Speech Delay vs. Autism: Top 5 questions on Diagnosis, Denial, and Regression

Last week we continued our classic rebroadcast series with an episode from 2019, “Does my child have ADHD, a speech delay, or autism?”. This week Kelsey General, our Community Manager, joins me with our top 5 questions about this important topic.

1. What is the difference between autism, ADHD, and speech delays?

When you are having concerns for your child’s development, reading up on common disorders can make them all seem really similar. In fact, young children are often misdiagnosed for one or the other or given all three. Autism is usually the diagnosis that will umbrella all the signs and symptoms, but children with just some may get a speech delay or ADHD diagnosis. The good news is the intervention for these is all similar, the strategies from my courses will help improve the signs and symptoms you’re seeing whether you have a diagnosis of one, none, or all three. 

2. What are the specific signs of autism versus specific signs of speech delay?

If your two-year-old is not yet talking and you’re concerned about autism or a speech delay, some specific indicators can be related to how they are communicating. Are they pointing? Are they using gestures? Are they showing toys? Are they touching body parts? How is their receptive language? Additionally for autism concerns; are they eating well? Are they sleeping? Are they having tantrums? In Chapter Two of Turn Autism Around I share the 10 potential signs of autism. The big difference between autism and speech delay is going to be awareness and intent of their communication.

3. What if signs and symptoms look more like speech delay than autism, will my kid just catch up?

Do not chance it!! There is really no way to know if a child without intervention would naturally catch up because no two children are alike and there is no way to compare. But why wouldn’t you try intervention? I don’t mean you have to sign up for full-time ABA therapy, but read my book, take my courses, and try intervention at home. It cannot hurt. These strategies are based on good parenting, play, fun, and learning and will only benefit even typically developing children.

4. I am noticing delays and signs of autism, what should I do first?

First and foremost, Don’t panic! Take some breaths, it’s going to be okay! You need to assess your child, so you can make a plan and help them. We’ve recently made my one-page assessment digital, which you can still at the time of this recording access for free. Once you’ve assessed them, make a plan. Determine the areas your child is behind on and get to work. Not only can use take advantage of my free content but don’t get stuck there, join the courses and community, read my book, and put in the time necessary to get working with your child and turn things around. 

5. Is it important to get a diagnosis and label my child?

Yes and no. Is a diagnosis going to determine how well an intervention works? No. You can get started on intervention and turning things around without a diagnosis. You do not have to wait for a label to get started, like I’ve said before these strategies are not going to hurt or change depending on the diagnosis. But having an autism diagnosis can make the difference between receiving ABA and other services, placement in a safe school for the child, and especially funding in your community or through insurance. So get on the waitlist, contact your doctor, and do all of those steps to get on the path to a diagnosis, but do not wait for a diagnosis to get started.

Speech Delay vs. Autism: Top 5 Questions on Diagnosis, Denial, and Regression

Mary Barbera – Turn Autism Around Podcast Transcript

Transcript for Podcast Episode: 207
Speech Delay vs. Autism: Top 5 Questions on Diagnosis, Denial, and Regression
Hosted by: Dr. Mary Barbera

Mary: You're listening to the Turn Autism Around podcast episode number 207. Today I have Kelsey General back on the show to cover the top five questions we get about: Is it autism, ADHD or speech delay in toddlers and preschoolers mostly. So we cover lots of different questions we get and it's a great episode. Really good to follow last week's episode, which is a classic rebroadcast on the same topic. So I hope you enjoy these questions and our answers to the question is it autism or something else in a young child?

Welcome to the Turn Autism Around podcast. For both parents and professionals in the autism world who want to turn things around, be less stressed, and lead happier lives. And now your host, autism mom, behavior analyst and bestselling author Dr. Mary Barbera.

