Expert: James Michael Roan - 7/20/2009

Question
QUESTION: Hi -
My daughter is 24 months old.  She is very verbal - probably knows over 250+ words and talks in sentences the majority of the time (Can I have milk?  Mia (dog) is running around, etc).  She has a very shy personality and is slow to warm up, which I think leads to some of my concerns.

Specifically, she is very obsessed with her brother, who is 5 months.  She is very “in to” him and is great with him – always gentle and actually plays games like peek-a-boo and they both enjoy it.  In general, she loves playing with her dolls and has great imaginative play (puts in highchair, feeds, talks on the phone, etc).  But with some (certainly not all) questions like "Do you want to go to the Dairy Queen" she will say "Andrew (her brother) wants to go with" without actually answering the question.  Also when meeting strangers she will pretty much only talk about him (Andrew does this, that, he spits up, he cries, etc).   There are other questions that she answers accurately (do you want more milk, do you need help, can you want to go to the park, etc).

Other than that, she isn't too upset if we have a change in routine, has good eye contact, points, can accurately answer questions, eats all food fine, etc.  The only other thing I notice is that when she is nervous / in a new situation she will basically tap her fingers together.

Anyway - sorry for the long question but do you see any behavior here I should be concerned with?
We recently met with our pediatrician who suggested potential OT for shyness (? Not sure that would help) but we are waiting to hear back.

Thanks for your help!
Heather


ANSWER: Hi Heather;

She sounds fine to me, but to better settle your fears I suggest you download the M-CHAT and score it. If you have any questions write me back.

M-CHAT:
http://www.firstsigns.org/downloads/m-chat.PDF


Scoring:
http://www.firstsigns.org/downloads/Downloads_archive/m-chat_scoring.PDF


Kind regards,
James


Disclaimer:

While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find our resources useful.


Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting assessment professional responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.






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

QUESTION: Thanks for the info.  The only question she did not "pass" on the M-CHAT was #11, and that really isn't a huge deal (only one thing I can think of and its a loud blender).
Do you think things like toe-walking (she does this rarely), hand flapping (rare, tends to be when she is tired and frustrated) are things to be worried about?  I see the M-CHAT doesn't cover this so I'm wondering if this occurs in normally developing children as well?
Also - based on your expertise, would you think Occupational Therapy would be a good idea for shyness issues?  Our ped referred us - basically she is really shy (an observer) in social situations and takes a LONG time to come out of her shell.  Just this AM I took her to a class at the library and she cried when a little boy came up to her.  She was ok after about 15 minutes - didn't really interact with any of the kids but watched and was interested.  Finally played with some toys but by time she warms up most of the class is already done.  I'm not sure if this is just personality or what and if OT would be beneficial?

Thanks again for your expertise advice.  I really value your input.
Heather

Answer
Hi Heather;

Actually, I read some research last year that reported some form of stereotypy, such as hand flapping, occur in 20 percent of typically developing children. I'm not clear on what the OT would do for social skill improvement unless they are providing Stanley Greenspan's Floortime therapy, which is quite effective for developing joint attention and social interaction.

Kind regards,
James


Disclaimer:

While James Michael Roan has attempted to make the information on this web site as accurate as possible, the information is provided in good faith without any express or implied warranty. The purpose of this web site is to provide information to families with children, teens, and adults with an autism spectrum disorder or other developmental delay. James Michael Roan does not prefer any one organization to another, and it is not responsible for the information listed on an organization's web site, or any disseminated information either verbal or written. Please be advised we are not giving medical advice and that circumstances can dictate different treatments. If these issues affect you or your loved ones you should seek professional advice. This site is operated for informational purposes only. At no time will James Michael Roan attempt to diagnose or dismiss a potential diagnosis over the Internet. We hope that you find our resources useful.


Bio

James Roan is a certified school psychologist who has been consulting in the areas of autism, Asperger’s Syndrome, and learning difficulties in the United States and in Ireland for over ten years (http://www.jamesroan.com). James earned his M.Ed. in School Psychology and M. Ed. in Adult Education and receives ongoing post graduate training in autism at the University of Washington’s Autism Center. James Roan has traveled to Galway, Limerick, Mayo, Clare, Dublin, Cork, Waterford, and other cities and counties across Ireland assessing children and adults, and consulting with solicitors (lawyers) in defense of children with disabilities. James Roan was the consulting assessment professional responsible for many of the autism and AD/HD screening tools and other content for Access Special Needs.Com. James Roan consulted with the graduate department of the Waterford Institute of Technology in Waterford Ireland in the development of their graduate program for the certification of private autism tutors. James has conducted formal assessments of students in the Autism Unit in the Claddagh National School in County Galway Ireland.