Expert: Valerie Herskowitz - 12/14/2010

Question
QUESTION: Hi Valerie,
A few weeks ago at our 18 month well visit I filled out the CHAT questionnaire, I answered mostly yes except for imaginary play and pointing. We are now waiting for early intervention. I am wondering if pointing is something that can be taught? I have never really taught pointing to my son, only since the test have I introduced this. Also, I have just started encouraging pretend play, I have noticed my son pretend reading ,turning pages of his books, wondering if this is considered imagination play? My son wont point at things but will point to his eyes, or the light when asked but never on his own. He pointed once when he wasnt asked, he has started this pointing within a few days of me showing him how to do this. I'm hoping the pointing will all come together and he will begin doing it on his own. Is it a good sign that I have taught him and he has learned so quickly? His speech, I feel is delayed, says mama, dada, sheep, ba ba,says ball perfectly, banana, cheese, can, cat, block, truck, most of these words are bits of sounds not full words. Also, I am concerned that he doesn't point at object in his book but knows when a certain part of the story is coming next. He brings me things, brings me things sometimes when asked, listens to NO,responds most of the time to his name, kisses me, wants to be held, makes eye contact, plays peek a boo and hide n seek. I am mostly concerned about the pointing and am hoping it is my fault because I never taught him. Any info, advice you can give would be so very appreciated, as you can imagine, I am filled with questions and just want to be doing everything I can to help my son..Thanks in advance!!! Kristin

ANSWER: HI Kristin

First of all, nothing is your fault. And secondly, not every child learns to point. Pointing is just a skill that children learn as they are developing language. But some skip it all together. If he speaks at least 50 words and understands directions, then it sounds like his speech is on level. But if he only has a handful of words and more are not coming each week, then he does need a speech evaluation and possibly speech therapy.

The pointing would be an issue if the EI team finds more things that they are concerned about in the autism spectrum. Then they will teach him to point. But it may not be a big deal if he is able to show you things that you ask him to show you by bringing the items to you.

Keep me in the loop and let me know how the EI eval goes

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

QUESTION: Thank you for your quick response, it's appreciated. I am loving this site, I'm sure you are proud to be apart of it!What you are doing is huge to people like myself! I have felt recently very lost and have read and now received the most helpful information so far.I will let you know how the evaluation goes( not until Jan.7). Also, can you tell me what you think about imaginative play? I'm trying to encourage it, but my son seems to not be very interested. Like I wrote earlier, he does pretend read from his books. would this constitute pretend play? Oh, and my son more recently has been picking up new words. Today for example he said king and stairs, but seems to only say KKK or sss for the sounds, would that count for words? And also, my son holds his ears a lot, has since he was maybe 8 months old, mostly while drinking his bottle, or if he is tired. Plays with my ears as well.Sounds do not seem to bother him at all. I'm sorry to keep going on and on, I'm just so anxious... Thanks again. Kristin  

Answer
HI Kristin

I would say pretending to read books is one thing that children do as imaginative play, but we like to see things like rolling cars and saying "zoom zoom" or other things like that as well.

As far as the words... saying just the first letter may constitute a word in terms of linguistic value but the lack of a more complete pronounced word would be an issue for a 18 month year old-so again I have to recommend a speech and language evaluation.

Now you bring up the holding his ears...that's a red flag. First, have the doctor check his ears for fluid (since you say it happens while drinking). Secondly, take him for a hearing evaluation. If all that checks out, I am going to say he does have hearing sensitivities that are showing up when he gets tired (you know how sounds can sometimes bother us more when we are tired). Then, that would be a red flag for a sensory issue which is related to developmental disabilities.

When is your EI appointment?