Expert: Jene Aviram - 1/3/2010

Question
QUESTION: Hi Jene,
I have contacted you before about my son.  He has hit some more milestones since last contacting and I would love to know your thoughts about his development now.

I have some concerns which are:

- He is 13 and a half months old and has NO words as of yet.  Not even mama or dada in context.  He babbles and jargons (interspersed with frustrated screethes...) alot but I cannot decipher any actual words.  

- He is extremely fussy with food.  Although he is very healthy, he often is not interested in food at all and isn't great at "self-feeding" unless is is fruit or crackers.  

- He has a very mild "tic" (for want of a better word) where he brings his left shoulder up to meet his left ear (and his left ear down).  He doesn't do it often, maybe 3,4 times a week.  But I have noticed it.

- He is more interested in "household items" (a saucepan, a plug, a screwdriver etc) than his toys.  

- He looks at peoples mouthes when they talk.  He will look you in the eye, until you say something, then his vision is drawn to your mouth.  I'm not sure if this is a normal way of him trying to learn to speak - I've not seen other toddlers do this...

- He only turns to his name 50-60% of the time.  If we are at home, it is mostly.  If we are at the park, or he is playing with other kids etc - mostly not.  

- He is a bolter.  He walked from 10 months old and as soon as you put him down at the park, he's off.  Try and get him to stop to his name - impossible!  If we are at the park and he is off and I call his name, he will never turn to it.  Well, very rarely.

On the flip side:

- He has pretty good eye contact.  Can hold and maintain eye contact with us and other people.

- He waves hi and bye (this is a recent skill, in the last couple of weeks)

- He doesn't seem to have an aversion to other children.

- He seems to understand alot.  If I say where's daddy?  He will point at daddy.  If I say where are your books, he will go and get one (he loves being read to).  He seems to understand and carry out really simple instructions (on his terms.....of course!)

- He points at his wants (everything!) and is sort of starting to point to share something (plane etc).

Am I expecting too much of him?  I guess the total lack of words at this point is really concerning me.

Thanks for taking the time to read and respond to a worried mum's babble!

ANSWER: Hi again Melissa,

I know how scary it feels to be worried about your child developing appropriately so I know where you're coming from.  Your son is still so young and it's really hard to determine a lot of issues at this age.  I know how hard it is to wait a few months but it can really make all the difference.  Just in the last two months your son has started waving hello and goodbye and pointing to everything he wants!  This is huge!  And it's a really fantastic sign.  Most children with autism do NOT point to things they want, and if they do, it's often for a short time only.

In regards to his speech, he should have some words by now but this alone is not a big concern.  With some speech therapy and a bit of time, this typically works itself out.  Actually, probably the most concerning thing you said is that he is more interested in household objects than this toys.  If you had just told me this along with his tendency to bolt, and the way he focuses on people's mouths when they talk, I'd be worried.  But on the flip side, he does so many great things which are very atypical to a child with autism.

In our last discussion, I think you were going to mention your concerns to your pediatrician.  What did he say?  I don't think you're in the USA but does your son qualify for a speech and language evaluation?  I think I would start right there. Speech therapists are typically very aware of child development and can probably give you great insight after meeting your son.

I truly understand how difficult it is to wait for a few months, but another 4 to 5 months can change the whole picture.  By then your son might be chatting up a a storm and you'll marvel at how you were so worried before.  Your son is unusual in that he has a few concerning points but at the same time, he has some absolutely impressive skills.  This is why an extensive personal evaluation is the only way to really get the full picture.  It's simply impossible to diagnose over the Internet.  And sometimes when we're really concerned about our child, we tend to notice little things that other parents wouldn't think twice about.

If I were you I would explain my concerns to the pediatrician and ask how you go about getting a thorough evaluation.  Perhaps this will finally put you at ease.

I wish you so much luck and wonderful results.  I hope this has been of some help.  You're welcome to reach out to me anytime.

Jene Aviram
http://www.nlconcepts.com  


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

QUESTION: Another thing I forgot to mention is that he is a fairly good immitator.  He claps when we clap.  Does this thing where he bounces up and down by bending his knees when we do.  He does back and forth sounds with me most of the time too.  If I say mama, he'll say mama etc.  Only for certain sounds though.  Mama, dada, ditto, garden are his favourites.  No idea where the garden came from, he doesn't mean it as the word garden, it's just the sound he seems to like to make.

He also puts his hands up to be picked up (ALOT!!!)

ANSWER: Even MORE reasons to be hopeful.  These are really good signs.
The waiting part is the hardest.  Try not to focus on your concerns and just enjoy the special moments.  I know that seems impossible to do but your son has a lot of great skills and it would be so much fun to just relax about it.  There have been a lot of good changes since your first post and that is wonderful.

I wish you so much luck

Jene Aviram
http://www.nlconcepts.com

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

QUESTION: Hi Jene,
I thought I would write you with a follow up on how my son is doing.  He is just over 14 months - and still no words.  He says "ta" when he gives you something, that is all.  He is still waving alot and bringing myself and my husband things to show us, giving them to us and saying "ta".  I'm not sure if he is bringing them to us to "show" us, or to get us to do something with them!  He is still pointing alot.  Lots of pointing (and screetching) when he wants something.  He also points things out to us, mainly birds, planes and wheelie bins.  Those are his thing at the moment.  He hears the planes before he see's them and points them out.  

He still looks at our mouths when we speak.  His eye contact is ok, he will look at our eyes until we say something, then his gaze drops to our mouths.

He doesn't seem to have any sensory issues that I can tell.  He likes to push himself up into one corner of his cot when he sleeps, that's about it though.

I have cancelled the pediatrician appt on the 25th January as I have some hopes that I might be able to get into the Dev Pead that I really want him to see.  I have to contact her late Jan as she is opening some spots for younger children and I am hoping to grab one of those spots.  I'd really like him to see a developmental pead rather than a standard one.

That is all.  I just thought I would keep you up to date.  
Kindest regards
Melissa.

Answer
Hi Melissa,

I know you are worried and I know how stressful it is when you just want answers.  It's so much easier to just know what you're dealing with.  Sitting in limbo can really take it's toll.

It's really encouraging to hear that you might have an appointment on Jan 25th.  I do agree that a developmental pediatrician could shed more light on the situation than a regular ped.  In the States, we can often call a doctor each morning to see if there is a cancellation.  Is that possible to do where you are?  You might get lucky and get an early appointment that way too.

I do have to reiterate that your son has some great skills.  There are a few concerns but much of what you've said is a really good sign.

Hang in there.  And let me know how it goes.
Sending good vibes your way.

Jene Aviram
http://www.nlconcepts.com