Expert: Valerie Herskowitz - 8/2/2009

Question
QUESTION: Hi,
I have a 17 month old son that was born 5 weeks premature.  I have had him evaluated by Early On and they think that he is developing normal, but I still feel like he exhibits some odd behavior.  For example, he loves to be around me constantly.  He is my first born and I am a stay-at-home mom so I am with him constantly, but he wants to be with me even when my husband is home and is trying to play with him.  If he hears me, he says mama and comes looking for me. He gets upset even if we go downstairs to get something and he is upstairs. Everyone tells me this is very normal at his age, but I'm not sure. He loves to play with his Legos and seems to pick up the ones that match in size at first but then he will play with all of the blocks when we build things together.  He will carry them around, but if I tell him to leave them on the floor or take them away he will.  He laughs at wierd things like the garbage disposal or something making a loud bang noise.  For instance when his wagon handle dropped he thought that was funny so he kept dropping it so it would make that noise.  He notices lint on the floor and will pick it up and bring it to me, but he is doing this less frequently.  He also notices when something is out of place or is new.  For instance if our bar stools are sticking out he will push them back or if a drawer is left open he wants to close it, but if I tell him to stop and leave them them the way they are, he has no problem doing so.  As a matter of fact, I can tell him to stop doing anything and he will stop.  We originally called Early On because he wasn't pointing with just his index finger, he has always used his whole hand to gesture and grunted and looked at us to get what he wanted.  He has now started to use his index finger a ton more, but he doesn't always look back at us when he points to something of interest. He will follow our point and our gaze at something.  He can make animal noises but can't say the name of the animal.  He does day mama, dada, up, bye bye and is starting to imitate certain words we say.  For instance if we say green he will say gree or diaper is iaper and grandpa is anpa.  He even says Ahh and looks at our cat who's name is Oscar when he sees him or when he walks into a room.   He also has very good eye contact when we are on the floor playing but it becomes less when we are holding him and ask for him to look at us.  Our doctor isn't worried because he has good eye contact with him and he is a stranger.  He also doesn't flock to kids his age although he is very interested in them and will smile and wave to them.  I haven't really socialized him much with kids, which my mom says I need to do more, so I don't know if this could be why.  The OT said that he may have a sensory issue like with her vibrating toy, but he would touch it after he got use to it.  He doesn't have any big issues with my vacuum, hair dryer or my husband's vibrating toothbrush.  He is always waving to people in the stores or at restaurants and when we are walking around our subdivision.  He does flap is arms when he's excited or a little mad, but it's only for a second and he doesn't do it any other time, and  I think most normal kids flap their arms sometimes too.  He understands everything we say and wll follow simple directions.  He answers to his name, but sometimes will answer less frequently if we are in a room with a lot of people.  He sleeps well and eats well too.  He doesn't mind having his nails clipped, loves baths, his hair brushed, and teeth brushed.  He loves to be picked up and held and gives hugs and kisses, but won't sit and cuddle for a long period of time which I thing is normal since he wants to get up and go, but please tell me if I am wrong.  He knows all of his body parts and some shapes and colors. He loves to feed people and his stuffed monkey.  He will imitate us, play hide and seek, peek-a-boo, and gonna get you.  He always checks to see if we're watching him when he plays with something or accomplishes something.  He will give us things when we ask and bring things to us.  He notices when we enter and leave a room and has always reached his arms up to be picked up. He holds his arms up when we say all done and if he knows he's not suppose to touch something he will look at me and shake his head no and then look back at the object.  He will even act like he's blowing his nose and point to the kleenex or paper towel.  Early On says that he doesn't qualify for any type of intervention as I have brought these concerns to them and they aren't worried about it.  They said that it's only a concern when the level of the obsession or interest begins to affect their daily routine and when I can't get him to stop doing something. As far as noticing little pieces of lint on the floor and bringing them to me, they said they weren't concerned because he's not fixating on it and picking lint off of my rug constantly, just when he's crawling and sees it and he's at the age where he notices everything.  I know that he is going to be behind because he was born early and I'm hypersensitive since my cousin has an autistic son, but I just want to make sure.  I would rather be considered an obesssive mom than a mom in denial.  Please let me know if you think any of these things are a red flag.  Thank you.

ANSWER: Hi Shannon

Frankly I have to agree with Early On. He seems to be within normal limits for development at this point. I would watch to make sure that he continues to develop more words. By the time he is 24 months, he should have approximately 250 words and be putting a few words together. Also, watch to be sure he doesn't increase in the closing doors and drawers thing. Keep an eye on him for the next 6 months. You should see steady growth and development. I wouldn't worry right now, but I would keep a vigil on him for the next few months just to be sure the development continues.

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

QUESTION: Thank you so much for getting back to me so quickly.  My husband and I just has another question regarding your response related to opening and closing drawers and cabinets.  What level of activity is considered concerning regarding opening and closing doors?  Is it the fact that he closes a drawer that I may have left open and doesn't just leave it alone?  Or is it if he opens and closes doors for long periods of time over and over and I can't get him to go onto something else?  Thank you again.

Answer
Both. Just the fact that he has to close it is one thing. And the fact that he opens and closes for long periods of time is also concerning.

The comments that you made regarding the drawers as well as the the fact that he notices when things are out of place and the legos are things that are red flags. But to be honest, sometimes these issues go away over time in some kids. And being that you don't really have a lot of delay in other areas makes me say that you should just hold tight and wait and see. I really want to see what happens in 6 months.

I have two children. My oldest had a lot of these repetitive behaviors. He did end up needing speech and sensory based therapy, but eventually the repetitive behaviors went away. Today is a bright 20 year old who is a senior in college.

My other one is severely autistic.

Your son sounds more like my oldest. So don't get too excited now, but keep an eye on things for the next 6 months. Write me at anytime.