Expert: Dr. Sharon A. Mitchell - 11/19/2009

Question
Hi. My son just turned four and has very poor communication skills. He does not initiate conversation unless he wants something. His two older brothers have also had speech delays. My son's preschool teacher and babysitter both think he has autism. I don't and our doctor did not say anything about it at his well child visit last week. My son will be visiting a neurologist for possible seizure activity. Should we be concerned about a autistic diagnosis?

Answer
Just based on what you have described here, I would not say that this necessarily points to autism, although that is a possibility. There can be many other reasons for language delays.

Although your doctor may not have mentioned autism to you, he must be aware of the communication difficulties. Is your son seeing a speech therapist? That would be helpful, but you likely know this, having been through it with your other children. Does the speech therapist think she sees autistic tendencies with your little boy?

The preschool teachers sees your little guy among others his age so may be in a better position to compare his development with what is typical for four year olds. I would suspect that if both she and your babysitter have mentioned that they think they notice autistic symptoms, that they may be noting how he relates to others, as well as the communication difficulties.

Since you have a neurologist appointment coming up, you might want to discuss the opinions of the babysitter and preschool teacher with him. You could ask the teacher to write out her observations. If possible, she and the babysitter could do short videotapes of behaviors that cause them concern, then you could show these to the physician.

Here is a free, online questionnaire you could do, based on your impressions of your son. If the babysitter and teacher also did this, it might prove interesting feedback for the doctor.

http://www.childbrain.com/pddassess.html

Here is another screening checklist you might wish to look at: http://www.brookespublishing.com/store/books/wetherby-csbsdp/checklist.htm

The following article talks about things you might notice if your child is on the autism spectrum: http://www.nlconcepts.com/articles/symptomsofautism.pdf

Below is a list of development milestones that might set a child with autism apart from his typically developing peers: http://www.firstsigns.org/healthydev/milestones.htm

If you register for free at this site (http://www.firstsigns.org/asd_video_glossary/asdvg_about.htm) you can access their library of videos showing typical and autistic-like behaviors.

Given the fact that two people who have your child's best interests at heart have mentioned to you the possibility of autism, your son has language delays and a seizure disorder is also suspected, I think it is worth checking out the possibility that your son has an autism spectrum disorder. If it is not autism, then your neurologist and doctor can help you sort out what is hindering your little boy's development.

If you look into this and it is not autism, then you have put your mind at rest. If he does have an autism spectrum disorder, then you will be aware and prepared to help him develop to his fullest.

Best wishes,

Sharon A. Mitchell, B.A., B.Ed., M.A., Ph.D. candidate
www.autismsite.ca