Expert: Jene Aviram - 11/20/2009

Question
QUESTION: Is fine motor delay a sign of autism?  My friend's daughter is 13 months old. Her pediatrician has not identified any delays in language, social skills, or communication.  She did not creep or crawl by 10 months but by 13 months seems to have caught up...stands up, walks etc.  Although she points and imitates a crayon stroke, she still does not have a pincer grasp at 13 months.  Should she have an assessment?  thanks so much.

ANSWER: Hi Christine,

Many people with autism have fine motor delays, but a fine motor delay alone certainly does NOT equate to autism.  Fine motor delays are common in young children and many of these toddlers don't have autism.  

I do think that your friend should get her daughter evaluated because not crawling until 13 months is substantially delayed.  Her daughter is young enough to qualify for early intervention, which means that the evaluations and services are free of charge.  If her daughter is substantially delayed with fine motor skills, she will qualify to receive help from an Occupational Therapist (OT).  With a good OT, her daughter will catch up to her peers and close the gap easily.  Since crawling and walking are gross motor skills, she should also be considered for physical therapy.  This can be considered with a PT evaluation.

I would advise your friend to ask her Pediatrician who to contact for Early Intervention.  Your friend can request a full evaluation of her daughter.  If her daughter qualifies for services, the sooner she begins, the faster she will catch up to age level skills.

It's wonderful that you're such a caring friend.  There should be more like you!
I wish you luck and I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com

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

QUESTION: Thank you.  I just want to clarify...she was not crawling at 10 months, not 13 months.  As of 13 months she was walking on her own.  Do you still think she should be evaluated?

Thanks again!

Answer
Thanks for clearing that up.  It certainly changes the picture.  If I were in your friend's shoes I would wait another few months.  All kids develop at a different rate and it doesn't sound like she has anything to worry about.  If your friend is concerned about her daughter's fine motor skills when she is 18 to 20 months old, she should certainly request an evaluation.  It should be covered by her State and her daughter will receive any services if she needs them.  Or your friend will just get peace of mind, which is a wonderful thing!
 
Only a thorough evaluation can give a full picture, but from your post, my guess is that your friend's daughter is on track and will master all the milestones at her own pace.

I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com