About Michelle Fattig Expertise I can answer questions about educational testing, autism, Asperger's Syndrome, ADD/ADHD, Special Education, IEP, Learning Disabilities, Sensory Processing, Parent Advocacy, Response to Intervention, living and parenting with disabilities, parent rights in special education, school psychology, and more. I cannot provide a medical diagnosis.
Experience I am a school psychologist, medical technologist, author of the Annie Books series: Experience Aspeger's Syndrome and Attention Deficits Through the Eyes of a Child, RTI facilitator, ILCD facilitator, parent advocate, presenter, and researcher. My children and I have Asperger's, ADD/ADHD, and learning disabilities.
Organizations National Association of School Pyschologists, American Medical Technologists, Learning Disabilities Association of Nebraska
Education/Credentials Ed.S. in School Psychology, doctoral studies in SPED Law, SPED Systems Enhancement Leadership, and doctoral candidate Education Leadership. MT(AMT) and MLT(ASCP)
Question My grandson is 2 1/2. I am mildly concerned with his speach development and some of his actions. He currently has a very limited vocabulary and says only single words - no attempts to put words together. He is very bright and he knows his numbers and letters by sight and is using his alphabet magnets to spell words (even though he can not say most of them.) When he identifies the letters he often uses their sound rather than their name. Aside from the lack of speach - he often lines things up and gets somewhat angry if they get moved. He has a very long attention span and can play his games on my computer for long periods of time. He also flails his arms when he gets
excited - usually while playing his number and/or letter games. His vocabulary does seem to be growing but quite slowly. Does any of this sound like I should be concerned?
Answer Boys can be late in developing speech; however, the AMA does list not putting two or more words together by the age of two as a potential 'red flag.'
"What are Autism Spectrum Disorders?
Impairments in Social Interaction.
Impairments in Communication
Restricted and/or repetitive patterns of behaviour, interests and activities.
Other behaviours commonly observed in ASD
What is the difference between Autistic Disorder, Asperger's Disorder/Syndrome and PDD-NOS
Are Autism and Asperger Syndrome really different?
What are Autism Spectrum Disorders?
Autism is diagnosed on the basis of behaviour. This is because at this time there are no specific genetic or biological markers that accurately identify a person as being on the autism spectrum. There are three main categories of difficulties people on the spectrum have in common. These difficulties are:
Impairment in social interaction
Impairment in communication
Restricted and/or repetitive patterns of behaviour, interests and activities
Autism first manifests in childhood, with age of onset for a diagnosis being under the age of 3 years. This does not necessarily mean that a person is diagnosed before turning 3 years of age, only that symptoms were present at that developmental stage.
Although not stated in the main diagnostic schedules, many clinicians use the term “Autism Spectrum Disorder” (ASD) to describe a continuum of related disorders, including autism, Asperger syndrome, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). The categories within the autism spectrum are related to both severity and the presence or absence of some symptoms." Retrieved June 27, 2008 from: http://www.a4.org.au/autism.html
The following is an autism questionnaire:
Checklist for Autism in Young Children (Susan Mayes, PhD, Penn State College of Medicine) PROBLEMS WITH SOCIAL INTERACTION
__(1) Social isolation withdrawn, aloof, avoids contact with others, or prefers to play alone rather than with peers parallel play along side but not with peers difficulty establishing friendships
__(2) Limited reciprocal interaction limited social smile or eye contact (looks away, looks through people, looks at speaker’s mouth, needs tobe prompted to make eye contact, or does not make eye contact when communicating) limited sharing and showing (e.g., does not show a toy to an adult, seek recognition, or share an experience or accomplishment with others) excessively rigid play with peers (dictates play according to his/her peculiar and repetitive interests and rules) enjoys physical or sensory play with others (e.g., tickling, chasing) but has limited reciprocal social interaction (e.g., does not play social games or games involving turn taking)
__(3) Self-absorbed self-absorbed or in own world (e.g., engages in self-stimulating behaviors, talks to self, or fantasizes excessively about things such as movies or cartoons) oblivious to the presence of others or unresponsive to the social overtures of others
__(4) Socially indiscriminate behavior inappropriately talks to or hugs strangers invades personal space (gets too close to or touches others)no stranger/separation anxiety when young (not wary of strangers or upset if separated from parents) socially inappropriate, insensitive comments or behaviors (picks nose in public, asks personal questions)
__(5) Problems with social skills does not appropriately initiate or sustain peer interaction though may interact well with adults poor social reasoning (difficulty understanding social cues/comments, facial expressions, body language) wants to have friends but does not know how to make friends
PERSEVERATION __(6) Narrow or unusual range of interests and play behaviors obsessive preoccupations or extreme fixation on things such as certain movies or TV shows (reenacts or watches the same movies over and over), computer games, letters, shapes, numbers, counting, objects or topics (e.g., trains, dinosaurs, NASCAR, maps, planes, electricity, Yu-Gi-Oh, cartoon characters, etc.) unusual attachment to and holding or hoarding objects (e.g., small figures, string, other______)
__(7) Stereotyped and repetitive playrepetitive play (e.g., excessively lines up, sorts, spins, or throws objects; opens and closes things repeatedly; plays with the same toys without variation; draws the same pictures repeatedly; other_____) disinterest in toys or lack of normal and varied imaginative playunusual preoccupation with parts of objects (e.g., repetitively spins wheels on a toy)
__(8) Upset with change distressed by change (e.g., change in routine or schedule, parent takes a different car route home from school, furniture or child’s toys are moved, seasonal change in clothing, other______) difficulty with transitions (e.g., from one activity to another) extreme need to finish what he/she starts idiosyncratic or ritualized patterns (e.g., drinks only from a certain cup, wears only certain clothes, insists that food be arranged a certain way on a plate, other_____)insists that things be in a certain location or a certain way (e.g., doors must be closed, coats zipped, etc.) insists on doing things the same way every time overly precise and inflexible, upset if someone breaks a “rule,” rigid and literal thinking
__(9) Stereotypies (unusual repetitive movements such as hand flapping when excited, toe walking, bodyrocking, head shaking, body tensing, teeth clenching, teeth grinding while awake, finger movements, facial grimacing, repeatedly running back and forth, twirling or spinning, pacing, playing with saliva, skin picking) SOMATOSENSORY DISTURBANCE
__(10) Excessive atypical craving and love of spinning, tickling, climbing, rocking, swinging, bouncing, jumping
__(11) Unresponsive at times to verbal input (not react when name called or spoken to, hearing questioned)
__(12) Hypersensitivity unusual hypersensitivity to some sounds (e.g., distress or covering ears in response to loud noise, motors, vacuum cleaner, hair dryer, baby crying, sirens, clapping, alarms, toilet flushing, people singing) unusual hypersensitivity to smell, light, or temperature
__(13) Distress with commotion or crowds (uncomfortable/anxious in large groups, theatres, cafeterias, parties)
__(14) Extreme fascination with spinning or repetitive movements (e.g., revolving fans, Wheel of Fortune, running water), linear patterns (e.g., credits on TV, window blinds), minute details, lights, shiny surfaces
__(15) Abnormal sensory inspection excessively smells, mouths, chews, licks, or rubs inanimate objects or surfaces repetitively visually scrutinizes objects or finger movements close to eyesplaces ears against things that vibrate or hum or presses objects against face to an unusual degree
__(16) Tactile defensiveness or extreme dislike of: being touched or hugged touching certain things or getting hands dirty or stickywater on self or clothes having face washed, teeth brushed, hair combed, or nails cut walking in bare feet clothing that is tight, seams in clothes, or certain textures of clothing
__(17) High tolerance for pain (e.g., does not cry when hurt or does not respond normally to painful stimuli)
__(18) Sleep disturbance (e.g., difficulty falling asleep, waking during the night, waking early in the morning)
__(19) Feeding problems very picky eater, limited food preferences, insists on eating only a few foods hypersensitivity to textures (e.g., lumps in food) retains food in mouth without swallowing eats inedible substancesother peculiar eating patterns (e.g., eats only one brand, color, or shape of a food, other____)
ATYPICAL COMMUNICATION AND DEVELOPMENT
