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Sub q should in theory give close to 100% bioavailability, but we really dont know the one PK study never tested it, so theres no measured number and no dosing conversion behind it

Mild side effects may include injection site irritation, water retention, or fatigue

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Surgery for neuroma pain is a last resort that involves decompressing and sometimes removing the painful abnormal nerve branch

The short answer is Until you are satisfied with improvements in communication and the treatment no longer seems to be helping. Another useful response is, Consider discontinuing mB12 when stimming becomes more disruptive than language acquisition. I find it peculiar that parents pose this question at all