Expert: Ettina - 10/6/2009

Question
When my son was 2 we had him evaluated to see if he had autism or not. he wouldn't talk he would point and grunt or or make a ear piercing screech. he would also do a lot of repetitive things if he get his hand on a piece of paper he would run it through his fingers many times over and over until I would tell him to stop.and he would also bang his head on the floor or the wall and it wouldn't be a little tap it would be really hard. after he was evaluated they told me and my husband that are son doesn't have autism but he has mind process of a 1 year old and we can go through the school district and put him in preschool to help with his speech and his delay. so we did we put him preschool when he turn 31/2 and not even being in school for a full week he started to talk. now he is 5 yrs old and he is not fully potty trained it has taken us 3 years to potty train him he goes independently at school but if we don't tell him to go at home he goes on him self and now that he is in kindergarten with assisted help (he is not in regular kindergarten)but he wont listen to his teacher he runs around trying to play instead of doing work. and his school is only 4 hours long. and he is started to talk back to his teacher and to me and his dad. when we sit down and do homework each night we have flash cards with words on them and he can read up to 40 words he knows all his colors and basic shapes and he likes it when I read to him. he does great he only acts up like that in school what should I do.

Answer
It can be tricky to distinguish medium or low functioning autism (your son would be medium) from generalized developmental delay. Skill scatter, such as a beginning reader who is not fully potty trained, is more typical of autism, but lots of conditions involve skill scatter. More definitive would be the presence of social abnormalities, which you haven't mentioned.
Avoiding eye contact, lack of interest in other people, social skills delayed relative to other skills, lack of/odd facial expressions, etc are signs of autism, whereas a non-autistic delayed child will typically be fairly sociable and interact pretty much like you'd expect from a child at that developmental level (which for your son would mean kind of like a 2-3 year old). It's certainly possible for a non-autistic delayed child to do repetitive behaviors and self-injure, but the behavior tends to be somewhat infrequent and the kid still readily interacts with others.