__(20) Language regression or slowing at approximately 1 to 2 years of age (e.g., speaking a few words at one year but then losing speech or normal early language development and later language is delayed)
__(21) Visual-motor skills (e.g., assembling puzzles, building with Legos, operating the VCR) significantly higher than language skills during the preschool years or walking at a much earlier age than talking
__(22) Communication impairment absent or limited communicative speech but gestures to communicate (e.g., pulls an adult by the handand leads to what wants, hands an object to an adult for assistance, brings a cup to an adult for a drink)communicates verbally with others only when stressed or needing somethingdifficulty with reciprocal conversational speech (initiating and sustaining conversations, listening and responding to what others say), talks at people, or one-sided conversations on topics of interest to self
__(23) Atypical vocalizations or speech unusual voice quality or modulation (e.g., high pitch, sing song voice, lack of intonation, etc.) screeches or makes other odd noises (e.g., growls, hums, etc.) unusual repetitive vocalizations and sounds idiosyncratic jargon as if talking in own language echolalia (inappropriately mimics what others say, such as repeating instead of answering a question)sporadic speech (says a word or phrase once and rarely or never says it again) excessively recites from movies, cartoons, commercials, etc. uses rote or memorized phrases that are excessive, out of context, or not relevant makes pronoun substitutions (e.g., says “you” when meaning “I”) excessively repetitive speech and questionsidiosyncratic thoughts and speech (makes up words, nonsensical speech, unique views and perceptions)
__(24) Special abilities that are significantly higher than other abilities exceptional rote memory (e.g., at an unusually young age, identifies numbers, letters, shapes, logos, andcolors; sings or hums tunes; memorizes car routes; counts; recites the alphabet; reads; spells; etc.) phenomenal vocabulary or ability to memorize movies, books, or factual information remarkable ability to mimic movie or cartoon characters outstanding visual-mechanical skills (e.g., at an unusually young age, assembles puzzles, matches shapes, operates a computer or VCR, figures out how things work, complex constructions with Legos) remarkable artistic or musical talent extremely well-developed gross motor skills with delayed development in other areas (in contrast to high- functioning children with autism who often have writing or coordination problems)
MOOD DISTURBANCE
__(25) Overreactivity, irritability, low frustration tolerance, agitation, tantrums, meltdowns, explosiveness,aggression, or self-injurious behavior (distressed by minor events or occurrences most children can tolerate, such as intrusions, activity interruptions, proximity, confinement, performance demands, writingtasks, or when things are not the way the child thinks they should be)
__(26) Moodiness and emotional lability (the cause for mood changes may not always apparent, such aslaughter or distress for no apparent reason)
__(27) Difficulty showing and recognizing emotions, emotionally unresponsive in some situations, lack of empathy or emotional reciprocity (e.g., does not respond appropriately or provide comfort whensomeone is hurt or sad), or misinterprets the emotions or responses of others
__(28) Unusual fears, such as fear of elevators, steps, toilets, balloons, vacuums, tornadoes, other_____
PROBLEMS WITH ATTENTION AND SAFETY
__(29) Selective attention, ability to hyperfocus on activities, objects, or topics of interest to self (e.g., lines up toys, spins wheels, watches the same movie, assembles puzzles, builds with Legos, or draws pictures for long periods of time), but is inattentive, impulsive, and fidgety at other times
__(30) Limited safety awareness, fearless, or oblivious to danger (e.g., unsafe climbing, wanders about house at night, runs off by self, goes into traffic or water, walks off with strangers)
If the questionnaires support your concern, share the results with his physician, or request a free comprehensive multi-disciplinary evaluation through his local school district. The earliest intervention is reportedly the most successful. More information is available about high functioning autism at www.anniebooks.com. Please let me know if I can provide any more information.
