Expert: James Michael Roan - 9/6/2008

Question
QUESTION: my 17 month old grandson does not talk he says a few words, but cannot point or identify things or body parts. he is just clapping his hands now. he walked at 14 months and has a great sense of humor.he does make eye contact and reaches out to people and loves hugs. he singsongs to himself sometimes.i am concerned. please answer if you can.


ANSWER: Hi Donna;

I'll need more info please. Download the M-CHAT and scoring instructions below. The M-CHAT starts around 18 months, but is probably usable. Also comment on the "red flags" for autism below as to whether he is or is not doing these things and please provide more elaboration where appropriate. Please remember I cannot diagnose over the internet, however I can comment on level of risk and what to do next. Do you live in the U.S.?

M-CHAT: http://www.utmem.edu/pediatrics/general/clinical/m-chat.pdf

Scoring: http://psychlops.psy.uconn.edu/ED/downloads/M-CHATscoring.pdf


6-12 Month Markers:

•   Infrequent eye contact
•   Failure to orient to name
•   Does not smile in response to smiles from others
•   Social and emotional passivity
•   Fixation on objects

By 12 Months:

•   Poor or no eye contact
•   Failure to orient to name
•   Poor imitation
•   No babbling by 12 months
•   No gesturing by 12 months

By 16 Months:

•   No single words by 16 months
•   No pointing to objects or events of interest in an effort to share


I'll be back online Sat. and Sunday mornings Pacific Standard time.

Kind regards,
James

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

QUESTION: hello james, i did the chat scoring and he has 5 critical answers.they are numbers 2, 7,  9, 13, 15.  i do live in the uunited states. thanks for your guidance.

Answer
Hi Donna;

You'll need to do two things concurrently: First, call the special education department in your grandson's school district and ask to make a referral for assessment to their Early Intervention (IE) program. If he qualifies for services, he will receive appropriate intervention. The assessment and intervention is at school district expense. Secondly, take the M-CHAT with you to your grandson's pediatrician and ask for a referral to an autism team at a Children's Hospital or university near you. Autism is difficult to diagnose at this age, however, I am sure his social and communication delays will qualify him for the appropriate intervention program. He is lucky to have you "batting" for him.

Kind regards,
James