Expert: Valerie Herskowitz - 1/17/2009

Question
QUESTION: We are a family of 4. I am a stay at home mom, and my husband is working most of the time. We don't have family and friends living close by. As we are so busy with our routines, I put my 3 yr old in a playschool so he could interact with kids his own age. He has delayed speech development. He points to things he wants, has has his 'baby language' too. Ofcourse, he does come up with words now and then. And has the basic come, go, carry, hi,there, car etc. He has poor eye contact. And will interact with outsiders only when he wants something. He is affectionate.... but only when he wants to be or if he is in the mood. He screams and throws a temper tantrum when he doesn't get his way, but it is quite easy to distract him. He can look through or ignore a person completely... as if they are not there.... especially strangers/outsiders. He can repeat every dialogue or scene (in his language)and enacts it too. I tend to treat the television as a babysitter, and have just realised that the tele takes up majority of his time when he is at home. His school teacher met with me today and said she suspected he had characteristics of mild autism. She based her diagnosis on teacher made tests done by her daughter (who is studying early childhood education). They had a 2 month end of term break. SO when he went back, the teacher said she found he had deteriorated. as in he was not listening to her instructions, wanted his own way, and did his class work only when she sat with him. And he didnot want to interact with the other kids (which he was doing earlier). Please help. I need to know early, so if he does have a problem, I can get help early. SHe says when her daughter tried shake his hand/ or any physical contact, he would show his displeasure. But after 2 weeks, he gives her a hug now.... Isn't that normal. I am worried about his eye-contact and speech development.

ANSWER: I would agree that your child is displaying possible signs of autism ie: delayed speech and language, poor eye contact, low interaction, temper tantrums, and especially the repeating of dialogues. It's time for you to arrange for an in depth evaluation in order to confirm this diagnosis. He is young and can make great strides, so don't delay. He will need speech therapy and occupational therapy as well. If he is diagnosed, you can feel free to get in touch with me and I can help you make a plan so that you can get him the help he needs.

Valerie Herskowitz, MA CCC
valerieherskowitz.com

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

QUESTION: Hi Valerie,
THank you for you reply. I just wanted to clarify that when i say repeat dialogues, I mean not repetitively. He has seen the video so many times, he knows what the next scene is going to be and says it along with the character. He doesn't have any repetitve speech or actions. As for the low interaction, could it be due to minimal exposure. Could the poor eye contact be his way of dealing with fear or unconfortable situations. He has good eye contact with the3 of us at home, people he is comfortable with. Temper tantrums are not excessive in nature. Could it be that he is used to getting his own way being the youngest in the family, so has become head strong and determined. But when I am firm, he behaves himself. COuld this be more of a behaviour problem? Could this be because of neglect? My husband is a General practioner, and thinks he just has delayed speech. But being a mom, I am worried.

Answer
I know that my answer was probably not one that you wanted to hear, but because your child is demonstrating several "red flags" for a developmental delay, I am going to have to still stick with my first impression. If your child was just speech delayed, the other issues wouldn't be there: ie: temper tantrums, learning the videos by heart, poor eye contact, etc. He would just be speech delayed. Anyway, instead of worrying about what it is, why don't you just get him going on therapies to improve the problems. If you want, I can view him via the Internet if you have a web camera and see him for myself and give you a better opinion and the right guidance as to what to do.

I know it is difficult to accept that there may be some pretty serious issues going on (I have a son with autism), but as a mom, you have to get over that and focus on what to do about it so he can improve. There are so many wonderful interventions now that are available, but time is of the essence. Early intervention is the key.

Valerie Herskowitz, MA CCC
valerieherskowitz.com