The boy who is four years of age, internationally adopted from China at three months of age, demonstrates an obvious speech disorder and expressive language delay noted at 8 and 20 months of age, respectively. Based on his records, his mother conceived him at age 30, and was not hospitalized or medicated during pregnancy. Therefore, factors such as gender, heredity, and environment (Norbury & Tomblin, 2008) may be considered as the roots of the problem. The surrogate mother of the child, who has taken care of the boy since birth, serves as the main source of information and child support. The mother is a housewife who never goes out except to do some grocery or pay bills. Although the surrogate father willingly provides support to his wife, he is the only one working for the family, is usually out, and comes home at night after office hours. Therefore, aside from the mother, the child has no one to interact with at home. Nevertheless, he is very fond of the television, and replies to people when expected.
Faced with a stranger or visitor, the child behaves normally. He interacts and replies with people of all ages, although like most kids, he interacts better with other children. Whenever a visitor comes in, the boy resumes his activity, and responds to the visitor whenever asked. However, he has a very notable speech defect. He does not demonstrate other symptoms of delay except for his speech. When asked what his name is, he responds correctly, but shows inability for proper pronunciation and overall speech. In particular, he has difficulty producing the /s/ in his name and sometimes pronounces /t/ instead or deletes it in other instances. Likewise, he tends to substitute the sound of /k/ to /ch/ and so on. When at play with other kids, the boy does not talk much, but moves and does things according to expectations. At home, when asked to do a chore, he is able to obey instructions such as turning on/off the TV, looking for his toy, arranging his toys in the bin, drinking water on his own, and wearing his slippers. However, he has to be fed when eating, or else he will not be able to finish his food. His motor skills are all right. He can dance, move, go up the stairs, run, use the swing, slide, and play in the sand. However, when asked to draw or hold a pencil, he writes with palmar-supinate grasp. When asked to report what he has done, he struggles with pronunciation of words, and often times cannot be understood. Nevertheless, he tries to express himself but is a little shy with strangers. Moreover, he misses to name things at times, and points at them instead. His sentences are wrongly constructed, and even though taught the proper way, repeatedly makes wrong word order, which results in being misunderstood especially by visitors and playmates. II. Support and Resources Needed The situation of the boy calls for the services of a speech therapist. Immediate assistance may be necessary to correct the problem. Likewise, relearning of sounds and acquisition may also help to alleviate problems with