Early Assessment and Intervention Question for You...

[NewSLP]

I am a CF-SLP working with adults in a SNF. The majority of my
practicum experience was with multicultural populations and working
with adults. However, a friend of mine has some concerns regarding
her son who is 10 months old. As this area is not a strong area for
me I was wondering if I could get some advice from some other SLPs and
group members. Here is an attached de-identified email excerpt I
received from my friend.

"Honestly, I am soooooooo worried about him. he is very hyperactive,
difficult to sooth, difficulty sleeping, several GI problems and
allergies. and he had the hardest time learning to nurse. we did it,
but it took seven WEEKS! i am so worried this is all related.

We have tried to sign. I think he may understand it, but we have
never seen him do the gestures. We've been doing it for 4 months.

He did have his hearing tested, at about 6 weeks old. They said it
was fine.

Does he seem to respond to sounds (looking towards them, attending to
them, reacting to them, etc.)?he responds to sounds, but not always.
if i call his name, or ask him to come, etc, sometimes he does and
sometimes he doesn't. he doesn't really respond to commands. if a
car or an airplane goes by, he looks. if the cell phone rings, he
looks.

How does he respond communicatively (gestures, visual gaze, etc.)?
sometimes if i smile, he will smile. we try doing "so big",
peekaboo,, etc. he usually laughs but cannot do it on his own. if
he's not hungry, he will swat the bottle away from his face. a lot of
times i have a hard time engaging him -- he would rather crawl and
look at something versus look and listening to me talking. i've
really been trying to accentuate the motherese, and point to things,
and talk to him all day long, but he's just not very interested. i
have trouble keeping eye contact with him.

Does he produce other vocalizations such as laughing, screaming,
crying, squealing, etc.?yes, lots of laughing, squealing, crying,
grunting, and generalized whining. its like he wants to communicate
but cannot say the sounds
How does he react during tickling, raspberries, etc. (expressive &
receptive responses)?
he giggles, laughs, squeals, etc.

overall, as I said, he does not imitate, he does not babble, and he
does not say mama, dada, gaga, kaka.........nothing. i know this
could be normal for him, and he can catch up, but i also know this is
a marker for several other developmental problems. can speech
pathologists differentiate this at his age, 10 months? We went to a
lecture by dr. patricia kuhl out of U of Washington the other night,
and the point she made was the early you detect a problem, the better.
i am seeing the pediatrician again on Monday. i want a referral to a
speech pathologist. any other ideas?"

Thank you. I look forward to receiving advice for my friend. I do
realize there is only so much which can be done without having a
client in front of us.