In general when it comes to therapy you want both short and long term goals. And if a child isn't making progress in 3 months it's time to reevaluate therapy, therapist, and or even diagnosis.

As some pointed out it's possible the therapy isn't appropriate for your child- and this is why definitive diagnosis is so key. Does your child have autism? Does your child have apraxia? Does your child have autism and apraxia? Those are very important questions because while there is a great amount of awareness for autism- which is typically treated with a behavioral approach- there isn't so much awareness about apraxia, a motor planning impairment that is also neurologically based. Like autism -apraxia typicaly coexists with "soft signs" such as sensory processing disorder, motor and/or weakness issues in the body. Here is some parent friendly info on apraxia http://www.cherabfoundation.org/2006/parent-fri... It's very common for children with autism to have underlying and typically undiagnosed speech impairments in addition to autism. Apraxia appears to be a common impairment that coexists with autism which is why I mention it. But some have dysarthria instead or as well for example. While motor planning therapies would be key for apraxia -strengthening therapies would be key for dysarthria. Again accurate diagnosis is key so you can seek appropriate therapy.

What you shared is a real red flag to me - the fact he's doing better outside of therapy. In particular what stood out to me is fact you say he had "intent" to speak outside of therapy. While it's true that some speech therapies may be ineffective to address autism- one should also be aware that ABA can be highly inappropriate to address a motor planning impairment. If a child has both apraxia and autism -the ABA needs to be modified so as not to be used to address the motor planning impairment. To understand why this is so key -with apraxia the impairment is the inability to perform on command -so the more they would want to say or do something -the less likely they are able to if they feel stressed to do so.

I'd seek at least 2 opinions from private SLPs. In addition to an SLP/OT for preschool aged children I highly recommend an evaluation by either a pediatric neurologist or developmental pediatrician. This page may help you in securing insurance coverage http://pursuitofresearch.org/2012/07/10/insuran... I'd use support groups (online or in person) to see if you can get names of professionals that others recommend in your area. You'll know who's good typically because you'll have to wait to get in to see them! But it's so worth it.

Again in order to know if you are advocating for appropriate therapy and placement -you first need to know diagnosis is accurate.

I have a 5 years with ASD. I had him in speech therapy twice a week in Pre-K (Tuesday & Thursday) , Wednesday occupational & additional speech therapy, & Thursdays private speech. I recently had to stop the private therapy because I felt it was too much on him but also I felt as if every time we went he was basically doing the same thing. For 30 minutes he was basically throwing a tantrum & not getting anything accomplished. At 1st he liked it but I think he got comfortable & felt as if he can do what he wanted & not work. He's nonverbal. Maybe give your son a little break but keep working with him at home. My son does better working one on one rather than in groups. In class he doesn't say much but in therapy with just the therapist he says a little more. He's not a shy kid he just does better in a smaller setting.

I would try a different therapist to see if he responds any better.

Hi Elizabeth! I'm a parent of 2 children who were both special needs and co authored the book The Late Talker with one of my children's neurodevelopmental pediatricians. I run the Cherab Foundation http://www.cherabfoundation.org/ and apraxia.org and have been outreaching for over a decade now :D My boys are today 17 and 19 and doing amazing -so just want to help others because I know what it's like to be given a poor prognosis- and it's so worth fighting (advocating) for your child- especially when they are younger -but any time. There really is so much hope from what I've seen. The fact you are in school and in a group like this to learn more tells me you are going to be one awesome special education teacher!!!!

One thing I did was I gave my kid a break. He had ABA 6. days a week for 2 hours. then we cut back to 3 a week and responds better that way. Another us we try to take what he is into and incorporated to his therapy. He loves it. Also, we understand that his out put is nothing nearly as his input. He understands a lot more than what he gives out! What I do when I see he is not in the mood to participate I talk to him and tell him like after this we can grab some pizza or tell him it will make us happy if you make this work today so we can watch you favorite movie or get to the park. Sooner than later I slowly pull back and now we are at a point I tell him, " look honey, you have to do this. This is for you not me. We all need help to do things and we all have to get it together to be able to say I want pizza please or when we are lost we can point and say this is my home or address. We all have things to do. One day this will be behind us once you do so much better and follow through. Its hard, but baby steps babe" Man, its hard, but this is how we do it. Also with a little candy sometimes and he makes it work. He has grown so much. Hope this helps hugs! BTW my kid is stubborn too so fights and stuggles will come, but just he patient slow and understanding and ask how dose he feel about what you just said or say ok. They will eventually come around with your help too.