Expert: Trey McGowan - 10/5/2007

Question
Greetings,
My question may seem a little hyper-active mommy, but with all the press surrounding autism lately I am so worried.  My son is a happy and very healthy 17 month-old.  He has always been a little big, almost 11lbs at birth and now 30+ and tall.  He speaks over 100 clear words and some short phrases, does some color recognition and loves to dance to music and have books read to him.  He refers to myself and my husband by our names (mommy and daddy) and points to items of interest, labels almost everything and wants to involve us in his play.  Here are my concerns: he toe walks...I'd say about 50% of the time now (he has been walking since 12 months and this just started recently), he likes to stand with his head to the floor for a few minutes (maybe a few times a day), he shakes his head when tired (I took him to the ped for this at 10 months and she said she thought it was a self-soothing method), he is sometimes a little aggressive (hitting when mad and sometimes pushing smaller peers out of the way), he rarely has temper tantrums and he loves to ask for hugs and nanas (he still nurses).  I think that is all, but the toe walking and some of the other physical things worry me (he also occasionally flaps arms when very excited, but that seems to have subsided).  Any info would so be appreciated and if you have any ?s that I haven't covered, please ask.
Best

Answer
Hello, Amanda!

I look over what you're explaining and indeed, there are some autistic traits. However, simply showing a trait or two doesn't mean 'autism'. Even neurotypical children often show some signs, and even if there are a few unusual traits, the effect may be minimal on their development in education and social areas. And really, that's the biggest point of concern in autism.

The toe-walking, head-touching, and head-shaking are definitely sensory stimulus, or 'stimming' as they tend to be known in the ASD community. They are because these things cause sensory input that the child either finds pleasurable, or that 'ground' him. They are, indeed, possible signs of ASD, and something to keep an eye on in case they further develop, but in and of themselves they aren't a danger to the child. Consider them eccentricities, rather than freakouts.

The hitting is a very common, and indeed *normal*, aspect of growing up with a lot of children, and though it should very definitely be discouraged, it's not something that you should be seeing as a big red 'warning' label. Not unless it continues, or it seems to be extremely out of control.

Now, don't get me wrong: when I say it's normal, and that you shouldn't worry, I don't mean 'let him hit all he wants' (and I'm sure that you've considered it but I like to cover bases). The earlier you start teaching them that hitting isn't an appropriate reaction, the sooner they will begin to learn this. Discipline is a *must*. Not necessarily by spanking (it's hard to teach that hitting is wrong when you hit to punish, after all; save it for when he's older and can comprehend the difference) but through making sure he understands that hitting is not a good way to say he disapproves of something. The sooner it's dealt with, the less chance it will stick as a habit and the less chance he will lash out in later life. Whether or not he has an ASD, it's definitely a habit that should be curbed in one way or another!

As I say often, I'm not an actual doctor. Please, *please* don't take my word as gospel. I haven't witnessed the child and I haven't got a good feel on what other aspects there might be (eye contact, learning ability/disability, peer relationships, et cetera). I definitely feel strongly that your child is happy, healthy, and just a little unusual in his ways of enjoying himself. Now, it may well be that getting him to a doctor and having him tested officially may find differently. There's only so much that can be done through typing, after all. So if you are genuinely worried, then a specialist would be best to calm your worries. However, from what you have said here, I think the normalcy (if you will excuse the term) far outweighs the 'odd' body habits. In other words, everything seems fine!

If you can think of anything else that you need to ask, feel free to do so! Hopefully I was able to reassure you.

Trey