Expert: Jene Aviram - 2/24/2010

Question
My son is 25 months old.  When he was 12 months old he refused to eat solid food and was finally diagnosed with a feeding disorder and dysphasia.  Over time he overcame the dysphasia and now eats finger foods very well.  He still does not eat from a spoon or drink from a cup (drinks only from a bottle), however, in the last year with the help of an occupational therapist he is eating finger foods very well.
Now my biggest concern is his speech and his overall receptive and expressive language.  He talks very little and says only about 5 works regularly.  When he does try to talk the words are not clear and often are missing sounds.  For istance: "ready set go" is said as "uh uh uh ooo".  He also does not point at body parts or point at pictures in a book when asked.  He seems to know what a cat is, or a ball is, however, he cannot point at it when asked.  My son does make good eye contact, gives hugs, and seems social.  He goes to public daycare and seems to get along well and does all of the activities the others kids are doing.  He does simple 6 piece puzzles and plays correctly with toys.  He moves from toy to toy.  He pulls me by the hand to what he wants, however, he does not point at an object to share it with me.  Although if something is "cool" he will occasionally look at me for my reaction.  He follows some directions and seems to ignore other directions. My speech pathologist does not think he has autism, and thinks it may be apraxia, however, the no pointing issue has me very concerned and does not seem to be an apraxia symptom.  I have searched for others with similar problems as I have stated and can find no answers.  Like most parents I want to understand what the problem is so that we know how to address it.  May I have your thoughts?

Answer
Hi Kim,

It does sound like your son is more likely to have apraxia than autism.  While he does share some characteristics of children on the spectrum (not pointing or sharing objects with you by giving or pointing) it's certainly not enough to qualify for a diagnosis of autism.

Your son seems to have many skills that most young children on the autism spectrum lack.  For example, he has good eye contact, he participates in activities at day care, he plays appropriately with toys and he appears social.  These are total contrast to a child with autism.

I'd like you to read an article called "How do I know if my child has autism?"  I think this might help you put things into perspective http://www.nlconcepts.com/autism-howdoyouknow.htm

Since your son is already receiving services he has obviously been evaluated in the past.  I would call this agency or organization and ask for a re-evaluation.  I would request a psychological (this will give you answers about being on the autism spectrum) and I would also request a speech evaluation (this will give you answers about possible apraxia.)

Waiting for answers is the toughest part.  But you're obviously a very proactive mom and are doing all the right steps.  It sounds like your son has come a long way already and with you behind him, I have no doubt that his progress will be great.

I wish you much luck and success.

Jene Aviram
http://www.nlconcepts.com