Expert: James Michael Roan - 1/13/2008

Question
My 20 month old son has many good skills.  He has between 15-20 words....like up, hi, thank you, ball, bubble, nose, mouth, moo (for cow), Mama, Daddy, etc.  He was a late walker but he was a very large baby...so motor skills seem to come late for him.  He eats with a spoon..learning how to scoop.  He stacks blocks, scribbles, loves being read to, pretends to talk on the phone/ comb his hair/ sweep, and is a very loving child.  He sometimes imitates actions and words.  He always watches other children when we are out.  My concerns are....he only points to my facial body parts and to a ball in a book.  He follows occasional directions but nothing consistent.  He never points to something he wants...and usually the only request he makes is "up".  He will play simple games and is appropriate with toys.  He can have a temper but nothing lasts for more than a few seconds.  I know I am all over the place with my thoughts and I apologize.  In your opinion, are these typical 20 month old behaviors...or should we consider having him evaluated?

Answer
Hi Kristy;

He sounds pretty typical (normal) to me. Yes, he should be pointing by now, however, in autism we are looking at a group of behaviors.  How is he socially? I suggest you go to my web page at: http://www.autismspectrumdisorderfoundation.org/
and download the M-CHAT and Scoring at the bottom of the page. If he is at risk for autism according to the scoring, then send me details regarding the items he failed.

Kind regards,
James