Dr. Robert Needlman
Specialist in pediatric behavior and development.
|
|
 Ask Dr. Needlman
Four-Year-Old Cannot Communicate in Sentences | | | QUESTION | | | Dear Dr. Needlman,
My child is almost four years old and cannot speak in sentences. She repeats everything she hears, she knows the alphabet, can recognize letters and numbers, and is very good on the computer. She sings and remembers stories that have been read to her yet she still cannot tell me if she is hungry, tired, etc. She has had a hearing test and her hearing is fine. Should I be concerned?— Fluer in San Jose, CA | | | ANSWER |
November 7, 2001 | | | Dear Fluer,
It sounds as though your daughter is quite bright, and that you have taught her a lot. Still, I think you do need to be concerned. A four-year-old child ought to be able to use words to make her thoughts, feelings, and needs known. She ought to be able to ask questions, and tell you things (such as, what she wants to play with). She ought to be able to make things up, for example telling you that the baby doll is tired and is going to go to sleep, but first the mommy doll has to read her a story. She also ought to be able to understand most of what you say to her, as well. A four-year-old child who cannot use words to do all of these things is in need of a careful evaluation.
The evaluation is necessary to define the scope of the problem. It may be that the problem is only in the area of using words to communicate. Speech and language therapists can often be of great help in cases like this.
Many children who have communication problems, such as you describe, also have difficulty with social relationships. For example, they may not make eye contact in the usual way, may seem emotionally distant, or may avoid interacting with other children. Other children with social development problems may seem overly friendly in a very random way, not appearing to make distinctions between family members and strangers.) Some children with these sorts of problems also have very limited interests. For example, they love to memorize bits and pieces of songs or commercials, or even whole children's books, but they show no interest in make-believe play, or playing with peers.
Children who do not use spoken language normally, have odd relationships with peers, and show very limited play interests may have the condition called autism. While autism used to be thought of as a completely un-treatable condition, we now know that many children with autism can make tremendous progress, given the right educational treatments. You can learn more about this condition on the autism section of our site.
If you suspect that your child may have autism, it's very important that you have her evaluated by a knowledgeable specialist, such as a pediatric psychologist, neurologist, or behavioral-developmental pediatrician. It's easy to read about autism and conclude that your child has it. Before you worry unnecessarily, it's wise to have a professional either confirm your suspicions, or give you reassurance that the problem is in fact not autism.— by Robert Needlman, M.D., F.A.A.P. |
|
