Expert: Valerie Herskowitz - 9/23/2009

Question
QUESTION: My daughter just turned 18 months old this week. She is wonderful and I know I may be worrying for nothing but I have some concerns with things she does and I wanted to see if someone with autism experience could tell me if they are red flags or not. To start I can say she has not been delayed developmentally. She smiled before 3 months, crawled at 7 months.. babbled very early. Right now she says around 50 words and is starting to combine them.. i.e. oh-no, all done, bye airplane ..things like that. She also points to things she wants. If she wants me to sit next to her she says momma and points to the seat. She has a tea set and pretends to pour tea in a cup and drink it.. she also will give some of her juice to her dolls..if she sees an airplane go bye she points up and says airplane.. so all seems good. But there are some things that concern me. She flaps her arms fairly often. When she is upset she does it.. sometimes when she is excited and recently she was at a play gym and was on a slide and seemed to get nervous and flapped her arms and said uppie so I could get her as apposed to her going down the slide. Is this normal at 18 months or would this be a "red flag"? Also when she switched rooms in daycare from the infant room to being in the toddler room she had a hard time adjusting. For the 1st week she cried and would ask them for "ni ni" a lot. Basically wanting to sleep as a coping mechanism. She seems better now (3 months in) but she gets attached to toys there and gets upset when you take them away. Another thing is even though she has been in daycare since 3 months she seems so shy. She seems to like kids but she really doesn't like anyone other than myself or her dad or grandma to hold her. Something else is.. (we live in an apartment) and have used the elevator daily her whole life. I would say in the past month it has happened that she is now afraid to get on. She will get on.. but she holds on to the side and steps over the opening between the doors and says "owie". She now does this everyday.. when before she just stepped over it with no problem. I am sorry this is long I just wanted to give as much info as I can. She also used to call for momma or dadda when she woke up in the morning from her crib and now she seems to just play and look out and talk to her toys. She will say uppie sometimes but usually i just hear her and go get her. Is it odd that she stopped calling for us. Lastly.. she repeats a lot. If we see an airplane she will say airplane.. and it will go by.. and she will probably say it a good 10 more times. If we see a truck go bye she will say "that?" and i will say its a truck and then she will say "more" wanting another truck to go by.. if we are driving and a car beeps she will say "beep" and then probably say that a good 5-10 times. I dont know if any of that is anything to worry about but I thought I would ask. Again I am sorry this is so long and I just appreciate any information you could give. thank you.

ANSWER: HI Brenda

Well, I must say you are a very astute mother.

Certainly your daughter is developing quite nicely in the speech and comprehension areas. That's a good sign.

However, you do bring up some red flags in regards to her behaviors. The ones that I would keep my eye on are the repetitive speech and the anxiety issues. I don't feel the fact that she isn't calling out to you anymore is a problem.

Let's watch her for the next 6 months. If you notice any increase in the above issues or a decrease in her development, write me back right away. I am hoping that the red flags go away. But for the time being, let's watch her but not worry too much!

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QUESTION: I really appreciate the quick response.. though now I will say I am even more concerned. My only other question would be do you think it is possible that these things will go away or is it likely that if you have red flags at all that most likely there is some underlying issue? Being that at least as of now.. her speech is good, she answers to her name, Dr. even commented on her good eye contact.. does that make autism less likely or is it too early to tell since she is only 18 months.

Answer
I person can have some little things going on without it being autism. I really doubt your daughter has autism. I think you should watch the anxiety and repetitive speech-not as signs of autism necessarily, but just as possible concerns by themselves. In other words, these behaviors might totally go away. But even if they don't, it doesn't mean she has autism. It may just mean she has some repetitive behaviors and anxiety issues. I would also watch to see if she develops any ritualistic behavior-like always wanting to do the same thing, wearing the same clothing, or if she shows finickiness about foods or anything like that.

Right now I wouldn't worry. Often, these things go away with the maturation of the sensory system. Let's just watch it.