Expert: James Michael Roan - 10/3/2008

Question
Hi,
my son is 20 months old and he seems to show signs of slow development and odd behaviors/habits. I would like to enquire whether he does display signs of autism with the following negative and positive traits that we observed:

Negative:
1. When we offered him food that he has never eaten before,  he will react very strongly by shaking his head and refuse to open his mouth; he only eat porridge, cereals and yogurt ,and seldom chew them.
2. During meal time, he will sometime shake his head and refuse to eat the first mouth. However, he relents after a few attempts and subsequently eat with little fuss.
3. He refuse to drink from any bottle other than those with sprout or teats; he reacts very strongly when offered bottle with straws and non-drip.
4. He is afraid of drilling noise, dryer sound, sand, rice, physical fruits and balloons and cried whenever he encountered them
5. He has the habit of venting his anger by banging/slapping his head; sometimes he will slap his head lightly even when he isn’t angry
6.  He seldom wave goodbye at people despite numerous requests to do so
7. He called both of his parents as "mama" but sometimes do utter "papa"
8. He love toy cars and will keep repeating “car”
9. He seldom point at things and do not point at us when we ask him where's "papa" or "mama"
9. He love to mess things up after we have lined / stacked them up nicely though he used to stack blocks when he’s young
10. He has very limited vocabulary; the only words he speaks with intent are: "car", "star", “milk” and bubble” (he can point at them and utter the words)
11. He likes to lead our hands to take the things he wanted instead of pointing at it
12. He does not take any interest in other kids except the toys they are holding onto

Positive:
1. He has very good eye contacts and will look straight at us whenever we look at him
2. He will smile at us whenever we smile at him
3. He is very sensitive to the surrounding especially to sounds; he will turn his head to look at where the sound is coming from
4. He will respond to us whenever we call his name, especially when we sound very excited
5. He do wave goodbye to us occasionally
6. He knows how to play peek-a-boo and hide and seek with us, e.g.: my wife will hide in a room and I will ask him where’s mama. He will go and look for her
7. He does understand simple instructions e.g.: he will go to the bathroom when we tell him its bathing time, go to his playpen when we say its sleeping time, etc
8. He responds to certain scene to the cartoons on television; e.g.: prior to a scene showing insects, he will smile at us and say "kaka" (his meaning of insect) even before it appears


Answer
Hi Koh;

Please keep in mind I do not diagnose over the internet.

Your son does show signs of mild autism, but that does not mean he has autism. You will need a formal assessment for that. He also demonstrates some possible oral motor problems that are likely contributing to his speech delay. Let me know if you live in the U.S.. If you do I can provide more direction of what to do next.

Kind regards,
James