Expert: James Michael Roan - 8/5/2008

Question
Hi!  My 15 mo son is not pointing, and I am concerned about Autism.  He will
reach with his hand while leaning towards something that interests him, and
will also look at me (or whoever is holding him) while he is reaching.  I am
just concerned b/c he doesn't point w/ 1 finger.
He DOES look towards what I point at -- up until about 3 months ago, he
would just look at my finger, but he understands now that we are trying to
get him to look at something.
He has over 30 words, says "Oh, no!" while putting his hands on his head,
says "want up" and "want down", and "fall down."   He also has a stuffed dog
that he calls "Free" (because we called it Ruffee) & he brings it everywhere &
gives it hugs & kisses.
He rolled over late, walked at 13 months, and will bring us books when he
wants to read. He also understands commands -- but doesn't always follow
them.  (Like "get your milk & come sit here with Mommy" -- he does it about
60% of the time, the others he will just do one or the other.)
He will not always answer to his name, especially if he is watching a cartoon
or is intent on playing with a toy.  However, if I say something other than his
name, like "look at that!" or "what is this?" he will look over at me.  
He has had all shots except the MMR (got a LOT of grief from his dr about
that, but stuck to my guns.)  They also made a mistake & gave him a 4th hep
B shot -- b/c of that, and the way I was treated when I said no to the MMR,
we are looking for a new dr!
Sorry that I have written a book -- my main concern is how important
pointing is in "normal" development & when you should worry if it doesn't
show up.
Thanks so much for your time!  
Tara

Answer
Hi Tara;

I had the same problem with my granddaughter's pediatrician...we got a new one also!

In autism we are looking for signs of social delay, which can also exist independent of autism. So we are looking for examples of typical social development of which pointing is just one. Pointing generally comes on by 15 months. Pointing while looking back and forth between the object and you is a social bid and social exchange. Bringing and showing is social. Requesting is mildly social. Generally, receptive language is significantly delayed even in high functioning autism. He sounds fine in that department. Let me know how he does with:
-sharing
-showing and showing off
-exchanges of eye gaze when interacting and/or reading a book together
-his interest or lack of in interactive games like peek-a-boo
-interest in other children
-play with other children


KInd regards,
James
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