Expert: Valerie Herskowitz - 12/18/2009

Question
Hi Valerie

My name is Julie and I have an 18 month old daughter. She had a Developmental Specialist meeting this week and he has referred her for an assessment. I am waiting for them to call me to set up an appointment. I wish for some advise on what you think.

I first started to see red flag signs in my daughter just before she turned one. I noticed that she didn't like cuddles and still doesn't and she flaps her hands and is usually inconsolable, this was before she had her first birthday.

Now she is 18 months and she now displays many red flag signs. I will list some of the issues for you.

No single words other then the occasional Mom (often indiscriminately)but is babbling without meaning.
Does not comprehend to what we say to her (eg. get the ball#.
Does not point when asked where's.....? but will point to random things.
Poor close/engaging eye contact but has reasonable distant eye contact.
Rarely engages, often prefers to be on her own.
Often approaches strangers in a overly enthusiastic manner and touches them #she often scares people with her aggressive forwardness#.
Does not engage in reciprocal situations and often ignores when someone is trying to talk to her and talks at you.
Rarely waves hello/goodbye, often looks confused.
Does not raise her hands above her head and has only the last couple of days started to shake her head no.
No imitating of people, sounds or things.
Rarely responds to her name.
Excessive attachment to her wrap and focuses very intensively on the corners and makes stimming sounds for long periods of time.
Frequently covers/flicks her ears, hearing test came back normal and no medical issues#checked multiple times).
Hates being handled, especially her hands and feet.
Resist cuddles although will often give kisses.
No imaginative play as yet.
Rarely plays with her toys, is often just mouthing or fiddling with them.
She is very aggressive and violent and has been aggressive with other children and laughs at it.

These are some of her issues and recently she has started to walk on her tip toes. She walked at 14 months but now that she has been walking for some time, she seems to have a clumsy way about her.

Can you please tell me your thoughts are.

Thank you and kind regards
Julie

Answer
Hi Julie
Thanks for the very detailed letter.

I am glad that you have the appointment for the formal assessment.

I think you know in your heart that your daughter is displaying many of the classic signs of autism. At this point, I am guessing that she will be diagnosed by the specialist to be on the spectrum. As hard as this is going to be for you, the most important thing is to try and focus on what you need to do for her. It will be natural for you to want to mourn for awhile-that is totally normal for a parent that hears that their child is not developing in the appropriate fashion. Depending on who you are, you may need to accept that feeling sad is ok at this point.

But in addition, you must start getting busy. Your life will begin to change (it may have already). Having a child with these types of issues requires you to be focused on helping her and it requires a lot of time and energy. I believe that parents can be an integral part of the intervention process. Hopefully, after the assessment, she will begin to receive some services like speech and occupational therapy. But that will not be enough. Research indicates that it is very important at this age to begin an INTENSIVE early intervention program. It is recommended that 25 hrs a week or more is necessary to insure maximum potential. Your daughter is very capable to learn and grow. But she must have the input that she needs.

Firstly, we must focus on language and communication. Before she can learn to speak, she needs to learn how to communicate. This is one of my areas of specialty, and I can help you with this.  If you would like, I can help you develop a hone program to start to teach her communication skills as well as to help you teach her verbal imitation. Doing both of these things will help her get on the road to proper communication and speech.

In addition, she needs an intensive sensory input program to help her become less resistant to touching and sound sensitivity.

You can email me directly at:
info@valerieherskowitz.com

Good luck-My thoughts and prayers are with you. I have been down this road many times with my families and of course, personally, since my son has autism.

Stay in touch!