Expert: Valerie Herskowitz - 10/17/2010

Question
  
My 2 year old grandson is speech delayed but we are concerned about
autism. He tries to say @ 50 words, but not clearly.

Recently, he has started to point at things of interest and will point when
asked at certain pictures in books. He smiles at others. He understands
and obeys simple commands. He sometimes, but not always responds to
his name . He bites and head bangs occasionally. He shows interest in
other kids, makes good eye contact with his mother but not so much with
others.     

Occasionally he will flap his hands while running toward something
exciting, but doesn't spin or have unusual finger movement. He tried
preschool for a couple of weeks, but he would cry for 45 minutes and
watch the door until she came back each time. Apparently, he could not
be comforted. His teacher found this behavior unusual. When I babysit,
he may cry for a few minutes.

He is mesmerized by Sesame Street but nothing else captivates his
attention for long. He doesn't warm up to most people right away, but
will interact after he becomes comfortable with a new person. He does
have some imaginative play like pretending to pour milk in a cup or cut
up food items with toy utensils. He regularly helps his Mom with
gardening, watering plants, etc.

Occasionally, he would hand lead. He will go to the refrigerator when he
wants something to eat. He can kick a ball and ride a tricycle. He doesn't
demonstrate any odd play, no lining up objects or spinning wheels. He
will push a shopping cart around a lot and likes peekaboo and hide and
seek.

He shows interest in toilet training. He sometimes has temper tantrums
but they don't last for unusually long periods of time.

He is scheduled to receive speech therapy and and a developmental
evaluation. In the meantime, we are worried, so I'd like to know if these
behaviors are typical for his age. The problem, in our minds, is that he
does have some flags, but none of the things he does seem overly
unusual to us. Thanks

Answer
Hi Sue

I am really glad you are going for the evaluations. These are not typical behaviors-he does have red flags. It is obvious that he is not communicating effectively-thus the need for hand leads-that is a big red flag. Also the limited attention and limited interests plus the temper tantrums.

Let me know the results of the evaluations-and then we can go from there.