Expert: James Michael Roan - 3/28/2009

Question
QUESTION: My 23 month old son has a number of issues going on and I would like any & all comments, thoughts on the matter.  Here is an overview:
Good stuff:
-walked at 11 months
-good eye contact
-says about 70 words
-does pretend play, such as feeding stuffed animals with bottle
-uses toys appropriately
-reaches for things when he wants them
-likes peek a boo and playing games
-likes to hand us sticks, pinecones when walking outside
-likes to imitate sounds and some faces I make
-gives hugs (maybe 1 to 2 a day)
-does not like to be held much, but says "uppy" when wants to be held.

misc:
-loves music unusual amount of concentration on music; sometimes calms him

worrisome:
-suspected seizures since he was young. Eyes used to roll up briefly. This seemed to stop; and then a few weeks ago did not wake up on time & I came in and he was limp. Slowly came out of his haze.
-stims (some eye stimming mostly at mealtimes); presses on eyes sometimes, stares closely at blinking lights etc.
-runs repetitively back n' forth past vertical lines, gates, fences etc.
-runs around edges of room when in overwhelming situation--like a party; seems anxious
-smiles at other children but rarely approaches
-does not point
-does not ask for anything
-not sure if he follows my point/hard to tell. I think he does 1/2 the time.
-does not follow multiple step directions, such as pick up ball bring to mommy. Will however grab a stuffed animal if you say "Where's monkey, where's cow? etc"
-does not for the most part say mommy daddy
-cannot say any two word phrases yet, except "up down" and a few names of songs

medical:
-had antibiotics once for sinus infection got rash afterwards for 5 days


What we've done:
Scheduled him for EI screening
Put him on GFCF diet
Scheduled him for 72-hour EEG
Increased routines around bedtime/naptime etc.


What do you think???  What else can we do. We are sick with worry.


ANSWER: Hi Diane;

You are doing all the right stuff. I'll venture to guess he may qualify for services through EI. I strongly suggest you purchase a book on Stanley Greenspan's "DIR Floortime." This technique has been vindicated and validated in the research for establishing the foundation of social behavior: joint attention.

On the autism front, don't worry. If he has an autism spectrum disorder it sounds, from your description, that it is mild.








James Roan Bio:

James Roan (roanpsych@gmail.com) has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disability and with enforcement of their rights. James Roan was the consulting psychologist responsible for many of the autism and ADHD screening tools and other content for www.accessspecialneeds.com. James Roan consulted with the graduate department of the Waterford Institute of Technology in the development of their graduate program for the certification of private autism tutors.

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

QUESTION: Dear Dr. Roan, My son has now been in EI for almost 5 months and is almost 28 months old. He is heavily sensory seeking (stomping, wants pillows piled on him etc.) His eye contact has improved & communication has improved dramatically, both receptive and expressive. Our D.A.N. doctor has him on MB12 shots & nystatin. He now wants to give him gentamicin for an overgrowth of klebsiella and enterobacta bacterias (based on stool). Is this safe? We are terrified to give him an antiobiotic.  Since he was on nystatin his stool has been fully formed for the first time in his life. Could the bacteria naturally clear out without this antibiotic. He also wants to have our son do a DMSA test and collect urine for 6 hours to test for heavy metals. How safe do you think this is? thanks very much in advance for your help. We love our son very much.

Diane

Answer
Hi Diane;

Good to hear from you again. I am not qualified to answer all your questions, however, it is general knowledge that most children on the spectrum respond VERY negatively to antibiotics often resulting in seizures and increasing severity of autism. I would proceed with great caution. You should consult with an environmental physician expert in dealing with heavy metals and autism.

How severe is your son's autism? Has he been assessed properly?

Kind regards,
Jim



Disclaimer:

While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find our resources useful.


Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting psychologist responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.