Expert: James Michael Roan - 2/20/2007

Question
This is going to be long! :)

I have seom concerns over my 18 month old son. The history is important-as he was adopted from Africa. He was bron with an inguial hernia, and since it was a potemtially dangerous condition, the orphanage put him in the infirmary (there is an over night nurse if needed) rather than with the general population. This place was like solitary confinement! No windows, no toys, no music, and barely the size of a closet! The other babies n there were sick and it was a quiet room aside from a crying child.

Wefoud him at 7.5 months, and for his entire life up to that poinnt, he had been flat on his back in a tiny cot staring at a white ceiling. During the 3 months it took for us to get all legal work done for him, we had him in a provate room with a private nure, and lots of stimulating toys. When we cam back, he was MUCh more interactive. Prior to this, he just kind of stared  had his tongue out a lot, and barely smiled. When we saw him at9 months, he was sitting up (we had his hernia repared), playing with toys, and smiling! We brought him hime at 9.5 months.

he was a late crawler (11 months) and in general a good baby, but as time goes on, we notcied some "red flags" for autism and so we had him evalled by Early intervention at 14 months. He didnt qualify for services.

the first time we called EI was becase he wasnt walking, talking, pointing, waving, feeding himself or meetig any of the other milestones. By the tiem the therapists arrived 3 weeks later, he was waving, clapping, feeding himself cheerios, and babbling, but not using any words consistently.

anyway, since that EI, we felt pretty good about our son, but recetly, I have noticed some things that are "off" and my fears about autsim have rturned.


At almost 18 months, he still doesnt have any words and his receptive language skills arent great. He can do MANY things, but only when HE wants to, such as clapping hands, stomping feet, getting a toy etc.

He almost aways has something in his hand and he loves to wander and explore the house. He could pace aroudn the first floor all day if we let him! He will open the kitchen cabinets, unroll the paper towel, and jump around!

Aydin babbles, however he still does not have any words at almost 18 months (he occasionally says "Mom mom mom" when calling me. He never really pointed at things, except in books or on dolls etc. he learned to wave bye bye and clap his hands, but now only does it occasionally. When i sing the "clap you hands" song, he will take MY hands ad clap them together, rather than his own. Same thing with "insy winsy spider", he will make my fingers do the walking, altho he does copy my fingers at times, but doesnt put them together on his own.

He learned how to do the "So Big" hands and he will still do this.

He LOVES music and playing peek a boo. He LOVES Backyardigans, and when we put it on (twice a week at most) he will jump and laugh and "talk" to the TV. When we turn of the TV, he will try to turn it back on by pushing the ON button, so we disabled the front panel, and he will now bring me the remote and shove it in my face letting me know he WANTS TV. So he is able to communicate his wants in his own way.

As for communicating, he will look at things he wants such as a drink, or food, or the remote and say "oooooh". He does not point for the most part. He can be independent when he wants to and will pick up food from a bowl or plate and eat himself.

he knows how to use a spoon, fork, and sippy cups and straw cups. He can also finger feed, and recently has been able to take bites of food as oopposed to shoving the whoe thing in hismouth.

As far as playing goes, he has some things that he plays with, he LOVES those FP learning tables, and he can throw and pick up a ball. If i tell himmto give me the ball however, he rarely does this.

He undestands a lot, as in if i say "im going to tickle your tummy" he will grab his tummy and giggle. If i say "lets go" he will follow.

There are times when he DOESNT respond to his name, but for the most part, he does.

Once he started walking at 15.5 months, he never stopped! He will walk all around the house all day if we let him! He doesnt have a destination (that i know of) but he will walk up and down the hall, around the kitchen, open cabinets, and walk around the fam room etc. exploring everything.

He almost always wants to be holding onto something, especially if it has something "Dangly" (think a work badge, a toy with floppy legs/arms, anthing with string or a cord) so that he can shake it.

He is a very loving kid and loves to give hugs and kisses. He is excited to see either me or dh when we pick him up from daycare. He makes good eye contact, and he smiles a lot.

Also wanted to add that we adopted a baby girl the exact same age and are raising them as twins. She was showered wit attention and is right on target if not ahead in all areas, so at times I wonder if she overshadows her brother...

cann you please let me know if these are major concerns and if it soudn like autism, or if it is more of a delay that will get better with therapy and time?

My major concerns are these:

DS will sometimes tune us out, and will play on his own, seemingly unaware of others in the room. He loves to shake dangly things, and he doesnt communicate verbally.

Things that are positive:

he makes great eye contact, loves to play, loves to smile and laugh. Understands some simple commands. He responds on cue to certain phrases such as "im gonna get you" or "im gonna tickle you" and responds appropriately. He does well with strangers and in new settings. He plays peek a boo, and other nursery tye of hanfd games (pat a cake etc). He knows how to play with most toys, he can throw a ball and retrieve it. He LOVES music! He seems well coordianted (he can jump without holding onto anything) he can climb up and down the stairs, on anf odd the couch etc

anyway, this is a novel, but I am hoping to get some of your insight as I have been reading your resposes to other concered parents as well.
thanks!

Answer
Hi Mom;

Please understand that I do not diagnose over the Internet. If your son has an autism spectrum disorder, it would be on the very high end and perhaps subclinical. I suggest you go to accessspecialneeds.com and log in as a free user. Take the M-CHAT and send detailed results, item-by-item, to me and I'll be better able to counsel you. He sounds very social and nonverbally communicative, so I'm not very worried. He may be suffering from some developmental delay due to understimulation during those first 7 months before you rescued him. He's lucky to have found you.

Kind Regards,
James