Expert: Valerie Herskowitz - 2/15/2010

Question
QUESTION: Hi,

Ive been concerned about my some of my sons behaviors. My brother is autistic so this is probably why I am so paranoid. My son makes really good eye contact but will not look at me in the eye if I hold him. He points to things all the time and loves to play and laugh. He learned to walk about a month ago and is doing very well with it. He can stand up from a sit down position and can pick things up off the ground. He is very interested in other children and the people at his daycare think he is doing just fine. He flaps his arms some times like he is going to fly away and this concerns me. He is almost 14 months old. If I ask him where his belly button is he pulls his shirt up and shows me. He will respond if I tell him to get his ball he grabs it and brings to me and when he plays with his toys he brings them over to me. He responds to his name some of the times but he usually wont when he is playing with something or he is interested in something. He likes to bang his hands on things and likes to take pictures and wave them around and bang them. He gets upset when you take the pictures away from him. He will only fall asleep at night when he is being breastfed by my wife. He babbles and says dada baba daddy mama and sounds like he tries to say dog and ball. I guess the main things that concern me are that he doesnt look at me when I hold him or get real close to him and that he sometimes flaps his arms like if hes in his child seat or when hes excited or tired or he wants something. I know I might seem like im rambling I just dont want to leave anything out. Do you think I am paranoid or could something be wrong???

ANSWER: Hi Nick

Since your brother is autistic, you are very astute to be concerned about your son. I would certainly bring him to a developmental pediatrician who is skilled at diagnosing children with developmental delays at a young age so you don't miss anything. A regular pediatrician will not be skilled with young children in this area, so don't bother asking that person. The banging is a concern as is the eye contact, and the arm flapping. The inability for him to fall asleep on his own should be worked on at this time-you may need to try and get through a few rough nights, but you need to get him to a point in which he can learn to soothe himself enough to sleep on his own. Speech should start emerging now, but it's a little too early to determine if he is late in that  area. He should be following some directions and coming when you call him.

Please get him evaluated-early intervention is key. He may not have autism, but he still could have some minor delays which you wouldn't want to overlook.

Keep me posted

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

QUESTION: Thanks for the quick response! My son actually went to his pediatrician and the ped said that he was always very good at determining whether a child is autistic or not. He said that my son is way too social to be autistic and that the arm flapping and banging around in the way that he does is normal. Its all so confusing because he does seem like a normal little kid except for like I said when I hold him he wont look at me or when he flaps his arms which i guess isnt as much as I thought but he still does it. I think I still might get him evaluated. What would you say are the biggest signs of autism in a child his age (14 months)?  Thanks again for your help

Answer
The social part is good, I agree. I don't know if the arm flapping and banging around is normal-I guess I would have to see him in motion to give a definitive opinion. Basically, your son should be starting to speak words that have meaning (not just random sound combinations), following some very simple directions, imitate speech and other things that you do, sit and listen while you read to him for a couple of minutes, identify familiar objects...there are more but you would need a complete evaluation to go through the whole list.

Just keep an eye on him. Many children who have relatives with autism may not get full blown autism but some delays. So just keep an eye on him

And if he is not talking by 16-18 months, write me back