Expert: James Michael Roan - 5/18/2008

Question
Hi James,
My 23 m/o da. is receiving birth to three services for a language delay  and in the past 5 months she has caught up with peers in language.  She speaks in two word phrases, sometimes, three or four.  Her birth to three team and pediatrician feel she is typical, but she also has a hospital based speech therapist (who specializes in autism) and suspects she is on the spectrum.  She passed the MCHAT, but was screened in for the spectrum by the ADOS performed by her hospital based therapist.  She had a perfect score for play (imitates others, plays with objects appropriately, etc.), but is inconsistent with her eye gaze, joint attention skills, and gesturing.  She will make eye contact but only sometimes, enjoys being cuddled and playing with other children.  She frequently does NOT want to be cuddled by her overly affectionate older sib and will say,"Leave me be."   She does not make eye contact when making a request and does pull me around the house.  She will point to things, although not that frequently.  She is interested in sharing experiences as she will shout," Look at me" or "Watch me" when performing what she perceives as a daring feat, but again that is inconsistent.  For example, she might point (with touching the object) to an animal and say horse to me, but won't look back to check if I'm looking.  What do you think? Also wondering, one therapist says all that matters is that they are capable of accomplishing these tasks (eye gaze, etc.) while the other says it is not "yes" / "no" but a matter of degree that is important diagnostically.  I really appreciate your time reading and responding to my novel!

Answer
Hi Cindy;

She could be just low socially or it is possible that she has a very high functioning form of autism such as Asperger's syndrome (AS). These children stand out only at school around peers who are not long time playmates. They play according to their own agenda and remain aloof from crowds and groups. It's next to impossible to diagnose at your daughter's age.

Kind regards,
James