Expert: Jene Aviram - 7/23/2009

Question
My son is almost 2 1/2, and honestly ... sometimes he just seems a little "different" to me. It's not one thing, but a lot of little things. I looked at the M-CHAT, test, but a lot of things on there weren't really black or white, and some things I wasn't sure about.

* He has a good-sized vocabulary (over 100 words), but he seems to be pretty far behind his peers in combining them. (His sentences are mostly things like, "Go walk" or "Want snack," whereas other children I know say things like, "He's chasing the kitty.")

* Not much interest in other children. He likes his baby brother and often gives him kisses or asks about him (he'll say, "Baby?" when the baby starts crying, for example). He can identify a friend's daughter, who we see often, in pictures, though when she comes over he doesn't really play with her, or with most other children we know.

* Often seems not to hear his name or other directions. Granted, this is often because I'm telling him to stop doing something he shouldn't be!

* He sometimes covers his ears. This is a new thing, and very infrequent. (He's never shown any oversensitivity to noise or anything else, that I've been able to tell.)

* He's just extremely independent. I joke sometimes that as long as I fed him and changed his diapers, he wouldn't care if I was there at all! That's not really true ... he does like to follow me around the house, and gets upset if put in his room for a timeout. But he often seems to content just to play with his toy cars and trucks all day long. (He does play with other toys, like balls, but vehicles are the hands-down favorite). If I sit down and try to play with him, he'll push his cars back and forth with me, but he almost never approaches me to play. (He will ask for help if a toy breaks, though, telling me, "Fix it!")

I just don't know any other children like him, and I'm starting to worry.

Answer
Hi Alexis,

I always say that you should follow your instinct. If you feel that something is not quite right with your son, it's absolutely worth getting an evaluation.  Believe me - if everything turns out perfectly, peace of mind is a wonderful thing!

One thing is for sure, your son is a very bright boy with good coping skills.  This is certainly a great thing, but it also makes diagnosing or identifying a problem a little trickier.  This is exactly the reason you are unsure, an unclear about some answers for the MChat.  

All the behaviors you mentioned may be found in a child on the autism spectrum.  However, they may all be found in a typical child.  You see, it's not just a behavior, but a set of behaviors and most importantly, the degree to which these behaviors are present in a child, which determines if the child qualifies for a diagnosis.  This is why a comprehensive evaluation is so important.  

If you had told me just about the speech delay and the covering of his ears, I really wouldn't think much of it.  However, it's the lack of interest in his peers, and your last paragraph about the independence that I believe an evaluation is so important.

Call your pediatrician and tell him your concerns.  Ask who you contact for early intervention.  The evaluation, and most likely, any services if granted, will be free, depending on where you live.  I also think it's a good idea for you to read this article called "How do I know if my child has autism?"  I think it might help you, and perhaps even ease your mind.  You can find the article here
http://www.nlconcepts.com/autism-howdoyouknow.htm

I am not for a minute saying that your child has autism.  I simply saying that I believe an evaluation is warranted.  You have nothing to lose by getting an evaluation, and everything to gain. I've heard countless people regretting not getting an evaluation sooner, but I've never heard anyone say they're sorry they did, or that it was a waste of time.  Everything may turn out just fine and then you'll smile back on these early days and wonder how you could have been so worried.  I wish you and your family great luck and success.

Jene Aviram
http://www.nlconcepts.com