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Having trouble learning words. Difficulty with reading visually and memory retention. Should I be concerned?

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My son is 6 1/2. He just completed his k5 year and has been in speech for two years. The speech therapist believes he has a language based delay. K5 was very difficult with the phonics approach. After 6 mos of trying to teach him the alphabet and sounds with little success, I bought a leapfrog DVD. Surprisingly, within a few weeks, he knew ALL of his letters and sounds. As far as going to blends, it was an epic fail. He got "t" says "tuh" and "a" says "a" but couldn't put them together after weeks of practice. My mother in law told him to spell the word "cat" - c-a-t, and to remember it at the end of the day. And he did. I was approached about teaching him word language because breaking up the words for him is difficult and he looks at me like he has no idea what I'm saying. He just wants to hear the word. I found a special needs teacher and he has started sight words - first clapping, eyes closed, and writing. 5 letters first week got all but 1 (same one all the time was wrong), week 2 overwhelmed but got them all, week 3 we had to back down to 2 and got 9 of the 12 right and always the same 12 right. Now trying to make a three letter sentence. "I see you XXXXXXX Knowing all those sight words by themselves, he gets overwhelmed seeing the "sentence XXXXXXX Last year in speech he did "around the room XXXXXXX He would make it through the kitchen, missing one here and there, but each time they changed - one day he couldn't tell you the name of the fridge, and say "ummm, the... XXXXXXX and get frustrated, they next day he would get the fridge right and forget the oven. So I see difficulty with reading visually and memory retention. Retention really concerns me because every aspect of learning builds. Because I homeschool, I have seen LITTLE cooperation from the school. They help with speech but have refused an IEP for my other concerns unless I enroll him, even though this is against the law in IL. I will fight the school but in the meantime, any diagnosis terms I should be concerned? Pls help

My two biggest concerns are memory retention - how he forgets things in day to day that I feel he should remember. To me, once we learn it's a fridge - we always remember it's a fridge. For my 6 year old, it changes. It reminds me of a "block" - he knows it, but sometimes can't remember it's name. It's hard to see him struggle when he so clearly want's to remember.
Two- the written language seems to be tough for him to process. He goes at a much slower pace than a school - which is perfectly fine - but I'm worried that he's possibly dyslexic. With his "umm" and "thing" terms, no understanding of rhyming, went through major trouble writing letters - often mirroring them but has corrected that specific problem.
The dr. that seen him for his breath holding said it related to the connection with his vagus nerve. - Could this be any relation?
Posted Fri, 19 Jul 2013 in Growth and Development in Children
Answered by Dr. Anjana Rao Kavoor 3 hours later

Thanks for writing to us,

It is natural to be concerned about the difficulty your young son is facing.

Normally, children start babbling by initial few months of life. Learn to say one word by 10-14 months and say two words by 22-26 months. And start making simple sentences by the age of 3-4 years. Yes there is a delay here in the case of your son.

Thinking in terms of diagnosis, there are many different diagnoses to be considered. Diagnosing your son will require a child psychiatrist and a psychologist who would use some standard testing methods.

I could shed some light on the possible diagnoses and their respective features here for you, so that you can learn more about the condition your son may possibly have.

From the information you have given, he is unable to use more than 3 words at a time (which is expected at his age), he has an atypical pronunciation, difficulty with memory retention, reading difficulty, usage of fillers in speech like 'things' and 'umm' etc, writing difficulty with mirroring (which is currently solved) and breath holding spells.

Most of these symtpoms fall into a category of disorders called 'Communication Disorders'. Under these there are what are called 'Language disorder' where there is difficulty in expressive language (called Expressive language disorder), here the child understands all that is spoken to him but is unable to express Eg. child points or uses gestures to indicate desires, wants to communicate and maintains eye contact, relates well to the mother but the vocabulary is severely limited. They also have difficulty retaining words.

If the child is unable to understand what is being said to him/her in addition to the above then it maybe 'Mixed receptive-expressive language Disorder'.

In 'Phonological disorder' there are speech sound errors. There maybe omission of sounds, distortion, atypical pronunciation. When a normal 3 yr old cant correctly articulate m,n,ng,b,p,d etc, a 4 yr old cant correctly articulate f,y,ch and 5 yr old cant correctly articulate th,s,r. This is a rough way to find out.

If a child with normal IQ level has significant difficulty in reading alone, makes errors in oral reading, difficulty in sound discrimination and in sequencing words, the child may have a 'Reading disorder'. If problem with writing then "Writing disorder'.

If the overall IQ is low along with delay in adaptive functions like bathing, dressing, feeding self, toilet control or delay in achieving motor skills like walking, running etc., apart from language delay then he/she may have 'Intelluctual Disabilty'.

Each one of these can be present alone or in different combinations.

They are diagnosed only after administering standardized tests like IQ test, standardized tests of expressive language and receptive language etc.

Breath holding spells can be seen in children along with other conditions mentioned above but there is no specific relation to it.

A child psychiatrist would be the right person to approach.

Hope this answers all your queries,
Dr. A. Rao. Kavoor
Above answer was peer-reviewed by
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