Expert: James Michael Roan - 2/20/2008

Question
My son is 17 months old.  I am worried about some of his behaviors. I read a lot about autism and have some concerns:
My son points at objects in books with his index finger. But, whenever he wants to show something or to get our attention to something, he does not point by curling his fingers and sticking out the index finger. Instead he points with hsi whole hand flat and his index finger curved a bit down. So it's like a gesture - but fingers are not curled like in normal pointing. I do notice his index finger curved down a bit....Should I worry.

Also, my son still does not consistently wave bye bye. He does it maybe 5 % of the time that we wave buy buy to someone.

He does not have any stereotypical behaviors or repeated movements.

He does have like 10 word vocabulary - we speak 2 languages at home so he may have speech delay - and we are waiting for an evaluator to write a report.

Lately he started repeating the same word twice (not always but sometimes)...for example, he sees a dog and says "dogie dogie"...

My most important concern is with his pointing - is the fact that when he wants to show something or get our attention to something - that he points with flat hand rather than curved fingers with index sticking out - is that something to worry about?

I did take him to 2 specialists - neurologist and autism clinic director when he was 14 months - who told me I need not worry about anything.

But I am still a concerned mother.
THANKS in advance!!!

Answer
Hi Ally;

Not pointing with the index finger is just one of many behaviors we look for in autism. By itself it means nothing. You can take the CHAT at: http://depts.washington.edu/dataproj/chat.html

Here are the scoring instructions: How is the CHAT scored?
The CHAT is very easy to score. There are five key items: A5 (pretend play), A7 (protodeclarative pointing), Bii (following a point), Biii (pretending) and Biv (producing a point). If a child fails all five key items, they have a high risk of developing autism. Children who fail items A7 and Biv have a medium risk of developing autism.



Red flags for a risk for autism:

6-12 Month Markers:

·   Infrequent eye contact
·   Failure to orient to name
·   Does not smile in response to smiles from others
·   Social and emotional passivity
·   Fixation on objects

By 12 Months:

·   Poor or no eye contact
·   Failure to orient to name
·   Poor imitation
·   No babbling by 12 months
·   No gesturing by 12 months

By 16 Months:

·   No single words by 16 months
·   No pointing to objects or events of interest in an effort to share

By 24 Months:

·   No spontaneous two-word phrases
·   Loss of any language or social skills at any age

Let me know if your son fails the CHAT or if you have any more questions.

Kind regards,
Jim