Expert: Jene Aviram - 2/19/2010

Question
Hi Jene,
We have chatted before about my son, Tom.  I hope you remember me.

He is now almost 16 months old and I am still worried about his development and constantly going through the "Is he? Isn't he?" procedure.

Somethings he does makes me think - no, he can't be.  Then others make me think he definately is.  I know no child is the same, but he does somethings that they say he wouldn't.  But then he does some of the major red flags too.

I do have an appointment with a Developmental Peadiatrician on the 7th April.  It seems so far away and cannot come soon enough!

Firstly, my concerns:
The biggest three are 1) he still often does not turn to his name.  If we are at home and he is playing and I walk into the room he always will.  But I wonder if it is more my voice he is turning to, rather than his name.  If we are out, it is much harder to get him to turn to his name.  For example, today I picked him up from daycare (he goes 2 days a week) and I was a couple of metres from him, his back to me, and I called his name a number of time to no response.  Speaking of daycare also - he loves it, never cries when we leave him at all and to be honest, he doesn't really seem excited to see us at the end of the day either.  That breaks my heart.  Is this typical in an ASD child?
2)He is still looking at our mouths alot when we speak.  He quite happily makes very good eye contact, but the minute out mouths move to talk his gaze drops to our mouth.  This happens mostly when we are up close, not so much at a distance.
3) He still has no words.  No mama, no dada.  He sometimes says "ta" when giving us stuff and says "tea" when we go to the cupboard where the tea cups are kept and says "car-keys" when we give them to him.  That's about it.  Oh, and "dat".  Everything he points to is "dat".

He also isn't really waving - he did it for a while, then it stopped, not he only does it to objects or the cat.  Ie: if we are on the bed with the cat and the cat jumps off, he will wave to the cat.  Go figure....  Mind you he did this with clapping and dancing and they both started up again.

Which brings me to the good things
- he points to everything.  Both what he wants (the glass on the table etc) and what he is interested in to show us (like the plane in the sky, the bird on the wires etc).  And says "dat".  

He loves playing hide and seek and gets great enjoyment out of it.  Although I am always the initiator - he doesn't iniate it.

He has just started to pick my phone up and put it to his ear.  Which I guess is pretend play?  And he will copy us drinking out of a cup.  

He brings things over to us to show us.

If I point to something he follows my point.  Or if I even just say "look over there Tom" and look in the direction, he will follow my gaze.

He understands very simple commands such as "put that back", or "give to mummy/daddy"

He doesn't seem resistant to change.  He has no repetitive movements (that I know of anyway), doesn't line things up or spin wheels or stack things.  His tantrums are fairly minor - in general he is a pretty happy chappy.  Although he can run off of the smell of an oily rag when it comes to sleep....

I don't even know what I am asking of you Jene, I guess sometimes it is just calming for me to sit down and type this out.

I hope if he is on the spectrum, that because of the good things, that maybe he will at least be on the mild side, or high functioning.

Thanks for letting me get it all out!

I'll let you know how I go with the Dev Pead appt.

Kindest regards
Melissa.

Answer
Hi there,

Waiting for answers is the hardest part.  I know how difficult that must be for you.  And believe me I understand that April seems like so far away but it's actually the perfect time.  By then your son will be 18 months.  Even then it's hard to diagnose but before that is practically impossible.  As children grow any delays become more apparent so a professional can get a clearer idea.

I do think your three concerns are valid and worth pointing out to a professional.  Have you ever checked his hearing?  I think that's worth looking into in your son's case, especially since your first and second concern are related.  I'm not too concerned about his lack of speech.  Many toddlers are late developing speech but your son seems able to express what he wants and needs in non-verbal communication such as pointing.

Melissa, I have to reiterate that the skills you mention are just wonderful.  And they are so opposite to most kids on the autism spectrum.  Most children on the autism spectrum do not point.  Your son does.  Most children on the spectrum do not make eye contact.  Your son does.  Most children on the spectrum have repetitive and stereotype behavior.  Your son does not. Almost all children with autism will not follow a point.  Your son does.  Most children on the spectrum do not bring things to show you.  Your son does.  Do you see how wonderful this is?  

Autism is really hallmarked by a social deficit.  Your son seems to have this in tact.  Of course it's impossible to diagnose over the Internet. One needs a full comprehensive evaluation to get a full picture.  But you do NOT paint a picture of a child with autism.  He might qualify for services of some kind but the word autism does not jump out at me when I read your post.  

I know that it's so hard to wait.  But you are doing all the right things.  Try to be happy that you have everything lined up.  A lot of parents wait till their child is almost three when then they really feel a sense of urgency and can end up on waiting lists for months.  You have everything under control.  I know it's tough but hang in there.

I wish you great luck and success.

Jene Aviram
http://www.nlconcepts.com