Expert: Valerie Herskowitz - 4/14/2009

Question
QUESTION: Hi,

I am a mother of two boys ages 9 and 12.  My 12 yr old has mild Aspergers Syndrome, so I am a little bit familiar with Autism.  I am concerned about my 11 month old nephew. My SIL is a single mother. She adopted her son at birth. I am concerned because her son has never made eye contact with anyone.  He almost never responds to his his name when called, yet we know he can hear. He has also has NEVER responded baby games like peek-a-boo.  He has some known developmental delays in motor skills and has just begun to do an army style crawl due to the help of physical therapy, but I find it interesting that now that he can crawl he almost never does.  He is very content to just sit in one spot and play with one toy, usually examining the toy very closely or mouthing it. He doesn't explore his environment.  He is very happy and he smiles and laughs a lot, but only at his toys or his dog and NEVER in response to people.  He makes no demands of his mother and doesn't care if she leaves the room. He doesn't use gestures or wave bye-bye etc.  He will only play with certain toys,ones that spin/light-up or or are shinny.  He is by far the most sweet, happy and easy going baby I have ever seen and I love him, but I am worried.  His mother is concerned too about his lack of eye contact, but she feels that he probably can't be on the autism spectrum because he is so happy all the time and doesn't have melt downs.  I on the other hand am very concerned, but don't know how I can help or if I even should.

Is is possible that even with all those red flags that his mother may be right to not be too concerned?



ANSWER: I think you are on the right track. There are red flags here. The smiling is great, but not all children with autism have meltdowns. Some are very happy. That said, there is a syndrome called Angelman's Syndrome where the child smiles all the time.

The red flags are as follows:
not responding to baby games
already been identified with physical delays
not exploring the environment
poor eye contact
the interest in spinning and/or shiny toys as a preference

I would get him checked out by a really good developmental pediatrician.

One thing-you didn't mention his speech skills. Is he trying to imitate speech yet?

Valerie Herskowitz
valerieherskowitz.com

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

QUESTION: Hi Valerie,

Thank you for the reply!  I had wondered if some children with Autism don't have meltdowns. My son with Aspergers Syndrome sure did.  That is good to know.   I never heard of Angelman's Syndrome, but I am definitely going to look it up. Though he doesn't smile all the time, just a lot.

In answer to your question, he babbles frequently and says things like da da da, ba ba ba, but only to himself.  He does not use his sounds to try to communicate nor has he ever imitated others.

Thanks for listening to my concerns,
Michelle





Thank You!


He is going to see a Neurologist next week, so hopefully his mom

Answer
Though it may be a little early for first words, I would say that someone should check him out, since you have mentioned the other issues. I doubt he has Angeleman's Syndrome, but you could just check it out as they have physical issues in conjunction with the cognitive and speech delays and they smile a lot.

Valerie