Mary: Hi there. Welcome back. This is episode number 207. I have Kelsey General here. She is our community manager and a coach for the Turn Autism Around approach and course and community. And so last week episode 206 we redid the classic rebroadcast of Is it ADHD, Speech Delay, or Autism? That was from way back in 2019 when I originally recorded that solo show. And you know, over time, I mean, I didn't even have the thought to write a book at that point. And we've created quite a bit of content around this very topic. So now Kelsey is here with our top five questions that we get about the diagnosis. And we were mostly talking about little kids, toddlers, preschoolers with early signs of ADHD speech delay and or autism. We're not really talking about teens with high functioning autism. And definitely we're not talking about adults who think they might be on the spectrum because our focus really is getting to kids as soon as possible. So we don't really focus on teens and adults unless they can use our courses to adapt our materials. Because like my son, Lucas is 26 at the time of this recording, he's still functioning in a lot of ways as a 1 to 5 year olds in terms of language and those sorts of things. So if kids aren't conversational like Lucas is not, then they're still in need of these kinds of general strategies. But of course the diagnosis is, is and the signs are very different in a toddler or a preschooler. So thanks for joining me, Kelsey. And we can just hop right into the questions.

Kelsey: All right. Well, the biggest one and we get a lot of confusion on all our social media channels on Instagram, Tik Tok, YouTube, Facebook, is often what is the difference between autism, ADHD and speech delays? They all sound kind of similar when we're reading about them.

What is the difference between autism, ADHD and speech delays?

Mary: Yeah, and they all are very similar, especially when you're talking about an 18 month old, two year old, three year old. My newest book, Turn Autism Around. The subtitle is actually an action guide for parents of young children with early signs of autism. But it's also an action guide for early signs of ADHD. And we don't have a crystal ball. We can't tell what it's going to be in the future. If we have a five year old, we can't look into the crystal ball. It would look backwards, like what would have happened if I would have gotten, you know, my son Lucas diagnosed early or what would have happened if we would have done X, Y and Z? So. My thing is that the signs, especially in a very young child's 18 month old, two year old, even three year old, are very similar. It could end up to be, quote unquote, just a speech delay or it could evolve into being more of an ADHD or it could be a genius level IQ. You know, giftedness can often look like an obsession with letters and early reading and hyper alexia, which we've done on podcasts. We can link that in the show notes with COVID and COVID isolation, could that be a factor in some of the delays you're seeing? Maybe, you know, especially during the shutdown, we did a podcast interview with Dr. Catherine Lord, who's one of the experts in diagnosis, and she talked about how the shutdown and the waitlist got longer and the evaluations got tougher with masks on everybody and full garbs. And, you know, so you really can't tell, if you have a two or three year old and they are not talking or not talking in full sentences and conversational and not sentences like "I want drink". That's not a sentence. That's a rote response, a carrier phrase, which I do not agree with. We can link the carrier phrase blog in the show notes as well, but. If you have a child that's not speaking or speaking. Well, speaking according to their age, plus you have problem behaviors, self-care, deficits, sensory processing issues. And a child under five. That to me is autism. You know, if you just have a child with speech delays, but their self-care skills are good, they're eating and drinking fine, they're sleeping through the night. They're potty training fairly easily. They're not having major tantrums. Then that might just be a speech delay. But you have to take all of the signs together. One of the things that we tell people all the time is check the CDC, act early milestones so you can just search for that, we can link that in the show notes to, but you can search for CDC milestones and then you can say, okay, my child's 15 months old, CDC milestones, 15 month old, and you can see what a 13 month old is supposed to be doing. And if your child seems behind, not just in expressive talking, but also understanding language, ability to sit, the ability to sit for a book, the ability to touch their body parts, the ability to play or share or engage with a peer, depending on their age. Just all kinds of other things that you might not be thinking of.

Kelsey: Yeah, I agree with everything you said. And the other thing I wanted to add is it is really, really tricky because some kids who actually do have autism don't necessarily have a speech delay. They may have a lot of labels, letters, and songs. You know, they might have the actual word count. But if a child is walking around talking about deers and cows and horses, they're not....

Mary: Or washing machines or trains obsessively.

Kelsey: Yeah. And not asking for water or asking for a cookie. And they aren't really communicating. Then that could be autism too. And on the flip side, you could have a child with a speech delay who's communicating everything. Maybe they're signing, maybe they're pointing constantly, maybe they're always checking in with you and they're really connected. And that can be a sign of a speech delay. And it is really, really tricky to tease out, I think. But I also think that people use trying to tease it out as a denial excuse. Well, maybe it's just ADHD. Maybe it's just a speech delay. Maybe it's, you know, just a sensory processing disorder. And at the end of the day, as me and Mary are saying, it is so tricky to tease out that you really can't do it without a full assessment. And that brings us into our next question.

