AboutSharon A. Mitchell Expertise Sharon can help with parenting and educational concerns. She has worked in teaching, special education and counselling for over twenty-five years and gives workshops to educators and parents on working with kids with autism spectrum disorders. Sharon speaks from both the education and parent points of view, having a son with Asperger's.
Experience Sharon is a special education consultant with a school district and autism consult for the province's Department of Education, giving workshops and individual consults. She is also the parent of a son with Asperger's who is away at university. Together they have a website at http://www.autismsite.ca that offers strategies for home and school. Sharon's Master's thesis looked at the long-term outlook for persons with high functioning autism and Asperger's.
Organizations
Website at http://www.autismsite.ca and sits on Autism Today's Panel of Experts (www.autismtoday.com)
Publications Co-author of Amazon.com bestseller, The Official Autism 101 Manual
Education/Credentials B.A. in Psychology,
B.Ed. in Special Education,
M.A. in Educational Leadership, Ph.D. Candidate in Autism
I have a little girl age 2.5yrs who I am keeping a very close eye on. She has an older brother age 9yrs with Aspergers, hence me maybe over analising everything!!
A little history: She NEVER made eye contact while nursing as a baby, I tried really hard to turn her head but she would always look away. Eye contact now is okay. She never liked to be put down as a baby, and wanted me ONLY all the time. Thankfully after about 5 months she got better with my husband/ family members. She never liked nappy changing, hair washing/ brushing. Now that she is verbal, she says everything 'hurts'. ie: barely touching off her at all.
She never did clap her hands on time (like her brother), she was 13mths before she mastered this, but she did everything else on time or before. She had great pointing, shared attention, bringing and showing all at the appropriate time.
She is painfully shy. If we are out and someone says hi, she will cover her eyes and 'hide' under me / the stroller etc. This has not improved with age. She can be like this with family members too, but not as much with children!!
She likes to play with the kids on the street that she knows, she is brilliant at imitation with them, and has a really great time.
Her first words came at about 15-16mths, they were 'all gone', dog, bear, juice etc. but did not say Mama Dada or her brothers name for a little while after this. She now has very advanced language, maybe sometimes a bit repetitive. She might ask the same question several times, but I think she is just wafting for the 'correct' answer? She uses pro nouns perfectly. She knows all the letters of the alphabet, all her numbers, colors, shapes etc. knows all the nursery rhymes. Her memory is amazing.
Her motor skills are outstanding, she can use a scooter, walk down the stairs one foot to each step, has been able to jump for a year now. She is quite active, but not hyperactive.
All that said, she seems to have no interest in toys. She LOVES to draw, play doh, use learning toys with animals / sounds etc. But she will not engage in any type of imaginary play. I have tried to use for example a block as an animal, she insists its a block and will not go any further with it. I have tried to say that all the little dolls are going to the 'park', but no she insists its the living room and laughs me off for being so stupid!!! She NEVER sits on her own and has a little play scene, with a running commentary of who said what etc. I have modeled for her, but she gets really angry, pushes it away and walks off.
Am I expecting too much from her? Is this within the normal range for her age? Sorry for such a long post, its hard to give a full picture in a shorter version. I know she would be far too young to diagnose as AS, but am I seeing early signs?
Your advice is much appreciated, thank you.
ANSWER: She sounds like a lovely, precocious little girl, with so many pluses in her favor. But I do understand your worry, especially consider the fact that her older brother has a diagnosis of Asperger's.
From an autism spectrum point of view, you mention a few skills she displays that are not common for kids on the spectrum:
- pointing
- joint attention
- bringing objects to share with you
- good use of pronouns
- outstanding motor skills
- enjoys playing with neighborhood children
You do also talk some aspects that are more worrying:
- lack of imaginary play
- sensory sensitivities
- lack of eye contact initially
- extreme shyness when people approach her
Of course any of the above characteristics do not point definitively to her being on or off the autism spectrum. As you say though, it is wise to keep a close eye on her development.
For future use, it might be useful to write down what you see her doing now and what you think she should be able to do, but isn't.
Around ages two to three, many kids develop the skills of imitation; it sounds like your little girls is already doing this. They also begin to develop imaginative play.
It sounds like this latter skill is concerning you the most.
First Signs is an organization dedicated to dispensing information on the warning signs of the possibility of autism. From their website at http://www.firstsigns.org/healthydev/milestones.htm , here is what they say about two to three year olds:
At 24 Months:
* Do pretend play with you with more than one action, like feeding the doll and then putting the doll to sleep?
* Use and understand at least 50 words?
* Use at least two words together (without imitating or repeating) and in a way that makes sense, like “want juice”?
* Enjoy being next to children of the same age and show interest in playing with them, perhaps giving a toy to another child?
* Look for familiar objects out of sight when asked?
At 36 Months:
* Enjoy pretending to play different characters with you or talking for dolls or action figures?
* Enjoy playing with children of the same age, perhaps showing and telling another child about a favorite toy?
* Use thoughts and actions together in speech and in play in a way that makes sense, like “sleepy, go take nap” and “baby hungry, feed bottle”?
* Answer “what,” “where,” and “who” questions easily?
* Talk about interests and feelings about the past and the future?
