Expert: Dr. Sharon A. Mitchell - 11/23/2008

Question
I have a 9 month old son who i suspect may have Aspergers.  I know he is very young, but he has horrible tantrums, cannot break his routine, doesn't listen to me calling him at times and is not yet eating baby food. Otherwise he is right on developmentally. He is being sent to an OT this week for his eating, but i am concerned there is a deeper issue.  He crys hours on end and refuses to drink his milk until the "right" person comes to feed him, only them will he eat. His behavior is eccentric and it worries me, yet he loves people and other kids. Any advice on if i should seek other help or if it is normal would be appreciated. thank you very much, Emily

Answer
Hi Emily,

Tantrums and crying for hours can be very hard on the parents, can't it?

You're right though. Age nine months is too young to diagnose Asperger's. One of the criteria for an Asperger diagnosis is that the child is not delayed in acquiring spoken language. Since it's rare for nine month olds to have a good speaking vocabulary, a diagnosis of Asperger's would be impossible yet.

You're doing the right thing for you son right now. While many youngsters at this age are still nursing or taking a bottle, many would be willing to take some foods by mouth by this age. Seeing an OT is a good idea. OT's can help with feeding and swallowing issues. And if your son is bothered by tastes/textures in his mouth, an OT can be helpful in ways to introduce foods and to desensitize his mouth.

As for an autism spectrum disorder, it's hard to venture an opinion without seeing the child and based just on the information you presented.

If you're concerned, I never think it hurts to consult with a physician. If you're wrong, then you'll be relieved. If there is suspicion of autism or some other condition, then you'll be armed with information and can begin helping.

A physical check-up never goes amiss. It would be important to mention to the physician or nurse your concerns about hand flapping and head banging. Other things, such as recurring ear infections could be affecting the child.

But at just under one year of age, it may be difficult to make a definite diagnosis about his development.

Without directly observing your child, it's very hard to give an opinion on if you should worry or not. My advice to you is to take your concerns to your public health nurse, pediatrician or Speech Language Pathologist.

But before going, you may feel better prepared if you first read up on the wide variations of what is considered "normal" for a child of your son's age. Even though we expect kids at certain ages to do certain things, there is a range and no two children develop at exactly the same stages.

Here are some sites that talk about typical physical milestones:

http://www.med.umich.edu/1libr/yourchild/devmile.htm

http://www.nncc.org/Child.Dev/ages.stages.12m.18m.html

http://parenting.ivillage.com/tp/tpdevelopment/topics/0,,4rwc,00.html

Below are a few websites that can help you sort out what is within the normal speech/language parameters for a child your son's age. Armed with this information, you can then speak to a public health nurse, pediatrician or speech/language specialist.

http://www.asha.org/public/speech/development/child_hear_talk.htm

http://www.comeunity.com/disability/speech/milestones.html

http://www.ldonline.org/article/6313

Even without professional guidance, there is a lot parents can do to help their child's developing communication and socialization skills. You'll find some suggestions here:  

http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm

http://www.hsdc.org/News/Speech/encourage.htm

If after looking at this developmental information,you're still concerned, I think you should speak to a Speech/Language Pathologist (SLP) to get the best advice. If you live in the United States, you can find a local Speech/Language Pathologist through this site:

http://www.asha.org/proserv/

In Canada, try here: http://www.caslpa.ca/english/profession/find.asp

For other countries and general information on finding SLP help, check out this site:  http://members.tripod.com/Caroline_Bowen/find-slp.htm

While an SLP might be one of the first professionals you want to see, a developmental pediatrician or child psychologist might also be helpful.

Below are two versions of a Checklist for Autism in Toddlers that your physician might use. It may be helpful for you to look them over to get an idea of what sorts of things a diagnostician may look for. The first link explains a bit more about the CHAT:

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=128&a=2226

http://depts.washington.edu/dataproj/chat.html

http://www.utmem.edu/pediatrics/general/clinical/m-chat.pdf

Sharon A. Mitchell, B.A., B.Ed., M.A.
www.autismsite.ca