Expert: Trey McGowan - 4/17/2009

Question
QUESTION: Hi,  I have an 11 month old daughter who I have had some concerns since she
was born.  I have always had concerns with her eye contact.  When I use to
feed her when she was a baby and even now, she does not hold eye contact
for very long.  This includes when she is being fed in her highchair.  Her eye
contact is good when she is not being held.  She has also disliked being
cuddled since she was born, if she is in the cradle position she tries to sit up
and get out of it.  However, if you are just holding her and walking around
she is fine.  She has been fine with sleeping, takes 2 naps and sleeps 12
hours at night with no issues.  However, she does need to be at home or in
the car to sleep well.  She also seems to have some sensory issues, she does
not like her hands or mouth touched (may be because of teething?).  
Although she will let you hold her hands to walk.  She is ok with eating solids,
although she has never seemed like she has a big appetite.  This may be due
to her chronic constipation which I can't seem to get under control with
dietary changes.  She has been babbling for some time and sounds like she is
trying to repeat sounds.  Although she seems to go through phases of saying
sounds.  Will say Dada for a few weeks, then Mama, then not dada etc..  She
seems to have a great memory.  She is very active and is constantly on the go,
there does not seem to be any issues with her motor development.  She is
gesturing towards items with her whole hand, not yet with her index finger.  I
am not sure if this is something she should be doing at this stage?  She does
try to imitate actions (ie/ brushing hair, brushing teeth, feeding me food) and
will show me items/toys.  She also will look in the direction of items I name
and seems to understand simple commands (ie/ come here, where are your
shoes? etc..) She does not sit for very long to play with toys, more interested
in crawling and cruising around.  The last few weeks when a friend, and once
a stranger has been holding her, when I asked for her to come back to me,
she has cuddled into them and not wanted to come to me?  Her name she
seems to respond to 50 of the time, it does not seem to be consistent.  My
doctor is not too concerned because he thinks she is young.  However, I
managed to get an appointment with Early Intervention Services.  This is my
first daughter and I just want to make sure I am doing everything possible
and she gets the help if needed.  Also, are you familiar with the tilt test to
detect Aspergers?  How accurate is it?  I tried it on her when she was around 8
months old and I think she kept her head in line with her body on one side,
but not the other, although I am not sure if I did it correctly.  Another positive
thing is she loves Peek a Boo and does imitate some actions (waves bye bye,
claps hands).  She will also initiate Peek A Boo by putting a blanket over her
and will also try to get me to catch her when she is crawling (she thinks it is
funny).  Please let me know if you require further information.  Thank-you!

ANSWER: Hi there, Olivia!

I tried to read through the block of text that was offered, but after three read-throughs, I'm still a bit confused. What exactly is it that is concerning you with your child? You give a great deal of information about what is *not* concerning you, but while you say you are concerned, I'm not sure I was able to find which part *was* concerning you. Can you clear it up just a bit for me?

Also, you mention the 'tilt test'. You need to remember that there are a vast number of other things which could cause the child to 'fail' this test. Among these are ear infections, neurological deficiencies, a physically weak neck, or even just a tired child. In addition, one single test being used to diagnose Asperger's is rather like using a 'sneeze test' to diagnose a cold: if the person sneezes when their nose is running, they have a cold. Not only are there many other things that could cause it, but there are a multitude of other symptoms that go into ASDs. Sensory, social, and logic issues have little to do with whether their head tilts to one side or the other. I find this 'tilt test' to be extremely iffy for anything except indicating that something is not quite right, rather than identifying exactly what that 'not right' is.

I look forward to a follow-up on this, that I might be able to help you further! Any additional comments or feedback are welcome as well!

Trey

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

QUESTION: Hi Trey,  I am sorry if I confused you.  The main things I am concerned with
are: 1) Not responding to her name all the time 2) Sensory issues : not liking
hands and mouth touched 3) Not liking to be cuddled 4) Clinging to a
stranger and not wanting to come back to me? 5) Chronic Constipation (which
I have read can sometimes be common in Autism/Aspergers  6) Not pointing
with finger, not sure if this is something that comes at a later point?   Thank-
you!  Olivia

Answer
Hi there, Olivia!

As you yourself know, since you mention it in your summary, these are all potential signs. However, if you are asking me 'Is my child Autistic'? That's something I can't answer. I am not a doctor, nor if I was, would I consider giving any child a diagnosis without direct observation. It's just too easy to make mistakes when you're just taking someone's word at something.

About all I can say is that if you are looking for a diagnosis on your child, you should look for a local expert (as opposed to a far distant AllExpert) who might be able to do the job more accurately, and more directly. I'm not sure where you are to be able to point you at anyone, but a look in Google for your city/state/province/whatever and 'autism support' or 'autism diagnosis' should help you find some names.

I truly wish I could offer more than this, but with this level of distance, there's nothing other than 'Go to one who can tell more'. I wish you all the best! Any more follow-ups, questions, comments, feedback, are more than welcome, though!

Trey