Expert: James Michael Roan - 3/18/2008

Question
My daughter is 2.7 years old and I have (perhaps irrationally) feared autism since she was 18 months old and I googled her arm flapping. She developed speech normally however, so for a while I was OK. But, I'm worried again and don't know if I should have her assessed, or just try to stop obsessing.

  The good things are that she speaks in long, communicative sentences and can carry a conversation. She answers questions and asks a million questions. She is funny, very sensitive and sweet. She has great fine and gross motor skills and could write properly with a pen at under the age of two. She loves kids and seeks them out wherever we go. She is pretty much a delight to be around.

  The things that worry me are: She used to flap her arms out of anger or anxiety. I told her to stop doing it around 18 months and she has. She still walks on her toes. She like to carry stuff around all the time. Sometimes stuffed animals, sometimes little princess figurines, mostly little toys. She gets tired of the little toy of the day in about 48 hours or less, but its worrisome to always see her carrying around something. If she sees something she likes at a store, she'll have a fit unless you buy it for her (I spoiled her), then she carries it around for a while. However, her fit if its not purchased only lasts a minute or two. She doesn't tantrum for longer than a minute. Also, lately she has been approaching other kids at the mall or park and saying "Hi kids, want to play?" or "Hi girl" or "Hi boy, want to play?" The kids mostly want to play with her too, but its really odd isn't it? She's so assertive for 2 1/2. I never see other kids doing that. Maybe she is just lonely. She doesn't go to day care or preschool and is an only child. I'm a professor so I'm able to work from home a lot. She is with my parents when I'm gone.

   I hear about how some high functioning children don't get diagnosed until they begin to have social problems later. They don't seem to know how to approach other children in an acceptable way. Is it inappropriate to talk to random kids in the mall? I'm so confused and upset. I guess that I just want to know if she's HFA or just quirky!

Answer
Hi Gina;

It's okay to be quirky! Girls with high functioning autism can be next to impossible to diagnose until they go to school or preschool and you watch the nature and quality of their peer interactions.How is her use of pronouns? Does she refer to herself by name or "I?" Is there anything unusual about the tone, volume or prosody of her speech? Can she answer simple "why" questions? What is the quality and frequency of eye contact? Can she act truly interactively with other children or does she need to have everything on her terms? Let me know.

Kind regards,
James