't know why some parents are so reluctant. I'm sure they have good reason, it's just hard to understand when you're not walking in their shoes.

One thing I might try if this family continues to stay in your home is teaching him a few sign language signs. I was able to teach my daughter signing (with a book/video from the library called Signing Time) and it helped us tremendously to bridge the timeframe of babbling/screeching to being able to understand each other. I probably taught her 25 signs or so and used this skill daily. It helped us so much and didn't impeded at all in her learning to speak. Also came in very handy when I needed to remind her to stop a behavior while out in public. She loved that I could talk to her without talking to her when she was with her friends. Her friends thought it was cool that we communicated in sign.

Main thing is protect your family (kids especially) from him as much as you can. We want to teach our kids empathy, but not at the price of them being bitten or mistreated. If that happened in my home, I would let their parent handle it the first time and then I would step in after that if it didn't stop. If they don't like it, maybe that will be the incentive they need to find a place of their own. Two birds down with one stone :)

Take care - you're a very kind and generous person.

It sounds like you noticed being a mom yourself.. if he has delays, his parents need to realize things.. the earlier they get help the better it is.

See if you can mention something to your sister in law.. offer to set up an appointment. NJ have really good early intervention that come to the house and are very professional. Plus sell it to her- it’s free..

I do think mostly boys especially 1st children speak later, and it takes a while to develop sentences-but I trust you to notice there is something a bit off having 2 kids yourself. And if their child did not pick up how to behave from your kids.. he needs help.

Try suggesting in a polite way that you can call and set up, or that you can be home / or not home when evaluations are going on ( just in case). Not much more you can do.

You need to find a way to talk to them about following the pediatricians recommendations to get an evaluation. The sooner the better. What you describe needs evaluation by a professional. and a professional has already recommended specialized testing. Use this to help you get them to understand that it's not just your opinion.

G. - you need to say something. This is something that is going to affect his whole life and how he will "turn out"!!

If you noticed he was sick or hurt himself, wouldn't you say something? This, to me, is like that. I would say something about it. Or leave a book out on what 3 year olds SHOULD be doing, saying, etc.

They are living with you. You are seeing the full picture. Say something. Not like "hey when Jane was 3, she was doing x, y and z" but point out things that feel off to you.

It's hard to say. My son was speaking in full sentences at age 3 but his best friend he liked playing with at preschool hardly spoke much yet. He grunted and used some made up words...he spoke kind of like a little caveman. It was a little startling how different the two boys were. By the time they both started school his friend spoke just fine. But on the other hand this could be a problem and I believe in getting your child evaluated if that is recommended by the pediatrician. But what can you do if the parents do not schedule an evaluation? Not much. I have a friend whose son seems off...I'm pretty sure he suffers from anxiety and perhaps mild autism. She would get very very offended if a family member ever said anything to her and would complain to me. She was very patient and sweet with him but let him call the shots too much (otherwise he had a meltdown) so basically he got to do whatever he wanted. It was hard to watch...then she moved away. Last I heard from her, her son was refusing to go to school and she would plead and cajole but in the end give in every single day. The principal even came to their house to show her son he was nice. I always wonder what happened with them. Also, I strongly believe that a routine is extremely important for kids, but again what can you do? This is not your son. :(

If they're going to be living with you for a few months, instead of another 2 weeks or so, then I think it's important for you to retain some control over your household. Unless your kids are adults, then I assume your kids go to school, have a bedtime, and need their rest. So it's ok to say "since we're going to be living together until after the holidays, I would like to talk about some more reasonable schedules. My kids go to bed at a set time within reason, and it's upsetting them to have their little cousin up so late. We need to have the house quiet after 8 pm."

And if you know that the pediatrician has recommended an evaluation not by seeing a text on their phone but by their sharing that info with you, look into some resources in your town that fit their needs, budget, insurance or lack thereof, and present it to them as you would any info to a new resident. Often helpful neighbors supply new residents with the best restaurants, the numbers to the local utility companies, choices of internet and cable tv, for example. You could compile a list that includes helpful stuff, plus child evaluation choices. If you don't know about the pediatrician's recommendation directly from your relatives, then stay out of it.

Many of his issues can just be due to poor nutrition (perhaps he's not getting enough food from mainly breastfeeding), fatigue due to no sleep schedules, etc. Try to subtly encourage some stability in his schedule. Try to make him a tempting toddler meal from healthy ingredients. Try to engage him in food prep (putting cherry tomatoes on a salad, tearing lettuce leaves, choosing between carrots and green beans for supper, for example).

I hope they all get the help they need.

A lack of routine can make a big difference.
His parents are getting advice from their pediatrician.
They will eventually get advice from any school their child attends.
It would be best for you to stay out of it unless the parents ask for your opinion.

Additional
If they are in denial - they already know and they are not going to take kindly to any discussion you try to bring up with them about this.
Trying to bring it up might drive a wedge between you and them and then what will you do?

Also - there's a chance that the evaluation happens and they say there's nothing wrong with him.
Some kids are late talkers - they take it all in and when they start to talk it's in full sentences.
Tantrums at 3 yrs old is common - there's terrible twos and terrible threes.
Our son skipped the terrible twos but he made up for it during the terrible threes.
The move and lack of routine could really be throwing him off.
Lots of 3 yr olds kind of snack all day rather than eat regular meals - their stomachs are the size of their fists - it doesn't take much to fill them up and they get hungry again at odd times especially during growth spurts.

