Expert: James Michael Roan - 11/11/2008

Question
QUESTION: HI James,
I have been concerned about son almost since birth.  He is now 8 months old (next week) and my concerns continue.  He seems to be meeting motor milestones okay (although he does not yet crawl, nor can he get to sitting from his stomach.  Otherwise, he sits well, reaches for objects, has reasonable fine motor skills, etc.  The problem is social/emotional.  He has never reciprocated anything verbally with me.  He does vocalize, some consonants but mostly vowel sounds.  he says da-da and maybe ma-ma although these articulations are not in any way directed and usually occur during play. He rarely smiles in response to my smile.  He actually seems to smile less frequently than he did in the past, although he has never been very smiley.  He laughs rarely, but will laugh when tickled and occasionally when you say something in a funny voice (this is usually only when he is tired, though).  He will respond to his name, or my voice, if i walk into a room, but he does not do so during an interaction.  Specifically, if i am sitting in a chair and he is playing with an object, I can call him forever and he won't bother to look. Also, if I am showing him and object, he will not really look back at me.  He might, but just often he will not.  I will say, look at the duck and he will look, but won't look back at me.  His eye contact is not great.  He seems to like looking at me from across the room more than he does close up.  It is the name thing that really haunts me and the lack of shared attention.

ANSWER: Hi Stephanie;

I also share your same concerns. It is impossible with the information I have thus far to determine if it is autism or simply a social delay. In any case I would recommend you read up on Stanley Greenspan's DIR Floortime Model for establishing joint attention.

Also, if you live in the U.S., contact the special education or special services department in your school district. They are responsible for assessing, and if he qualifies, providing therapy at no cost to you.

Please comment on if he has any sensory obsessions such as running water, finger flicking at the sides of his eyes, and zoning completely out in front of the television. Any and all information you can give me will help me better address your concerns.

Kind regards,
James







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: Thank you for your quick response.  He has never seen television, so I can't speak to whether or not he zones out.  Although I will catch him zoning out once in a while at nothing.  Just not focusing his eyes.  He is not having a seizure, though, I am sure because if you approach him he will snap out of it.  I have not noticed finger flicking, although he does stare at his hands and will sometimes flap them open and closed (as in bye-bye).  He also has started--just three days ago--a very bizarre head shaking thing. He shakes his head in a "no" motion with the face tilted slightly toward the ceiling.  I am not currently in the United States, but I could move there to look into services.

Answer



Hi Stephanie;

I suggest you have evaluated by a team or someone expert in the area of autism. Meanwhile, read up on the DIR Floortime model. It has been validated through research as an effective means of establishing joint attention. At this point, therapy is more important than a diagnosis, which will be VERY hard to get at this age.

He's very young and will respond well to social therapies whether he has autism or a social delay.

Kind regards,
James









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.