Expert: James Michael Roan - 1/16/2009

Question
QUESTION: I have some concerns about my 11 1/2 month old son.  My friends and parents tell me I am paranoid and he is fine, but I'd be curious to gain your insight.

He is a full term infant.  His gross motor skills seem fine...he has been crawling since 7 1/2 months and cruises on furniture.   

He began to babble at about 8 months.  He says babababa mamamama, nanana, and dadadada.    Sometimes he'll repeat dadadada if I say it to him.  Some days he babbles often and some days he does not talk much at all.

He enjoys peek-a-boo and sometimes even initiates it with a blanket or bib.  If I show him how to do something with a toy (press a button, put a ball in a bucket, he can usually figure it out).  

He always reaches his arms up to be picked up.  He verbally will indicate something he wants  by grunting at the object.

We have exchanged back and forth sounds by screaming back and forth, but he hasn't done that much in the last month.  

My concerns are this...while he does make eye contact he doesn't has much as other children his age.  He doesn't respond to his name a lot of the time either.  He typically will respond if he is not engaged, but if he is engaged with a toy, he won't.  He does not wave bye-bye, clap, or repetitively bang two objects together.  

He doesn't seem to engage in any self stimulating behavior.  He dances to music but doesn't seem to hand flap or spin wheels.  He will intially be intrigued by a cieling fan but it doesn't "put him a a trance like state" and he will look away after a few seconds.  

He seems to understand no, but sometimes laughs when I say it forcefully.  He cannot follow commands on words alone.  If I hold out my hand sometimes he will give an object to me but he does not look at me while doing this.  If I show him how to put and object in a container he can do it.

He has recently started to use his index finger to point, but it is not coupled with joint attention.  He doesn't look at me, just uses his finger.  However, if I am holding an object in front of me he will reach his arms up at me, and look at the object, as to ask me for it.  

This is all the relevant info I can think of.  My suspicions are that you will tell me to keep an eye out.  I had him evaluated at 10 months by Early Intervention, and they said he was fine, but I am unconvinced.  I'd be curious to know your opinion.  

Thanks much,

Lisa

ANSWER: Hi Lisa;

You are right. Keep you eye out and keep a log of skills lost and/or gained especially in the areas of eye contact, joint attention, sharing, showing off, examining hands, flicking fingers or dangly things to to the side of his eye and, of course, spinning things.
How often does he respond to his name if you walk into a room where he is and he is not engrossed in a favorite activity? An special sensory avoidance or seeking behaviors? Is he unusually attracted to water?

I also suggest you pick up a book by Stanley Greenspan on the topic of "DIR Floortime" for establishing joint attention with him. He does have social delay. Communication delays and social delays are inextricably tied to each other at this age. A delay in one causes a delay in the other.

Kind regards,
James









Disclaimer:
While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find my resources useful.



Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting psychologist responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.


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

QUESTION: I haven't noticed that he is unusually attracted to water, although he does like his bath.  I haven't noticed any sensory seeking or avoidance behaviors...although I have not had much success in feeding him food besides baby food or Cheerios.  I don't know if this is a sensory issue or not.  The other thing is he loves to roll a ball around and chase after it.  He could do this for a long periods (half hour).  Sometimes he will play with us, but he is just as happy playing with himself.

Another thing I forgot to mention is that he does have pretty severe separation anxiety.  I don't know if this is ASD related or not.

If he is not engaged he responds to his name most of the time - I'd estimate 75% or above.  If he is heavily engaged it is probably below 50%.

Thanks.

Answer
Hi Lisa;

He certainly is a borderline kiddo. It's really hard to say at this age. Did the Early Intervention folks rule out social delay? What assessments did they use?

Regards,
James




Disclaimer:
While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find my resources useful.



Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting psychologist responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.