Of course you need to protect your kids if they are being bit.
Are your kids older?
Often you just have to directly closely supervise 3 yr olds and intervene when they are about to lose it.
They don't play well with others yet - it takes some kids till 5 yrs old before they play cooperatively with other kids.

I don't know how long they will be living with you - that situation is a strain all the way around and gets worse the longer it goes on.
Don't start going on about getting him evaluated but tell his parents that they need to watch him closely so your kids are not hurt.
It will get better for you when they are in their own home.
This isn't your kid to raise.
If they want your opinion they will ask you for it.

I have 3 grandchildren on the spectrum. What you describe could be autism. The youngest granddaughter is now 3. About a year ago, she was much like this. Her parents had all 3 of their children evaluated through the school district. The district provided resources paid for by the Federal government because of "no child left behind" law.

At 2, my 3 year old granddaught could only use single words, no sentences. She's been in speech therapy for a year now and speaks at age level. She still has difficulty speaking clearly, hence is still receiving speech lessons. Parents and siblings understand her nearly all the time.

She started preschool this year because of a new program in which a social worker comes to her home and helps her learn how to follow directions, how to ask for help, how to manage her feelings, how to get along with other children and much more. She is now confident and doesn't have major meltdowns. She is doing well in preschool.

I suggest because her parents are overwhelmed with their move and reasons for it that getting an evaluation feels unmanageable. However, unless they ask for your opinion and help, you cannot get involved. If her parents are concerned, you might offer some information BUT only if they ask for it. Some parents would welcome that. Others would not. I suggest you be cautious.

As B said, she needs routine that possibly includes regular eating, a routine for bedtime, perhaps a nap at same time everyday. Most kids have some behaviour problems without stability. Routine is an important part of feeling secure.

If his parents don't have a routine for themselves, children and parents are more anxious. I suggest your brother and sister-in-law may not be able to consider how to help their son. Being sensitive is a reasonable response.

Two of my nephews (not same family) weren't speaking clearly at 3 (not much at all), and then it came together a year later. A lot can happen in a year.

My child was misdiagnosed as being on the spectrum. He was diagnosed too young. He had fluid in his ears from unknown allergies. That fluid caused him to not hear properly (just enough for sounds to be muffled) but it wasn't detected - and he just found speaking and not being understood frustrating. I could make sense of what he was trying to say, but others could not.

I have a nephew who had the same type of issue (and had his adenoids out in elementary school) who stopped speaking altogether and became quite withdrawn. People couldn't understand him. Behavior sometimes is the result of a medical condition and can be overlooked.

Three is really young. There are other signs to look for, such as eye contact, etc. Tantrums are still really common at age 3, and are not necessarily a sign of developmental delay. If he's not on a regular sleep schedule or nap time, then he may not be well rested. If he is frustrated at not being able to communicate clearly - then there's that too. Biting can also arise when a child can't ask for toys, etc.

As far as keeping clothes on, I babysat kids who stripped. That's not necessarily a sign either.

If it were me and I had a real sense something was off, next time one of these behaviors came up (such as biting) and they make a comment "Say Has your pediatrician suggested anything?" (or daycare provider, etc.). Go from there. Maybe share an experience you've had, and say how helpful the pediatrician was in your case in a supportive way.

The parents are in serious denial. This child has problems. This child is in your home disrupting your life and your children. You have a responsibility and every right to point out potential neglect of health care and behavioral issues that the parents are refusing to believe.

What these parents don’t realize is that they will be asked “why”, why they failed to act sooner.

What you can do is video record his behavior.
Tell the parents you have serious concerns and that he needs help.

If they refuse to give the child help and care he needs who is living in home then you will not be an accomplice to neglect.

It’s sad to have to play the “I told you so card”.

Also constantly point out all his behavioral issues to his parents and everyone in the home.

When he can’t speak properly you can say very loudly:
“use your words”
“I can’t understand you”
“repeat after me”

Make big deal about him biting people and throwing tantrums.

Give the parents a front row seat to reality. The child can’t communicate and is totally out of control.

The if they want to raise a child who acts like a dog. I suggest getting a pig play pen and making the child stay in it. You don’t want him biting your children. Also since he doesn’t listen to or understand basic commands “Don’t touch that” “stop” this is seriously saftey issue for a 3 year old. Since he is in your home if he gets hurt or injured these people can sue you.

It’s all fun and games until children get hurt.

Yikes! Early intervention is needed.

If he doesn't like wearing clothes = That sounds like sensory processing to me. An occupational therapist can help. I had sensory issues when I was little (Still do). It's awful to live out of sync. Everybody has some sensory issues, but, when your daily life activities suffer from sensory----Reg flags fly! This is a true neurological concern in my book.

Usually speech, sensory, etc....can overlap.

Yet, on the other hand, he has no bed times rules. The parents sound like they feel so bad for him that they are compensating and letting him stay up until he falls asleep on his own. Does he sleep through the night?

All in all, I don't understand why the parent's aren't following what the pediatrician says to do.

The Pre-K teacher should be picking up the slack and sending him for testing. If he his not in a 3s program, I would be leaving a few articles out for them to read about delays.
Kindergarten is very, very academic these days. It's not all play and learning a few letters and numbers like it used to be. If there are delays, he will need services. It's best to listen to the Dr and get services now. The earlier the intervention, the better.