Expert: James Michael Roan - 4/15/2008

Question
QUESTION: Hi James
My 22month old son (23 months on May 18th) is a very bright happy little guy.
He does concern me a bit..
he has at least 30 words and the vocabulary is growing by the minute.
he can do puzzles, remembers everything, names pictures of people, animals etc...loves to draw, "read", can recognize letters on the keyboard and on flashcards, loves his friends, family, kisses hugs etc..
my concern is ever sinc he was 6 months old he did this weird thing w/ his hands when excited...
he used to flap them and now when he sees fast cars, shows that excite him, bubbles (mostly things moving) he grimaces his mouth and jumps and twists, stiffens his hands and fingers..almost seems unvoluntery but def. is in response to things he gets excited about...
he has meaningful conversations w/ us in his own language..
at times he pinches our hands and loves to JUMP all over the house, off of steps etc (he learned this in gymnastics and loves to jump)..
he pays attention, has great eye contact, great attention span...it is this hand thing while jumping that he does which concerns me...should i be worried about autism or any other neurolgical disorder?? i hear sensory issues can show in this way...
his pedi whom i respect did not seem to be concerned and thinks the more he expresses himself the more he will grow out of it..
oh...he also is very set in his ways as far having the same breakfast and playing w/ the same toys..although he will go anywhere and be fine...crowds too...will sleep anywhere i need him to and loves to be out...should i be worried?? thanks so much
Maria
PS sorry for being all over the place!!!

ANSWER: Hi Maria;

Since I work in autism and almost exclusively Asperger's syndrome, those experiences influence my comments. I have seen the behavior you describe in boys with Asperger's syndrome when under stress. I have not found anything about it, however, in the research literature. The litmus test for Asperger's syndrome is watching the individual play in a group of their peers and here any social delay manifests itself. I'm not saying that I think he has Asperger's, I really have no clue. He sounds like he is developing normally, but observe him in a play group of peers and let me know what his behavior looks like compared to the others.

Kind regards,
James

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

QUESTION: Hi James,
Thanks for the quick reply...
when he plays in a group he is usally the leader..trying to be funny, hugs his friends and pretend plays...is this normal for aspergers?

ANSWER: Hi Maria;

He does sound like a typically developing child. The best way I have of distinguishing Asperger's/PDD-NOS is the Asperger's child is  very serious looking chap who plays according to his own agenda and as long as others are willing to follow, they are fine with it, however, if a child/children decide to deviate from the "plan" then the Asperger's child will continue along their own track. They are difficult to spot when around adults, family members, or kids in the neighborhood they have established a play relationship with but will look quite different at school. It takes an experienced eye to catch the differences. I sometimes can see no qualitative differences in a child at home and at play with neighbors but see quite a different picture at school or the daycare.

Kind regards,
James

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

QUESTION: Hi James,
If it weren't for his hand thing that he does i would think he were completely normal.  We are out every day in random places and he is always very friendly with everyone..he is also compassionate and easy going w/ his friends..he goes w/ the flow while playing and thinks his friends are very funny..he laughs a lot when they try to make him laugh.  He is like this w/ strangers too..
does aspergers go undiagnosed a lot?
are you able to live a near normal life w/ it??
he does not go to daycare but we do go to a play group and he seems to follow along w/ what the teacher does, imitates, sings, follows directions..sometimes he goes off and does his own thing but so does every other 22 month old in the class....
is this all normal of an aspergers???
like i said...i would think he were just like eveyr child except for the hand twisting when he gets excited about something..this does not happen when he gets upset...thanks so4 much

Answer
Hi Maria;

Asperger's does go undiagnosed a lot especially this age. I also see many children who have the Asperger's profile, but are not sufficiently impaired to receive the formal diagnosis. We call this very mild form "subclinical Asperger's."

They do have normal lives, but because their social delays interfere with their ability to fit in as well as others they are often the target of bullies and are at risk for clinical depression in later childhood and adolescence.

Generally their is a parent or grandparent that has undiagnosed Asperger's in the family. They appear rude, insensitive, and don't observe social protocol. They are often very successful at careers that do not involve participation with a lot of other adults.

For reliable information visit Dr. Tony Attwood's website.



Kind regards,
James