Expert: James Michael Roan - 5/25/2007

Question
QUESTION: Hi,
I have a 19 month old daughter who has a provisional diagnosis of autism.  We had her evaluated at 15 months for some concerns.  She would not always turn when we called her name, she was spinning herself in circles (not excessively), she pushes down on her diaper when in her highchair or carseat until her face turns reds and she sometimes grunts while doing it, and she had not started talking.  She is now receiving ABA therapy and has made many improvements.  She has always been very affectionate with my husband and me and she does interact with kids her age.  Her eye contact has improved greatly and she says a few words, bubbles, water, and go.  She pretends to talk on the phone sometimes and tries to give her stuffed animals water from her sippy cup.  She points and gestures for things she wants and is very verbal (although we can't understand most of it.) She does not spin in circles anymore but she does like to tap objects on the floor or she will tap them together while holding one in each hand.  She has just started bringing things to us such as books to read, etc. She also follows simple commands and has excellent receptive skills. She does not line up objects, or bang her head.  She laughs a lot and is generally a happy little girl.  Do you think it's possible that it could just be a delay?  We are planning on continuing the early intervention therapy until she is 3 (or hopefully, longer).  Thanks for listening!
Melissa

ANSWER: Hi Melissa;

It's great to hear that your daughter is doing so well. If your daughter does, in fact, have autism it is most likely high functioning autism. I have personally witnessed children make unbelievable improvements with early intervention. If your daughter does have autism, she will always struggle with social thinking and relationships. On the other hand, children with expressive language delays often look like children with autism. It is also possible she has been misdiagnosed.

Does she point to objects or activities in a desire to "share" them with you? What is the quality of her eye contact? Are you able to establish shared attention on a toy or activity?

Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: Hi James,
Thanks for your reply. To answer your questions...She sometimes points to things so that we will look, but sometimes she will just point randomly to something that interests her.  Her eye contact is much improved. It is definitely better with my husband and not as good with other people, but she's getting better.  Yes, we are able to establish shared attention on a toy or activity.  She plays with toys appropriately and doesn't just focus on one aspect of a toy.  We too think that if it's autism she is high functioning.  We'll keep our fingers crossed.  Thanks again for your comments.
Take care,
Melissa

Answer
Hi Melissa;

My guess is she is what we call "subclinical Asperger's Sydrome," meaning that (thanks to you getting services early) she no longer would meet diagnostic criteria for autism or Asperger's Syndrome. Her improvement also supports an average or better intellectual ability, which indicates a very good prognosis for her. Don't stop with the language and intervention services. It is estimated that over 60 percent of children under age 6 would benefit from them socially and linguistically.

Have fun with her. My little girl graduates from high school next week. In a "blink of the eye" they are gone.

Stay in touch if she presents with any more unusual behaviors.

Kindest regards,
James