Expert: Valerie Herskowitz - 3/26/2009

Question
I always tell people that my daughter is "a different kind of baby." She has always been very demanding, very persistent in her screaming (for hours on end sometimes) and when I read about Dr. Sears' "high needs baby," it sounded like he was talking about my baby.

My main concern is her extreme anxiety around new people and being left without Mama, and the fact that she neither uses any words consistently nor seems to understand much of what I say. I often worry that she may have a social and/or language delay. Below is a long list (sorry) of traits that I could think of. Can you tell anything from my laundry list?

General
Very clingy, cries/whines if mama is out of sight for even a second
She smiles wide and often, at predictable things (peekaboo, Elmo, the cat, etc.)
She clutches random objects or toys tightly for hours at a time, and has a complete meltdown if you take them away. (Her favorites are hairbrushes, coat hangers, spoons, or highlighters.)
Has violent tantrums when she doesn’t get her way (throws head and torso backward, mules kicks, flails arms, scratches and bites)
With any object she encounters, she has two moves: first, shake it to see if it makes noise, second, see how it tastes.

Gesturing /Communication
Just learned to clap her hands, no gesturing otherwise
Doesn’t point or follow my pointing
No longer waves bye-bye (stopped suddenly in December)
She clearly understands a handful of words, and she will often look in the direction of an object if you ask her where it is (ball, duck, book, Elmo, dada, cat), but overall, she doesn’t seem to really understand language or almost never follow commands.
Doesn’t use any words consistently; sometimes will say “Mama” and “Dada” or ask for a “Ba ba”. She does babble all the time, using many consonant sounds (ba, ka, ta, sa, sha, ha, na, duh).
Will often give real kisses if asked (oh so sweet)
Sometimes uses the sign for “all done”
Loves to imitate the cats’ meows
Some days she will imitate behaviors (like touching her belly button), but most days will not (and most of the time it is like she doesn’t understand you at all)

Physical
She is very tall and thin, not much hair
Has been able to go from lying down to sitting by herself since 9 months old
Can hold and manipulate objects, pass from hand to hand, throw a ball
Crawls very well (started crawling at around 10 months)
She started pulling up at 10.5 months
Stands/cruises on the tops of her feet (curls her toes under)
Stands by herself, can take a step or two, “walks” when you hold her hands, often on her toes

Social
Extreme resistance and anxiety in new places or around new people – she takes about 20-30 minutes to adjust if I am there, sometimes never stops crying (for hours) if I leave her
Seems frightened of people, or shy, even if she has met them before
She laughs often for me and her Dada, usually at peekaboo or other unexpected actions (cat sneezing)
She knows her name and responds to it
She enjoys looking in the mirror, will sometimes wave at the baby in the mirror
You can’t really engage her in any type of game or activity (she will watch you play peekaboo and laugh, but doesn’t reciprocate, she doesn’t give you toys, she doesn’t imitate behaviors)

Eating
Doesn’t ever seem to be hungry (feeding has always been a challenge)
Doesn’t hold her own bottle or cup
Gags on nearly all solid food, often vomits during feedings
Weaned completely from nursing the day before her birthday

Sleep
Still requires naps every 3-4 hours
Sleeps through the night, in her own room, from around 9:30pm to 7:30am
Has had at least one episode of ‘night terrors’


Answer
Hi Michelle,
One thing that I can say is that you are great observer and your list is wonderful and quite descriptive. From your list, there are many issues that I see as "red flags." Basically, the lack of speech and the extreme anxiety to new things along with the meltdown when you take things away. And the objects that she likes are unusual. Also, the lack of consistent imitation.

I hate to say it, but you need to take this list to a qualified individual (psychologist, developmental pediatrician, or pediatric neurologist) and get an opinion.

Afterwards, write me back.

Valerie Herskowitz, MA CCC-SLP