Expert: Jene Aviram - 2/18/2010

Question
Dear Jene,

Last week, I had my son evaluated by early intervention and they said he had a 25% delay in both communication and cognition, and so I 'qualify'.  My question is, does this mean that he is at risk for autism?  I asked the evaluators if this meant that he had autism, and they emphatically said no, and explained that his delays were so slight, but they wanted to be on the safe side and get him support.  

The reason why I called early intervention was for the following reasons:

-Doesn't respond to name consistently, he will respond to his name, but not all the time.
-Doesn't make eye contact while being held.  He will make eye contact at other times, but never while being held closely.
-At this point, he doesn't say mama or dada with any meaning, but says them both along with lots of other 'words' without meaning.  When I ask, where's dada, etc. he doesn't look to his dad.  

Now that I've done more research, I'm getting worried about other behaviors. They are:

I've noticed recently that he will wave bye bye when we're leaving a room or when he sees a door.  I'm wondering if this is my fault since I would say, we're leaving now, we're going bye bye, and I'd wave to show him the hand gesture for bye bye.

He is happiest when he has something of interest in his hands.  For example, when feeding him in a high chair, he always asks for the spoon, so he can hold it and sometimes wants to use it to spoon up food for himself, although he has no coordination at this point.  Other times, he just wants to bang it on the tray.

He can play on his own for a while, and will come to me at some point, snuggle for a few seconds and then he's off again.  When he is playing, it's tough to get his attention.  When the evaluators were here, he would look at the toy they were showing him, look up at the evaluator, and then look back down at the toy, but that is not always the case with me.  Sometimes, he ignores me.  

He is not walking yet, is 13 and 1/2 months but he is standing on his own and has taken a couple of steps before sitting back down.  He will walk with a push toy.   He was sick with 2 bouts of pneumonia when he was 12 months, and it took about a months worth of antibiotics to kick that, and at that time, he was asking to be held all the time, so I wonder if I should account for that.  

When I pick him up at daycare, he is happy to see me, but no squeals of happiness and he doesn't always come over to me to be held.  He will usually come toward me and then get distracted and go to something else.   If he is sitting at the communal desk, he'll see me and smile and raise his arms to be picked up.  He'll start immediately telling me by pointing at what he wants me to take him to.  

What he is doing:
Babbles constantly.  Seems to have his own language, for example, before climbing up the stairs he says something in a questioning tone...almost sounds like, hello????  

Points to everything.  Gets mad when he's pointing to something and I don't give it to him...like my cup of coffee!

Belly laughs when we play peek a boo.  Will play hide and seek sometimes as well and gets a real kick out of it.  

Feeds us food.  Offers us his toys.  For example, he will give me all the pieces of his puzzle.  He will try to then put the pieces back in the puzzle if I encourage him to do so, but will get frustrated and then move onto another toy.  

Smiles at certain strangers, but will not smile at others and just stare them down.  

So, this has been a very long post, but I wanted to give you as much information as possible.  I am trying to be hopeful, but I'm afraid I've been feeling overwhelmingly sad and sometimes unable to enjoy time with my son since all I seem to see now are 'autistic' behaviors.

Any perspective you have will surely help.

Answer
Hi Suzi,

You are doing all the right things.  I'm not sure what led you to get your son evaluated but you are clearly very proactive.  Since you qualify your son will be receiving services.  This is just a wonderful thing because he will learn new strategies, skills and speech before old ways become a habit.

Your son is still so young.  A lot of what you are seeing might change.  Kids grow and change all the time.  I will say that your list of positives is just incredible.  Almost every one of those things are totally the opposite of what a child on the autism spectrum is likely to exhibit.

If I were in your shoes I would concentrate on services for your son now and ask for a re-evaluation at about 20 months.  At this point, things are a lot clearer.

Have you heard of the M-CHAT?  It's typically also for 18 month old's but here is a link for you to keep on hand.  Answer the questions and click "Show me now."  It will tell you if you should be concerned.  http://www.nlconcepts.com/autism-mchat.htm

Also, here is an article called "How do you know if your child has autism?"  I think it might give you peace of mind.  http://www.nlconcepts.com/autism-howdoyouknow.htm

Although one can never diagnose over the Internet, I can say that your child has many skills that are quite contrary to most toddlers with autism.

I wish you great success.

I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com