Expert: James Michael Roan - 1/15/2008

Question
QUESTION: My son just turned 3 years old and he has no speech.  He speaks only sounds and some words.  He has severe reflux and has had it ever since he was a baby.  His social skills are okay and his fine motor skills are okay but not great.  He is lovable and makes great eye contact which I am hearing an autistic child can do also regardless of what is said.  I am worried about him.  My pediatrician feels he is on the spectrum but my Occupational therapiat and speech therapst don't agree.  The speech therapist believes he has no speech because we always give into his cries for things.  He got used to that and that is all that he does.  She said some tough love should stop that.  My O.T. lady believes that it is sensory issues.  In my heart I don't believe he is autistic but he does make a humming noice to either sooth himself from the reflux or when he is bored and flaps his hands occasionally which my advanced 1 and a half year old does when she is excited also.  we can't figure it out.  Please help me as much as you can.

ANSWER: Hi Gina;

Firstly, giving into a child's needs will not prevent speech acquisition. He needs therapy not tough love. As far as the possibility of autism, go to my website at: www.autismspectrumdisorderfoundation.org and complete the M-CHAT at the bottom of the page and score it as well. If there is any risk for autism noted, send me detailed responses to the questions. I can tell you what to next from there. What country do you live in?

Kind regards,
James

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

QUESTION: I live in the U.S.  He failed the pointing question #7 and #15.  Also, I put a "no" for the imatating question.  he will imitate but not all the time and exactly what you do. As for the pointing, he will gesture to what he wants but it won't be a point.  Sometimes he will push me in the kitchen to the snack cabinet for example.  Otherwise he will cry until I figure it out.  That was it on there for the critical.  He has come along way since he has been on the reflux medication.  Back when he would have failed alot on the test but not anymore.  What do you think about the humming noise and occasional excited hand flapping?  I just don't know what to do from here.  Was this enough info?

ANSWER: Hi Gina;

First, ask your pediatrician for a referral to an autism team. They have them at universities and Children's Hospitals. What is most important is early intervention. It makes all the difference in the world. You can get that by calling the special education department in the school district in which you live and make a special education referral. Note that you suspect autism and want a full evaluation for speech and language, autism, sensory, motor skills, and social development.

Please don't jump to the conclusion that I think your son is autistic. I don't have enough data to make that call. I do have enough information to recommend you follow this up as soon as you can.

I don't have an opinion on the humming, but, as you know, hand flapping is often associated with autism. It also occurs in in about 20 percent of typically developing children also.

Let me know if I can help further.

Kind regards,
James

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

QUESTION: Thanks.  His pediatrician did make the referral to us but we are waiting because I have him in the early intervention now and will continue it. Would there be anything that would stand out that would assure me that he is or isn't autistic.  I have been told the eye contact which he has excellent eye contact. I have him in 4 different social classes.  One he goes to without me for his independence.  The other is music and free play.  I was just hoping you would be able to tell me if you thought that there was a strong possilbility that he is autistic or not.  I understand though. If there is any more advice or if you have an answer to my question please reply.  If not, thanks for your help.

Answer
Hi Gina;

Please remember, I am not diagnosing just providing opinion and information. I have heard enough from you about his behavior that leads me to believe he should be evaluated for autism. Unfortunately, I am unable to observe him in order to know for sure. You are on the right path and his early intervention services will work wonders for him.

Kind regards,
James