Expert: James Michael Roan - 6/26/2006

Question





Answer -
Hi Cheryl;

In autism we are primarily looking at social delays or even social aversion in some cases. The behaviors you describe can also fit an expressive language delay. If you suspect autism you want to know now, not in the future.

I suggest you first download the M-CHAT from here:
http://www.firstsigns.org/downloads/m-chat.PDF

Then get the scoring guide here:
http://www.firstsigns.org/downloads/m-chat_scoring.PDF

If there is any risk noted, you can contact me again to discuss the results. In any case you want to do two things:

1. If you live in the U.S. make a referral to the special education department in your home school district, and

2. Arrange an appointment with a university autism unit or an autism team at the nearest Children's Hospital for an evaluation. If need be, you can get the referral fro your pediatrician using the results of the M-CHAT.

Of course, you can discuss the results first with me if you like.

Actually, the autism doesn't get worse, just the symptomology. With "regressive type" autism, a child develops completely normally until around 2 1/2 to 3, then the child loses speech, social skills and eye contact. This usually correlates to an extreme reaction to infection or antibiotics. It is much less common than the normal course of development. Your son DOES NOT appear to follow the regressive type pattern.

If your son scores in any area of risk on the M-CHAT, take it with you to your pediatrician and get that referral for an expert team. Early intervention makes a HUGE difference in the life of a child on the autism spectrum.

Kind Regards,
James

Thank you. I answered the questions. He "failed" 11. (5,6,7,9,13,15,17,19,21,22,23) Could it still possibly be only a delay in expressive language?
I am taking my son back to Children's Hospital for a follow-up in 4 months. We also have people from the Alliance for Infants and Children coming to our home to evaluate him. The doctor from Children's Hospital is going to request that the Alliance send someone out 4 times per week. Twice for speech, and twice for development. At this point, is that enough, or should I push for more help? It seems everything will be in the hands of the Alliance.

Answer -
Hi Cheryl;

You have done enough! I responded to a shorter email, so I will add just a little here. This my advice for the meantime: Play with your baby all you can. Exaggerate voice and expression in all of your communications with him and others when he is near. Some children, who are low socially are that way because they don't, for unknown reasons, pick up naturally on the the subtle cues of communication such as vocal intonation (prosody), facial expression, body language, and most importantly later, the communication in the eyes (see Simon Baron-Cohen for this info in depth).

I was talking this summer with a wonderful young man suspected of having Asperger's Syndrome. I told him I was going so show him pictures of peoples' eyes and his job was to tell me what emotion they were conveying. He responded with: "That's silly! Everyone knows that there is no information or emotional expression in peoples' eyes!" My point here is that this intelligent boy appeared typical in every respect. He had many social problems around peers. He lacked many social skills that typical children have developed by the age of 4. These skills did not come naturally to him so now they have to be taught. It's tough but it is done every day. Knowing that your son may have similar problems in naturally acquiring social skills and knowledge, teach them to him. Encourage all verbal and nonverbal communication skills. Try sign language with him. The research says it facilitates verbal and nonverbal communication skills. Sign while talking to him.

Take care and I wish you both the best.

Kind Regards,
James

Hello again. Thank you so much for your help. There is a lot of info out there on autism, but so many variables, it gets hard to figure out what applies in each situation. My only other question, for now, is should I push for a diagnosis?
The doctor at Children's said that they don't like to diagnose/label kids this young, unless they have to, to get them services. I guess he will be getting all that is available through the Alliance. Should there be more?

Answer
Hi  Cheryl;

Let me know when you can what, specifically, the Alliance will be doing for your son. Then I can give you a better answer. Yes there is a lot of stuff out there, however, there is a lot of overlap. It took me years to navigate through it all.

As far as pushing for a diagnosis, it depends whether or not you need the diagnosis to get services. Again, it depends what the Alliance actually comes up with.

Kind Regards,
James