Expert: Valerie Herskowitz - 3/27/2010

Question
Hi, I have a 16 month old son who is severely behind on his eating. He does not tolerate solid foods at all. He eats Gerber Stage 3 baby food, and even that is with difficulty. He gags with every meal, sometimes to the point of throwing up. He is currently enrolled with ECI and receives speech and occupational therapy every other week. My son receives speech therapy because his speech is delayed. He can say dada, mama, doggie, and Harley but that is it. He is not progressing with the occupational therapy. He has been on it for about 3 months and still doesn't tolerate solids. He cannot sit and hold a bottle and drink it. He will only lay down and drink it. I will gradually lift him up into a sitting position and when the milk is no longer flowing, he will get mad and throw it. He doesn't drink juice or water at all. He only drinks milk. I offer my son food all the time and he refuses to eat it unless it is pureed. It seems like he doesn't know how to chew. He will lick anything though, for example chips and cheetos. He will taste anything I put on my finger that is a sauce. His therapist thinks that his gag reflex is high on his tongue. But my son met all his other developmental milestones. He sat up at 6 months, crawled at 7 months, and walked at 9 months. I also have a 3 year old son who he was trying to chase. My boys interact well. My 16 month old makes good eye contact, smiles, likes to be held and cuddled, and babbles with only a few understandable words. He does not tell me anything in particular, he just talks in general. I think he makes an effort to talk though. I just don't understand everything he says. My husband is in the Army, so we have access to all kinds of health care. Our pediatrician is off post though. I am thinking about changing doctors. They did not listen to me when I told them at multiple visits that my son was not progressing to solids. They said to wait a week and try again. My son is now 16 months old and does not eat solids at all. I personally made the referral for him to get therapy. My question is do you think that my son is showing early autism spectrum symptoms? Our occupational therapist referred us to an autism support group. I myself am a nurse and I think that he may have Sensory Processing Disorder and his gag reflex and sense of smell and heightened and maybe that is why he cannot eat solids. Other than this, he is a normal 16 month old. Any advise would be appreciated. Thank you.

Answer
Hi Cassundra

You are correct that your son is having sensory processing issues-the food problems are a sign. Not knowing exactly how your OT is approaching the issue, I can't comment on the therapy.

You mention that his speech is delayed. Is that for expressive speech only or receptive as well. Answering that question would make a big difference. If he is showing issues with his language processing, I would have to say that you are looking at a diagnosis on the developmentally delayed spectrum.

I know that the military has been pro-active in getting services for their families. I have spoken to many people on that subject. But if you feel you would like a second opinion, I would be happy to consult with you or your therapy staff. Just email me and we can work out the details:
info@valerieherskowitz.com

Let me know how it goes