I have a girl who is already 6 years old, going to attend Kindergarten 2 next year, together with once a week speech therapy support. She started with us when she was about 5 years old, and have attended Kindergarten 1, with twice a week speech therapy and once a week occupational therapy support in the past year. She is not diagnosed and did not attend any therapy previously.

The teachers are all worried about her because she is really SLOW. Prior to her intervention program with us, she was observed to be unaware of lip closure and she used to drool because of this. Now after 1 year of ST + OT support, she no longer drools. She is also quite talkative (but her speech lacks variety and details), and has all the foundation learning skills (e.g., writing, phonics, etc.). However, she always looks absent-minded, and does not do anything if not pushed or reminded by the teacher. Since she does not speak up in the class at all, the teacher does not know if she understands certain concepts.

She is also naturally anxious, according to our ST, even if she knows something, she has to get absolute assurance that she is correct, she refuses to say it out loud if no assurance is given.

She is able to write well, but her major concern is the speed of doing things. She usually takes more than 1 hour to complete one meal, be it individually or in a group (individual performance is slightly better). We tried to condition her but it did not work, she does not initiate any reaction even if she is hungry and deprived (and of course parents would not allow that to happen). She starts to cry badly if she is scolded or forced, and only babbles one thing when crying "I want mama". She is not yet off diaper, because she cannot control the bowl and bladder movement well, and still does not spontaneously indicate the needs to toilet. Even after a long-winded toilet training, she still passes urine in class occasionally. She is able to mingle with friends but refuses most gross motor activities or games by keeping telling us that she "cannot do".

I think she is within the average intellectually, but we are all worried that she can no longer keep up with the pace of the class if the academic learning gets heavier. Given her anxious nature, we are also worried that she might "shut down" even more in the future, when she notice the difference between herself and the peers.

Any experts or experienced professional could please give some advice on what exactly is her problem, and how to better help her? Thank you for your help.