Mary: Before you answer the next question. Just something you said triggered me to want to read the back, a quote from Temple Grandin. Temple Grandin wrote the foreword for my book. So I think this sums it up. "If your child has no words, a few words or is showing any kind of delays, Mary's book will help, while also providing step by step instructions for potty training, beating tantrums and more." So if it's just a speech delay yet they're typically, you know, doing those self-care and not having extreme problem behaviors. It might just be a speech issue. And also the receptive part of speech is super important. But go ahead.

Kelsey: Yeah. So let's get into the next question, which does talk about what you were just saying, Mary. Specific ways to tell what it is? Are there some specific signs that point more towards autism or something that points more towards speech delay?

What are the specific signs of autism versus specific signs of speech delay?

Mary: I'd say the number one thing and I mean, I'm a registered nurse and behavior analyst. I also did work with the first signs grant in like 2000, 2001. I went around the state of Pennsylvania training pediatricians on the early signs of autism. I got trained and certified in the STAT. I got trained in ADOSS. These are tests that can be done. We can link the blogs and the show notes for the actual tests. But if I have a two year old in front of me who is not talking, I am looking for pointing. I am looking for gestures, for showing, like bringing a stuffed animal to the parent. I am looking for the ability to sit, to attend, to sit, to eat. In my book, I talk about the fact that I didn't know this when I was writing the book. But like picky eating, extreme picky eating is actually one of the one of the add on potential signs of autism. Are they sleeping well? Are they eating fine? Are they addicted to a pacifier or bottle? That would be a big red flag for me. Are they having tantrums? And like I said in the last answer, how is a receptive language? Are they touching body parts? Are they singing songs like not even singing songs? Like just like if you're happy and you know it, clap your hands like a toddler who's not saying anything. If they're clapping or an imitation. Those are all really good signs. So in chapter two of Turn Autism Around, I have ten potential signs of autism. I think I did a podcast on that as well. These are just some of the things I look for. Like, like you said, Kelsey, like awareness checking in. Like when I had Spencer and brought him home from the hospital. Lucas was 18 months of age, just turned 18 months or about to turn 18 months. He was addicted to a pacifier. He had no idea that a baby was coming. A baby was in Mommy's belly like it was not even he was very darty. He was very hyperactive and wouldn't sit down, very addicted to the TV, and wanted to watch the same Barney VHS tapes over and over again. And I write in my book that I literally could have brought a plastic doll baby home for the awareness. So those are, you know, and a lot of this is from my experience, but it's also related to the hundreds or thousands of kids that I've directly assessed. So those would be the top kind of signs. For a two year old. Now, if you're talking about a three or four year old, pointing is out the window because kids then have to have other gestures. And if you have a child, that's three or four and very, you know, isn't touching body parts or or isn't talking in phrases or sentences that aren't rote or it aren't scripted. You know, you can have that scripting for movies and stuff that echolalia That is more into the autism side of things. But ADHD, you know, somebody explained it once and I don't know if this is how politically correct this is, but they basically said that, you know, autism is a spectrum and ADHD is kind of on the edge of the spectrum. And so some kids can get diagnosed with very high functioning autism, but they previously have been diagnosed with ADHD or vice versa. They could have a diagnosis of ADHD before or around age five. And then, lo and behold, it's really autism. A lot of kids are diagnosed with all of these things: speech, delay, autism and ADHD in some kind of sequence. I remember asking Dr. Copeland who I did an interview with on this podcast, who diagnosed Lucas. Like, what about adding additional diagnoses? And he basically said autism is the umbrella that covers hyperactivity and lack of focus and impulsiveness and speech delay and sensory processing. And he didn't feel the need to tack on a bunch of other diagnoses.

Kelsey: Yeah, and I think with ADHD, it's tricky because I think a lot of people think that ADHD is, oh, my child is running around and hyperactive and can't focus much, must be ADHD. But often it's a lack of skills due to, you know, autism or speech delays. And it's really I mean, we'd have to ask a professional, but I think it's probably not as accurate of a diagnosis to look into ADHD for two, three and four year olds. Yeah.