Since you are already well aware of what to watch for and are attempting to guide your little girl through imitation and play, you might find these books helpful:
Building Healthy Minds: The Six Experiences That Create Intelligence and Emotional Growth in Babies and Young Children (http://preview.tinyurl.com/yhg678y)
In addition to these books, there are things you can do to help this child become more comfortable when approached by adults. While some of this contact would be unexpected, when you know that company is coming over or she will run into adults, try creating a social story of what she may expect, devising a script for what she will say and do. Here is some information on the whys and hows or social stories along with some examples: http://www.autism-help.org/communication-social-stories-autism.htm. These examples are all written and may be at too high a level for a two year old. Social stories need not be this wordy or elaborate. Simply drawing out in a comic-book fashion what will happen may help.
Given your son's diagnosis, likely you have some familiarity with sensory sensitivities and way you can help. Here are a couple small books that might yield further help:
Your question is, "Am I expecting too much from her? Is this within the normal range for her age?" Well, much of what you describe is within or even advanced for her age. There are a few areas for concern. Perhaps her initial difficulties with eye contact are no longer apparent due to work on your part. Some of the other skills that worry you may be emerging in two year olds. No child develops in a lock-step fashion but considering the fact that your child seems advanced in other areas, it is a bit worrisome that she is so concrete in her thinking that imaginative play holds no interest for her. At least, right now.
Through the books above, and information you can glean from Dr. Stanley Greenspan's website at http://www.icdl.com, you may learn more about how to guide your daughter through play. The suggestions I made above will certainly not harm your child if she does not have Asperger's and they stand a good chance of aiding in her development. There are some children who at a young age do show symptoms of something on the autism spectrum, but with help later on do not any longer fit the criteria for a diagnosis.
Your children are lucky to have you for a mom.
Best wishes,
Sharon A. Mitchell, B.A., B.Ed., M.A., Ph.D. candidate
www.autismsite.ca
---------- FOLLOW-UP ----------
QUESTION: Sharon quote: " No child develops in a lock-step fashion but considering the fact that your child seems advanced in other areas, it is a bit worrisome that she is so concrete in her thinking that imaginative play holds no interest for her. At least, right now. "
I did think that she may have been gifted, as my brother is gifted and her very early interest in numbers and letters, (knew them and recognizes them all by 2yrs). At 2yrs she drew daddy with eyes, nose, mouth and ears. But from my research in gifted children, along with these advanced skills, would be advanced imaginary play.
Whatever it is, not only has she no interest, she gets angry about it, she clenches her fists and teeth and says "no" to any of it. I brought her to a large toy store for inspiration for Christmas presents, she only wanted to look at the little animals, and only asked for paint brushes! I tried to introduce the 'girly' isle (dolls/kitchens etc.) and she got really annoyed, and wouldn't even have a look.
I have been keeping a diary since her birth, so I was aware when she was reaching every milestone, usually early. I will certainly look at all the links you have suggested, and buy the recommended books. I also use the 'floortime' model with her, but if I follow her lead, it is usually educational/ books/ and she loves anything that has lights or makes music, doesn't always play with the toy as intended, just presses the buttons to hear the music (sensory, I guess).
She likes to sit on the same seat, close the doors when she enters or leaves the room, hates new shoes / jackets etc. Likes to carry around / sleep with some odd stuff, eg. bicycle pump, swimming goggles etc. (not always) She flaps her hands when excited.
She recently has started to use no language for certain things, usually when she wants something. Its not regression, she hasn't lost the ability to say what she wants, she has just decided not to. eg. She would point to the press and make noises, then if we pay no attention, she will say "up there". Then when we continue to 'play dumb' and say up where? she will not answer, it is only when we pick some random item and say 'oh you want this' and hand it to her (just to get her to say what she wants) she will say, "No I want the popcorn in the press, the red one". So she is well able to put her request in a very elaborate sentence for her age, we just seem to have to drag it from her now, as she never did this in the past.
There have been no changes at home for this 'babyish talk' to have started. I'm puzzled!!
But she loves throwing a balloon back and forth, pushing a ball/ car over and back for ages with me, would run to another room to share something (object or information about a bird in the garden etc) with me. One of her favorite words is 'Look' at whatever to share enjoyment, so I am confused.
I guess when she goes to pre school / school, all will become clear soon enough, but in the mean time I will intervene as much as I can and guide her towards reaching all her milestones.
Is there anything else that I have mentioned that would change your views? or give you greater insight, or in your opinion is it just a wait and see?
Thank you so much, you have given me so much information and taken my concerns seriously, thanks for taking the time.
Answer With the additional information you've provided, I can see even more why you are concerned. I'm not sure I can think of suggestions that you're not already trying.
For her language, I would follow the same tactics as you are when she does not use her expressive language skills when she wants something. Floortime is the model I would likely choose with this child and you're already following that. Perhaps in the books I suggested you will find some additional ways to develop her imaginative skills. She's still just two; this may take some time.
I'm not sure where the info is in the Floortime website but for the past few years they offered an inexpensive at-home course in May and June that you could take. Participants in the course have access to many online resources, to other practitioners and parents and to Dr. Greenspan for questions.
You're right that things may become clearer once your little girl enters school or preschool. But I'm wondering if it might be worth looking into this further now. That may give you access to preschool placements when she is three instead of four.
