Expert: James Michael Roan - 8/12/2008

Question
QUESTION: My son is going to be 21 months next week.  I have a growing concern that
he might have Autism.  He has maybe about a 10 word vocabulary.  He
doesn't always respond to his name and he usually flaps his arms when he is
really excited.  

On the upside, he loves playing peek-a-boo, runs away laughing when my
husband says I'm going to get you.  He will play a few notes on our piano,
looks at us for a response and he will clap when we start clapping.  He brings
his toys to us, he laughs at funny parts of cartoons.  He gives me hugs if I ask
him for one.  He's slow to warm up to people but then he's fine afterwards.  
He points to some things and will shake his head for no if I ask him
something that he's not interested in.

I'm sorry for such a lengthy letter, but I'm concerned if he is autistic or just
delayed in his speech.  I appreciate any response.  I took the M-Chat and
there are just a couple of questions that are questionable.

Thank You

ANSWER: Hi Maria;

I really need more elaboration. If you could use the M-CHAT as a structured observation tool for telling me more about your son I can be more helpful to you. Approximately 20 percent of typically developing children flap or have similar stereotypies for modulating arousal state.

My first thoughts are that if he does have an autism spectrum disorder it would be in the high functioning range such as Asperger's syndrome. These children often look as you have described your son when they are this age. Then again, I have seen children like you have described become entirely typical following early language/social intervention programs.

Let me know if you live in the U.S.

M-CHAT:
http://www.firstsigns.org/downloads/m-chat.PDF


Scoring:
http://www.firstsigns.org/downloads/Downloads_archive/m-chat_scoring.PDF


Kind regards,
James

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

QUESTION: Hi James,

I took the M-CHAT and the area of concern for me is question #14, he doesn't always respond to his name.  Because of this, I have to say yes to #20.  Sometimes I do wonder if something is wrong with his hearing.  This is also doubtful since he runs from another part of the house if he hears a favorite song playing on the TV.  The last question that I have to say yes to is # 11.  I sometimes see him plugging his ear when we are in a small room with a lot of people, like a party.  He just does it once in a while, and he doesn't do it if he hears the vacuum, sirens, loud music or when were at the mall.

We currently live in Virginia.  Thank you so much for getting back with me right away.  I really, really appreciate your feedback.

Answer
Hi Maria;

Most children don't consistently respond to their name , especially if they are engrossed in an activity. This question was derived through parent interviews where parents would say they thought their child might have had a hearing problem because it was a tough job to catch their attention. Undue sensitivity to noise is almost always in response to vacuum cleaners, hair dryers, and hand air dryers in public restrooms. It appears to be that high-pitched type of frequency.

To be safe, call the special education director today at your school district and ask how to make a referral to their Early Intervention program. It is at no cost to you and you can have him evaluated in all areas: motor, speech and language, social/emotional, and cognitive. Say you suspect an autism spectrum disorder and let them rule it out or in. You can always email me again for a closer interpretation of test score results.

I don't think he has an autism spectrum disorder, but it
is much better to be safe than sorry.

Kind regards,
James