Mary: I would kind of shake my head, you know, unless there was really no speech delay or very little and very little self care. Now, I do want to point out that a month ago, a month or two ago, we worked with a software company. We did a whole podcast on the Turn Autism Around assessment, which is one page in the book. Page 49, we worked with the software company to get that digital. So it's digital. You get scores in three areas: the self-care and daily activities: eating, sleeping, potty training, grooming, dressing, language and learning skills, language receptive and expressive as well as imitation and matching and social skills. And then the third area is problem behaviors, big problem behaviors, little problem behaviors and everything in between. And what I'm seeing, my goal is to get these scores more validated and more fine tuned we're still available for freeautismassessment.com. We can link it in the show notes and you can spread the word if you're listening. You can do the assessment. I would definitely recommend you doing the assessment and then watch the webinar that comes right after the assessment and consider joining our online course because we are dealing with all three things. Now, I will say that a few weeks ago we had Katty on the show. And she has a little boy named Santiago, who's only three and a half now. She joined the course a year ago. She only had the diagnosis and still only has the diagnosis of a speech delay and her pre assessment, which she kind of thought about what he was like when she joined the course. She had the documentation on paper that she was able to transfer in. So his self care was actually pretty good, 60 or 70%. The lower the score, the worse and you know, the symptoms are. So his self care was pretty good and his tantrums and problem behaviors were pretty good. Her only problem, really the child's only problem at two and a half was his speech score was 20%. Then fast forward a year. Now she's taken the toddler course. She added the verbal behavior bundle. She completed all the courses and did all the activities with really little help, very little outside services at all. And now his scores in those two other areas that he wasn't delayed in are fine, and even his language score was under 20% ish. You know, this isn't like real research at this point. This is just checking in to see is the intervention changing? He went from 20% to 85%. So huge change. Never got the diagnosis of autism. Half the members in our toddler course don't even have the diagnosis. And I asked her on the podcast, you can listen to it. We'll link it in the show notes here. This is episode 207 so Mary Barbara dot com for us 207 To get all the show notes that I keep saying we're going to put in the show that's going to be packed. But I asked her, like, did it upset you that I'm talking about autism, but I'm also talking about signs of autism. And she's like, no, I need help. I need to find out what to do. So I think the real key is, even if you think it's just a speech delay or you're on a waiting list, which the waiting lists are horrendous, nine months to two years for an evaluation for autism. Get in. Start learning. Start turning things around, whatever that looks like. And you can make progress. And so in the end, I think the intervention is going to be much more important than the actual diagnosis. And the diagnosis can change. It could go from level three autism to level one autism. It could go from ADHD to level two autism. It could go, you know, it could go to a speech delay then level three autism then level two autism. So nobody knows what it's going to look like in a year or two years or five years. All you can do is put the right interventions in place and then be at peace with whatever's going to happen.

Kelsey: Yeah, and I think that's a really good, good answer and good specific ways to tell what it is. My answer for that is still the same kind of as what I said in the first. I really look at their intent of talking because my son Lincoln, who does have a diagnosis of autism and then it seems pretty typical to a lot of people, but we still see things come up. He talked a lot, but in monologues and he wasn't communicating. He still struggles sometimes to communicate his actual wants and needs, but he can talk up a storm. And so there's lots of really, autism is a social communication delay. And so we really need to look at things that are on the M-CHAT, things that are in the assessment. Mary did a podcast episode on the M-CHAT before, which is a screener for autism as well, and really looks at those signs. But again, what Mary said is interventions are key. So that brings us to our next question, which we kind of already answered, but we'll touch on it with some more resources. I think it doesn't seem like autism. It seems more like just a speech delay. Do you still need intervention or do kids just catch up?

What if signs and symptoms look more like speech delay than autism, will my kid just catch up?

