Expert: Catherine Ridenour - 3/21/2008

Question
Hi Catherine, it is me again.
My grandson's great grandmother (the daddy's grandmother) was watching my grandson today, and called my step daughter because he had a fever and he needed to go to the doctor. While she had him at the doctor, she mentioned the M-CHAT. He informed her that the M-CHAT was not for children under 18 months old. He simply asked her some questions, and that was it. She also said that he informed her that it was no big deal if he wasn't pointing or waving. He is 16 months old. I asked her if he actually tested him personally, or just asked her questions. She told me that he just asked questions. I also told her that not pointing and not waving IS a big deal. I said she needed to go see another doctor. She said she is going to go by what her doctor says, and that is it. I don't get why this doctor informed her that not pointing and waving at his age is no big deal. I also do not get why he only asked her questions, and did not actually test him on some things. Why would a doctor dismiss these things?

Answer
Hi Joni,

Far beyond pointing and waving are the other behaviors or lack of them.

By age 1 he should have had several words or attempted words that had meaning. "Mom" or at least "Mmm" for mother, "Duh" for dad, "googiee" for cookie, etc. He should know and answer to his name. He should find other babies fascinating. He should get upset if his parents leave him, especially when he "runs away" he should look back to see if they follow and panic if they turn and walk in the other direction and wave "bye-bye".

There are screening tools for younger children. I am not sure of the names for them.

Below is a direct quote from: http://www.voanews.com/specialenglish/archive/2007-10/2007-10-30-voa2.cfm?CFID=3...

"Doctor Johnson says the medical profession has learned a lot about earlier signs of autism. She says the identification process can begin in the waiting room at a doctor’s office.

Parents could answer a list of written questions about their baby. Then the doctor could perform tests as simple as observing the baby's ability to follow a moving object with its eyes. Experts say failing "to watch a moving object may be a sign of autism."

Doctors and parents can also look for behaviors that are normal in babies under one year of age. For example, does the baby appear to respond to a parent’s voice? Does the baby make eye contact? Does the baby wave or point at things?

Young children usually have a favorite soft object like a stuffed animal or a blanket. But children with autism may like hard objects instead, and want to hold them at all times. They may not turn when a parent says their name or when the parent points at something and says "Look at that."

Doctor Johnson says the goal of the new advice is early intervention instead of the traditional "wait and see" method to identify autism. "


I wish I could use bold type in these answers to highlight the important factor but I'm sure you will see them yourself.

This is from the American Academy of Pediatrics:

"Warnings signs needing immediate evaluation include: no babbling or pointing or other gestures by 12 months, no single words by 16 months, no two-word phrases by 24 months and regression or loss of language or social skills at any age."

I suppose that waiting until he's 18 months for the M_CHAT won't be much of a disaster. But someone has to be SURE he gets it.

My heart goes out to you. I'm sure that the youth of his parents is part of the denial issue. It's easier to say he's ok than to face the fear he may not be. Hang in there for two months and then start pushing. Call your local school district and inquire if they have outreach specialists who can give you some help in getting him tested.

I'm sorry I can't do more.

Catherine