Expert: Ettina - 12/18/2009

Question
Hello,

I have a son whose going to be four next May. He has speech delay as he says words only. He does not communicate with sentences but one sentence which is ( I want ...) to the response of the question ( What do you want? ) He can point to things that he knows only. very much interested in books. He does not have any social relationships with friends on nursery although he does not mind playing around them and setting with them in the same setting ( class) He is generally a happy child. very cuddly. Makes very good eye contact with me, his dad and his teachers only. Little eye contact with other children. Lately he started to relate to his little sister. does imitate me and his dad very well but wont play imaginatively. He has very short attention span. He responds to his name every time we call him but I notice that he starts jumping high when watching his favorite shows on TV. He hums all the time and runs aimlessly in the house. He is potty trained since he was two and a half. Tells me when he feels he wants to go to the bathroom. He frequently put his hands on his ears without any reason especially when watching TV. he loves music. memorize most of the rhymes at school. He is not aggressive, on the contrary, he is a loving little boy. No tantrums. Has some food preferences but when forced he can eat other kinds of food. I am doubting that my son is on the autism spectrum. would you please advice if my thinking and worrying is right? another question is could the delay of speech cause some autistic like behavior to appear? Thank you in advance.  

Answer
He does sound autistic. Typically, a speech delayed non-autistic child would be just as sociable as most kids, but using nonverbal methods of interaction. They also wouldn't have the stimming that your son has.
Note, however, that your son's prognosis is pretty good. Of kids who grow from a classical autistic presentation to more Asperger Syndrome type (geeky but quite capable), all of them were using communicative speech by the time they turned 5. It's important to note that high functioning forms of autism appear to be common among engineers and mathematicians (as well as other highly skilled people), and some people have even suggested that Albert Einstein and Bill Gates might be autistic.
There are also some kids who act as autistic as your son does, but once they learn to speak they're left with so few quirks that they're diagnosed as ADHD or learning disabled instead of high functioning autistic. So that's another possibility.