Mary: I wouldn't chance it. We don't have two Lucas's or two Lincoln's or two Brentley's to go through and do experiments with. Yeah, I would just treat it. I would treat anything. And not that we're trying to, you know, smash out autism or or change anybody's personality or change, you know, we are trying to catch delays up, get problem behaviors down and to the greatest extent possible so that the child can be as safe as possible. I mean, they're not going to be safe if they're having tantrums and throwing themselves on the ground or hitting their head. So safe as possible, as independent as possible, eating, drinking, potty training. We want to get those skills up and be as happy as possible. We want a child friendly approach, whatever approach you're using. Saying it should be child friendly, the child shouldn't be crying. And so in my experience, kids with any kind of delays or differences need more than an hour or two or three of therapy per week. They need more than just sending them to a clinic for 5 hours a day. Because the parent. One parent at least needs to be calm, in my opinion. The captain of the ship. They need to learn child friendly, proven strategies to engage with your child at the grocery store, to know what to do if there's flopping in the Wal-Mart parking lot. They need to know how to pair the words, not to use carrier phrases, not to get more rote language. That's going to be a problem. They need to know what to do if the child is scripting. You know, from movies constantly. What do you do? And it's not a matter of, you know, sometimes it will get like a TikTok comment. Okay, what do I do? It's like I don't have, like, 40 characters. No one's going to solve your problem even if you join our online course and community. You're going to need to learn the information to apply it to your child, to assess your child or clients, to implement the procedures to come into the community and help get unstuck. Regardless of the diagnosis or what you think it might be, I would tend to. I would tend to put my energy in because I don't want to. You know, even when I found out that Lucas was probably going to get the diagnosis, I thought it was very mild. So I went up to this expert. This is actually in the verbal behavior approach book and chapter, the last chapter. And I asked this expert, Glen Dunlap, well, I think it's just going to be very mild, like PDDNOS at the time and like, do I need to do anything major? And he said in his 30 years of practice, he was a behavior analyst, I think, or had a Ph.D. He was an autism intervention. He said, In my 30 years, I have seen kids like you're describing your son who looks like a speech delay. Maybe it's mild autism and ends up to be moderate severe autism. But he's like, I've seen those kids and I think they should be okay at eight. And he's like, and sometimes they are, sometimes they're not okay. And he's like, And then I've seen kids with really severe autism who I think there's no way they're going to be okay at eight. And sometimes they are and sometimes they're not. And so he said, and I've got some flack on social media about this, like treat it as the most severe autism, you know, even if it's just a speech delay and I don't mean it like treat it like it's severe, you know, I just mean there would be no looking back when your child is 8 going, oh, shoot, I should have I should have listened to that Mary on that podcast. Like, I should have done more. And we don't want to guilt people. And, you know, like, I know everybody's got their own lives and own histories and own values. And it's just if it was me, it was my child, my grandchild, my niece, my nephew, I would want to do as much as possible to learn the techniques to implement, to turn things around as much as possible.

Kelsey: Well, and should you start intervention? Yes. Why not? I mean, we can call it intervention, but really it's just learning techniques to support your child's development, which I think all parents are striving to do, whether your child has a delay or not, but because your child has a delay or autism already ADHD or needs extra support, there are more fine tuned strategies that you can learn, but it's not like anything. If it all turns out that they have none of the things we're talking about, nothing would harm them. It's all fun and playing and just specific ways to use toys that you probably already have. And so. I guess why not do intervention? The only reason you wouldn't is, is if you're trying to stay in some form of denial, like there's just so much out there at this point.

Mary: Really we're not talking about starting intervention at a clinic full time. We're talking about the parent or early intervention, professional or ABA, professional learning, child friendly, parent friendly techniques to encourage language, encourage ginger and independence with self-care, and reduce tantrums all at the same time so you won't have to wait. Okay, well, we're going to work on language first and then we'll do Sleeping in two months. No, we're going to do the assessment and then we're going to make a plan based on that assessment. And if sleep is really a big issue, you got to tackle sleep first. As you gather the materials and get your child to talk, hopefully. But I think a lot of people are in silos. A lot of professionals are in silos just like, okay, I'm X, Y, Z, professional, and I am working on language or I'm working on the sensory system, or I'm working on problem behaviors. And what Kelsey and I do is we work on everything in a child friendly way, and it's really good parenting. Yeah.

Kelsey: Yeah. And so that brings us to our next thing. So, okay, I'm on board with you, Mary and Kelsey. Something is up. What is the first thing that someone can do after they do either the free assessment or notice on the CDC milestones their child's behind? So they're noticing delays and signs. What is the first thing they should do?

I am noticing delays and signs of autism, what should I do first?

