Expert: Valerie Herskowitz - 12/9/2010

Question
My 21 month old had her evaluation with a child psychologist yesterday and she diagnosed her as "pretty autistic".  My daughter does not flap her hands, no stimming, no repetitive behavior, no routines, does not line things up, and does not get stuck on things.  She is not afraid of leaving our home and is easily adapted to changes.  She is not afraid of loud noises or crowded places.  She is not afraid of being around others and will play around other children, but rarely with them.  She gets EI thorough the state and it is one on one therapy but she does see other toddlers there.  She is always looking at them and will constantly look at them to see what they are doing.  She even sat and played with another toddlers toy while he was playing with it.  However, my daughter tends to lick almost everything, as well as her self.  Almost everything she sees she licks.  She also bites herself.  She is delayed with language, only saying 4 words functionally.  She does not point things out and does not correctly play with toys (which I think is due to the sensory-licking of toys all the time).  She can have good eye contact and respond to her name being called.  But, if there are too many things going on she will shut them down.  For instance, yesterday she responded to me when I called her name and looked at me, but when we got to the evaluation she shut down.  She did not respond to her name and avoided eye contact.  The psychologist did too many things with her in a short amount of time and it made her walk around the room licking things.  Her OT things it is SPD (sensory processing disorder).  She started her on the therapressure brushing every 2 hours and it did a miracle.  She stopped licking, started to play toys  better, and even responded better to her name being called out.  Her eye contact increased.  But after being on the brushing for almost 3 weeks we had to stop because she got a stomach bug and it was making her irritated.  We restarted the brushing again 2 days ago.  It took about 2 weeks to see results last time, that when she had her evaluation yesterday it took no effect on her.  I think that if we never stopped the brushing she would have been diagnosed with SPD.  I just think that if it was autism her symptoms would have been worse and would not have resolved itself so quickly with the brushing.  I know that SPD could affect eye contact, responding to name, and language.  She did not start walking until 18 months old due to weak muscle tone, which is another sign of SPD.  She sometimes walks on her toes and outwards.  I know that is a sign of autism, but also of SPD.  She also sits using the w-sitting position due to her lack of muscle tone which is another sign of SPD.  What are your insights about all of this?  Do you think the diagnoses she got was a correct one?  Thanks for your help...

Answer
Hi Jenny

I do agree with the autism diagnosis. She does of course have SPD, but only as a component of the autism. Here are the issues that you have listed in your letter:

will play around other children, but rarely with them.
lick almost everything, as well as her self.
She also bites herself.
he is delayed with language, only saying 4 words functionally.  
She does not point things out
does not correctly play with toys
She did not respond to her name
avoided eye contact

As you can see from your own comments, there are some their that not only deal with sensory but also with social and language. This is why she got the autism diagnosis. If it was only sensory, then the issues would be only sensory.

It is confusing when someone makes progress-but that is a good thing! Young children with autism can make progress. So keep up with her therapy-make sure she gets speech therapy as well, and stay focused on improving your daughter's abilities rather than on the label.

Take care