Expert: James Michael Roan - 11/4/2007

Question
Hi James,

I have a 13 month old boy.  He has had severe reflux since he was born and is still being medicated for it.  When he turned 9 months, we went in to our wellness exam and the pediatrician asked if he was making eye-contact with us.  I paused and said - no, not really.  At that moment, a little alarm went off in my head.  My pediatrician thinks that he is too young to really diagnose at this moment but these are his symptoms/behaviors:

*  he does not respond to voices (adult)
*  he does respond to children.  He will chase other kids and will look at them.
*  he does not make eye contact with us the majority of the time.  However, he will from time to time (getting him out of his crib, bath time, and during random parts of the day)
*  He will play peek-a-boo and will chase me if I really get in front of him and make it a point to run away and say "Where's Mama".
*  Most of the time, however, he will not respond or look my way even if my face is right in front of his.
*  He started walking about 2 months ago and he paces quite a bit - he goes back and forth from our living room to our kitchen(back and forth, back and forth).  He usually likes to hold a small item in each hand when he does it.
*  He shudders (upper body and face tenses and shakes) when he is angry, frustrated or while he is pacing.  We took him to the hospital and a neurologist had a 24 hour electrode type test done on him to look for seizures - but he came out fine.  This seems to be voluntary - I think.
*  He does not share with us or engage us to play with him.  
*  He does spin wheels on his trucks - but for no more than 20 seconds - he then gets bored and walks over to another toy (I'm not sure if this is normal).
* He doesn't talk, point or wave bye bye.
* He does come over to me and raise his arms (and looks up at me) when he wants to be picked up.

I'm probably missing some items but as you can probably sense - there are things that he does that are great and then many others that are worrisome.  I've been doing some research and think that he may fall under PDDNOS.  Is 13 months too young to diagnose?  Are there time when children are delayed from a social development perspective only to "mature" normally?  I am thinking about finding a developmental pediatrician to take him to now rather than waiting.

Please let me know your thoughts.

Thanks.

P

Answer
Hi Patty;

You have done your research. I would definitely follow up with an autism evaluation as soon as possible so you can start early intervention services. Please keep in mind I do not diagnose over the the Internet, but your son is at risk for an autism spectrum disorder (ASD) probably in the Mild range, such as PDD-NOS. You'll have to look for a team who specializes in ASDs and who are comfortable assessing a young child. I suggest you look at Children's Hospitals and local universities near you. I also suggest you call your school district's special education department for information on where to get Early Intervention (Birth-to-Three)services. They are not cost to you.

Children with social delays do not grow out of them, however, with appropriate early intervention, they can learn strategies for coping with the social world and actually blend in. In fact, we all learn how to "blend in" when you think about it! After a while of reading and learning about social development, you will begin to identify family members and/or coworkers who may be on the spectrum. Children stand out from their peers so much because they have not yet learned what to do to blend in.

I hope this helps.

Kind regards,
James