Expert: Valerie Herskowitz - 1/27/2009

Question
I am writing about my son who is 40 months old. He has been having good motor skills and upto 30 month his communication was quite ok (able to identify 20-30 objects, 3 nursery rhymes, asking for things, reading book etc.). Suddenly he stopped taking interest in learning and was always itching to go out after his sibling was born. We put him in a play school where he was crying a lot and they told us that he was aloof & not interacting much (which was a surprise as earlier he was very fond of childrens and always playing with older children if he found a companion).After suspicions of autism, we saw an ENT specialist who prescribed medicine for wax removal from his ear. Suddenly his behavior changed he again started taking inteeests in books and at play school playing with the kids, the caretaker took back his words about autism. Then again after a month his crying started & he use to sleep v infrequently, eat very less and would calm down if we took him in a car. We went back to India where he had all sorts of test (MRI, EEG, ENT..) which came out ok. Afterward he was diagnosed as having liquid behind eardrums & enlarged adenoid for which he was operated. His crying stopped he is reading books again but not speaking much only repeating most of the times (also speaking a whispering tone which we can't follow as if to calm himself). Also he is hyeractive doing something or other. He is affectionate with his brother, plays properly with toys, shows proper expressions, chooses the right key to open the door, has good eye contact, responds to his name, follows simple instructions. But in the M-Chat test I could see him failing in item in pointing to parent object of intest or failing to look at something if pointed. Is it symptotic of severe autism because Aspergers are highly vocal.What you suggest to look out as we don't have good diagnostic facilities in India and he will be coming back to Europe next month.

Answer
Because of your son's delays, I would suspect a developmental delay that encompasses more than just what one would expect from someone who has a history of ear fluid. Aspergers is ruled out as they do not exhibit language issues. Also, children with developmental delays commonly have ear fluid issues. I am glad you got that under control. I am sure that it was uncomfortable which contributed to the crying. Because you mention that you do not have good services in India, I would recommend that I do a consultation with you over the Internet. I have clients all over the world. We use Skype and it's just like I am in your home. I would concentrate on developing some communication strategies as well as computer-based learning which I can monitor. I teach a class on computer-based learning on the Internet as well once a week. So let me know if you would like to arrange something.

Valerie Herskowitz, MA CCC
valerieherskowitz.com