Mary: Well, I think it's not a race. You don't have to panic. Take some deep breaths. No matter what the age of your child. You need to kind of put your oxygen mask on yourself and really make some planned actions. So I would say the assessment would be my first action to see if we have problems in all three areas, in one area, in multiple areas, if you just have problems in problem behavior. And their scores are 85% or better in self-care and in language. Then we have a term tantrums around many courses that you could take, which would be super helpful if you have delays in self care and the language with or without problem behaviors, you really should take the whole course. But you know you don't have to sign up today. You can read the Turn Autism Around book. You can attend a free workshop, you know, follow us on social media. But I would warn you, I just had a member join our toddler course just last week. And she told me she listened to all of our podcast episodes. And we're at over 200. You know, so she has a child who's diagnosed. Five year old. She's been listening for you know, I don't know how long she listened for a year or he has intervention going but it's not resulting in great turn around. And I basically told her like yeah she made major progress in sleep and in potty training with just the free information. But I did warn her, I'm like, do not stay in the sea of free. That's what I call the sea of free. Because when you're trying to learn anything, you know, we put out so much content, especially now that we're on TikTok and Instagram, we're putting out, you know, every day we're putting out a couple new videos and, you know, it's confusing and we're not trying to do that to confuse people. We're just trying to do that to attract people to say we have some strategies, some really helpful strategies. We have major success stories. Michelle C. We can link in the show notes. Katty was just, just a few weeks ago. We have major success stories and we know that people that do take advantage of joining our online course and community do make the most progress, you know? I learned to play the piano a little bit during COVID. Yeah. Could I learn to play the piano by just searching free piano courses online and everything? Probably. But it would take me a lot of time. I wouldn't have a community when I get stuck. And so and that's just for learning to play the piano. That's not that critical if I do or I don't. This is critical information. So once you've identified that you have a problem and this particular member, we went over her assessment scores and I told you that Katty's assessment on her little boy was mostly the problem was speech 20% to 85%. This person that has been listening to all the podcasts, her son was in the 35 to 39% for all three categories. He has a diagnosis, you know what I mean? Like our courses are specifically designed to help in all three areas. Oh, let me listen to that podcast. Let me take notes, let me listen again. Let me watch this video again and see if I can glean anything. I know people are like, well, why is there a fee? Shouldn't it just be for free? I'm running a whole business. Kelsea works for me, you know, 25 hours a week. I have a full time employee. And Rachel, like this, is a full time business. We give so much away for free, but really to make the most progress, I would encourage you to join our online courses and community and we can link that in the show notes as well.

Kelsey: Yeah, and I think that's a great first step. That's what I wish I did first. So when I first noticed delays, I spent a lot of energy fighting with people on waitlists, trying to get the diagnosis and. Well, that is important. Yes. You should contact your doctor. Yes, you should get on the waitlist. Yes, you can contact local professionals. Yes, you should do those things. But what I wish I would have done first was just learn what to do. There's a lot more hope in that. There's a lot more progress in that for my child and there's a lot less stress as a parent for me in that.

Mary: So yeah, yeah. And like you said, Kelsey, I would get on the waitlist. I would prefer a developmental pediatrician to evaluate your child. So I would if I were, you know, in Pennsylvania, for instance, I know that the big developmental pediatricians are at Children's Hospital, Philadelphia and Hershey. Those are the two areas closest to me. So I would find out how to get on both waiting lists and actually get on them, even if you think it might just be a speech delay or might be ADHD, get on them in a year when your name comes up. Actually, they do prioritize really little kids. So if you have an 18 month old or two year old, you're actually going to get rushed to the front of the line. And kids that are like over three are going to have to wait longer. So get on a wait list. You can always cancel it. You will have to put some real time into these up like assessment application waitlist forms. It's not just like, Oh yeah, put Johnny on the waitlist, it'll take you like an hour. But I would prefer, if possible, to go to a children's hospital where you're going to be seeing a developmental pediatrician. I mean, you get a diagnosis from a neurologist, a psychologist or psychiatrist, or even a specially trained pediatrician. So those are your only options that will be okay. But I still would wait for a developmental pediatrician in addition to any of those others, because developmental pediatricians can help. You can rule out other things and also be an expert on development.

Kelsey: Yeah. So that really brings us to our last question, which is, is it important to get a diagnosis we're talking about is it this is it, that is it is it important to label a child?

Is it important to get a diagnosis and label my child?

