What is appropriate time for diagnosing speech delay

[concernedParent]

My son is 30 months old now. We noticed his speech delay when he was two years old and enrolled into early intervention program. During this six months he has shown good progress, but he is not in a position to use speech as tool for communication. Apart from speech delay he don't have any problem in either playing with his sister or our neighbour's son. But he is not really playing with other children when we meet at parties. He can recognize all alphabets and even can spell few words, but he cannot speak if he needs water for example. However he pulls us near to water sipper to indicate that he wants water.

After reading so much information on the web, we decided to meet a developmental pediatrician to rule out possibility of autism. We even scheduled appointment. But now we are bit nervous. We mainly worried about what kind of diagnosis will be performed by developmental pediatrician. We don't want to put our son through unnecessary medical tests (such as MRI etc).

So, I am looking for advice on whether is this a good step to go through evolution by a developmental pediatrician. Should I wait some more time and get diagnosed ? Any advice one can provide is highly appreciated.

Thanks

[tobym]

Dear Concerned Parent,

It is always better to have an evaluation if you are worried about your son. If there are any other issues then it is always better to know early. Not having the evaluation will not change what is or what is not. In terms of having a diagnosistic evaluation there are many different tests that can be adminsitered and are all for different kinds of problems. Some are general and measure IQ and others are very specific like the ADOS which is for ASD. If you go for an evaluation you should ask in advance what kind of tests might be administered or is it just a screening. A screening is when you might go and give some general information and then arrange at another time for a full evaluation. A comprehensive evaluation should include the following
1. A strutured interview with you
2. A testing session with your son to measure variuous different skills ( all testing should be standardised and referenced to the typical population) testing should produce specific scores in whatever areas have been measured. ) Typically these kinds of tests are administered by Clinical Pschologists. However some pediatricians may have testing knowlegde. if you are seeking to rule out a particular diagnosis then it helps to make sure the person testing and diagnosing has extensive experience in that area and is aware of the specific tests that would be done for that population i.e. for autism you might do the ADOS, ADI, Vineland and an intelligence or developmental test.
3. A comprehensive report (anywhere from 8-16 pages) that in clear detail describes the results of the tests and their implications as well as a comprehensive list of recommendations for follow up
4. If you do get a diagnosis of any kind then this should be discussed at length as to what it is and what it may mean for your child and his future
Sometimes parents go for what they think is an assessment when it is really just an observation and discussion with a clinician. Allthough this can be helpful a full diagnostic assessment can provide far more information and detail about the child and is far more comprehensive. For parents who are not really sure about their child this can be important.

We have some more info about diagnosis on the website. Hope this helps!!
toby mountjoy