Expert: James Michael Roan - 3/16/2008

Question
QUESTION: Hi, I have 2 grandsons, one is 13 months old, the other is 16 months old. I am curious if my 16 month old might be showing signs of Autism.
These are what I have noticed:
He does not point or wave. The 13 month old points to everything and waves.
He is not interested in playing with the 13 month old, whereas the 13 month is very interested in him.
We live on 10 acres of land, when I take the boys outside, the 13 month old points to everything and looks at me every time to show me what he sees....the 16 month old is only interested in "running away"...just running...I am constantly chasing him, he will not stay close by. While he is running, he is looking at his feet. I will holler his name, sometimes he turns to look but he will turn around and continue to run. Needless to say, we can't go outside very often because of this, I am constantly running.
He will not imitate anything I do. Like peekaboo, or dancing. Whereas the 13 month old does. He will lay on the floor and watch TV for hours. He is too young to understand what a TV show is all about, so I associate that with "fixated" on something. I will turn the TV off at my house, his mother will let him lay there and watch. It is not cartoons either.
He babbles, it sounds instinctively like Chinese. He does not say any words. Any real words, he will only say mama and dada if you say it first. He will say uh-oh.If I say where is the ball? He just looks at me. He smiles at us though, if we smile first. If I ask the 13 month old, where is the ball, he will point to the ball. I do not know if this has anything to do with it, but he does not eat very well, it is like he doesn't like anything you put on his plate. He might take a bite and that is it. But he does not look under weight. He is also scared of loud noises. He is also scared of his grandfather for no reason. I have checked out the internet, and it shows that he might have some signs..but I want to hear your input. Thanks!

ANSWER: Hi Joni;

I have concerns also. If you live in the U.S. call the special education department of your grandson's school district and say you want to make a referral to the Early Intervention program. Mention autism concerns. They will assess him at no cost to the family and provide therapy and intervention services if he qualifies.

Also, download the M-CHAT and scoring instructions.

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


http://psychlops.psy.uconn.edu/ED/downloads/M-CHATscoring.pdf

You can take the results to your grandchild's pediatrician for a referral to a professional multi-disciplinary team expert in this area.

Here are some "red flags" 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


Kind regards,
James

---------- FOLLOW-UP ----------

QUESTION: Hi James, Thanks for getting back to me so quick. I took the test and my grandson failed these: 2,4,5,6,7,8,9,10,11,13,15,17,19, 21,22,23
On number 4..he will smile when we do it, but he won't do it back...my 13 month old will.
I also do forgot to tell you that when I kick the ball to him, he will kick it, and I will kick it back, and he will kick it again. The whole time we are doing this, he NEVER looks at me, he is only fixated on the ball. It is like he is not associated with me playing with him, just kicking the ball.
Also, I have been reading up on this, and I read that this chat test is for 18 months and older. He is 16 months. So would this test be accurate for him?
The 13 month old passed everything on this test.
How do I tell my daughter of my concerns. She is 20 years old, and OVERLY sensitive.

Answer
Hi Joni;

The M-CHAT, as a screener and not a test, is valid enough for that age. The KEY issue here is early intervention...the earlier, the better. These services must initiate immediately. He may be mildly affected or more severely. He must be assessed as soon as humanly possible. Take the M-CHAT results to the EI people and his pediatrician for a referral to a team at a university or Children's Hospital near you. You don't need a diagnosis, however, to begin early intervention.

I know this is a tough one, but your grandchild's future hinges on him getting help right away. I'm sure she has had private concerns of her own so it will not likely be a big shock. I have seen dozens of miracles worked in this area when a young child gets early intervention services.

Kind regards,
James