Mary: Yeah. And actually in my book somewhere, I think towards the beginning in chapter one or chapter two, I used to say it, it's, you know, get a diagnosis, get ABA therapy. But with some of the turnarounds I've seen with the parents in the online courses, I mean, I would get on a waitlist for sure and I would look around, but I don't know that. I would put these procedures in place, like I talk about Max and a few chapters and Turn Autism Around. And Max was a client who didn't think he was going to get the diagnosis. I took videos of the STAT to show that he did qualify for a diagnosis. Developmental pediatrician saw the videos come into diagnosis, but with four months of intervention, he was now pointing, he was showing he was talking more, he still has speech delay and he still had major problem behaviors. He still was delayed. But with those pointing and showing and wherewithal to know what was happening, she's like, you know, I was fully prepared to come in here and give him a diagnosis, but I'm not. He still needs intervention, though, so that is a personal decision. Michelle C. her daughter had two words, had severe self-injurious behavior, would have gotten a diagnosis of level three. But she went to a neurologist who just gave her a diagnosis generally and sent her to the next place to get the level. And she made such major progress that it would have probably been level three, but it was level one. And now she's fully integrated with no speech delay and she's doing fine in typical preschool. So like, was that something else or did it just, you know, like, I mean, we wrote a whole white paper up about Michelle C's daughter, which we can link in the show notes. I mean, it looked like she made a major turnaround, going from two words to 500 words in 33 days with my course only and community. But it was COVID and she didn't have any other therapy. So it looks pretty convincing. But nobody knows. Nobody knows if Max had a strep infection that was causing something. Maybe, you know, we don't. Like I said, have a crystal ball to look forward or backward. So I think it is a personal decision. Many half the members are, of course, in community, don't have a diagnosis when they join. And, you know, if I see an assessment that looks like 35% in all three areas, then if that mom did not have a diagnosis, I'd say, yeah, it looks pretty severe in all three categories. I would go ahead. And I do think that some of it is based on the severity of their symptoms, that they're having problems in what areas and how it's affecting your life now and how it might affect your life in the future.

Kelsey: Yeah, I'd agree with you, Mary. I used to also think a diagnosis was really important. Like I said, I think in the original podcast I did with you I thought that once we got the diagnosis, the race was done, we had everything we needed and everything was going to go up, but every turn would go up. I did everything we needed and I still think a lot of parents think that way because at that stage that's like, Oh, we just need to figure out what's going on. And, well. I actually still am pro-label for the reason that in my area it's really important to have that autism diagnosis, to get certain funding, to get certain if anything does go wrong for my younger son in school without an autism diagnosis is basically hoops. So it is really important here to have that diagnosis if they meet that criteria. And I know in other areas it's also important to get any help whatsoever. But I don't think you should sit around and wait for one or don't do anything until you get one. Obviously the most important step is intervention. And then looking at depending, like Mary said, on the severity of those symptoms, is this critical? Are there services I wish we could receive, but we cannot because we don't have a diagnosis> Am I trying to work full time and my child's getting kicked out of preschool and I need them to have a diagnosis so that they can be in a more safe placement? There's a lot at stake, but the core of it is to get on waitlists. You know, don't be scared of a diagnosis, but just take steps.

Mary: Yes, I think that those are all excellent points. And in the past ten years, all 50 states now require insurance to cover ABA for autism. They don't require ABA for ADHD or speech delays. So sometimes, especially if the child is wrongly diagnosed in order to get services, to get an IEP to get I mean, you can have an IEP with speech delay or ADHD, but you know, to get more services, to get ABA treatment, to get speech therapy, those sorts of things will probably require some diagnoses. So, so yeah. And it is a talking point and the conversation we have in our online community for toddlers and preschoolers because it is a stress and we do help as a community with bonus videos and and actually answering Facebook posts because like for each individual family, it could be like, yeah, I would try to get a diagnosis sooner for X, Y and Z reasons.

Kelsey: Yeah. So it definitely differs. But I think the take home message from, from this whole podcast is. Regardless of what it is, if you're noticing differences in your child or or, you know, they're not quite meeting all their milestones or you did the assessment and you're noticing some higher numbers in an area. Just learn how to support them in your everyday life. That's really the key here.

Mary: Yeah. Yeah. So in the end, really check those CDC milestones, do the assessment, see where your child may be falling behind in the milestones, and then learn more. We have a whole lot of free and paid resources to help you move forward regardless of diagnosis. So, yeah. All right. Well, thank you so much, Kelsey, for doing all that you do for our course and community and for these top five podcasts. I think they're a great addition to our lineup and I'm looking forward to doing more of them in the future.

Kelsey: Yeah. Thanks, Mary.

Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbera.com/workshop where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism. And you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/workshop for all the details. I hope to see you there.