Expert: James Michael Roan - 9/18/2008

Question
QUESTION: I'm getting really worried about my 14 month old son.  He isn't saying any words like 'mama' and dada' although he will babble to himself. He also seems to zone out when he watches TV and will never respond to his name when he is in this state.  Also when he fall over and bangs his head he never cries unless it really hurts and he is forever climbing.  He seems to prefer to play on his own and doesn't interact with children of his own age.  He also seems to prefer women to men although he had contact with both his father and grandfather.  When we say no to him he carries on doing it and will look at you while hes doing something he shouldn't.  Also he eats everything from cables to animal food and has always got something in his mouth although he will not use a dummy.  Also he never points to anything he wants and waves randomly and it;s not always to say bye or hi, he doesn't pretend play either.  He will occasionally play peekaboo or this little piggy.  When he plays with toys its only for a few seconds before he moves onto the next thing and doesn't seem to play with them in the right way, e.g. when he put the car down the slope it always goes on its side although we show him time and time again how its done.  His favorite thing does seem to be a ball and he also bangs everything in sight.  I'm sorry that it is such a long question but there are lots of things that I've noticed. I have asked a health professional for advise but the keep saying he has challenging behavior or its just a faze.  I'm unable to leave him alone for even a second incase he hurts himself or puts something in his mouth that is harmful.  I would be grateful of any help you can give me.

ANSWER: Hi Amanda;

I need you to answer some questions first, then look down the page and see how he stands up against the Red Flags for autism.

1. Can you establish joint attention between you, he, and an object or activity? Does he just look at the object or does he look back and forth between the object and your eyes.

2. Does he have social smiles? When you smile at him after a short absence will he smile back?

3. When you walk into a room and call his name, how often does he turn around and look at you?

4. When you say he "randomly waves," is he flapping his hands/arms or truly gesturing?

5. What country do you live in?


Red Flags (Print these and put them on the fridge):

6-12 Month Markers:

•   Passivity and decreased activity
•   Extreme distress reactions
•   Fixation on objects

By 12 Months:

•   Decreased positive affect and social smiling
•   Delayed gesture and language
•   Poor or no eye contact
•   Poor disengagement of attention
•   Inability to shift attention back and forth between different stimuli
•   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 interesting events in an attempt to share them with another

By 24 Months:

•   No spontaneous two-word phrases
•   Loss of any language or social skills at any age


Kind regards,
James

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

QUESTION: Hi.  Thank you for such a quick response.  Here are the answers to the questions you asked.  I live in England.  I think he tends to flap his hand more than wave as he tends to do this so randomly and also for 2-3 minutes at a time and when you do say bye to him he doesn't always wave, also he will sometimes flap both hands together.  He doesn't look at an object when you point at it or say things like where is the car.  If you give him the toy etc he will look at it for a few seconds then he will either eat it, throw it a way or play with it for a few moments.  I would say that he responds about 30% - 40% of the time to his name.  I can sometimes call him about 9+ times before he will look at me.  He will smile although he tends to smile more to women than men.

ANSWER: Hi Amanda;

Sorry for the delay. Does he play with toys properly? That is, does he line toy cars up or does he drive them around? Any sign of pretend play, such as using a banana as a phone or an object on his head like a hat?

Regards,
James

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

QUESTION: he doesn't really play with toys. The only thing he really likes are balls.  Sometimes he will roll them and sometimes he bangs them together. On the occasions he does play with cars he tends to focus on the wheels and then he will sometimes push them around the floor. his favorite place for anything is in his mouth.  I'm a full time mum and as of yet i haven't seen him engage in pretend play

Answer
Hi Amanda;

I am hearing some social and developmental delays. Some behaviors could be due to autism or to developmental delay. How is his eye contact, social smiles, and social interactions with you and other family members?

If you like, we can more accurately screen his development using the CSBSDP-Checklist. I'll need an email address so I can attach it to a regular email. My email is roanpsych@gmail.com

Kind regards,
James