Expert: Valerie Herskowitz - 3/30/2010

Question
Hi,

I am writing this to you in a highly emotional state.  I am so concerned for my son now but am not sure if there is anything wrong with him or it is me just freaking out.  My son was born 4 weeks premature and totally healthy.  Until one year of age I took him to have his hearing assessed to ensure (since he was a premmy) that he did not have any hearing problems.  All the tests came back as normal.  He is my second child and now 19 months.  It is hard not to compare him to his sister and I know that is unfair especially since she has been identified as an extremely advanced/gifted child.  At his age she was talking full sentences, drawing and could read at age 3 so we are really talking two extremes here.  I have to say that I never thought anything was wrong with my son.  He walked at 13 months of age and now at 19 months is so physical.  He can run and climb up slides that my daughter probably couldnt do until she was three.  people have commented at his physical strength.  only recently when I took my son to the health nurse for his 18 month old assessment have I started looking and studying his every move!!!!  She basically thought his social and speech development was delayed and even hinted at autism.  I did arrange for a speech therapist to assess him and she did not believe he had autism and thought that he was not too far off from talking.  The paediatrician thought the same thing but when I kept stressing about autism he said IF that is the case it is very mild and not something to consider till he is at least 2 and basically told me to come back when he is two but get his hearing checked again.  i have arranged for another hearing test and that unfortunately is 6 weeks away as they are so busy.

Can you please give me your honest opinion as to whether you think my child has autism - I am freaking out.  People that know him do not believe so and laugh at the mere idea of it but I now seem to question the poor boys every move.

This is what he does:

Has been babbling since birth and can say dadda and mumma and nana and food - only when he wants to though!!

He is a happy baby, smiles laughs enjoys tickle time and hide and seek and catch me - when I chase him

Responds to nursery rhymes, smiles when I sing them and anticipates the next action

will clap and wave only if he wants to - not on command

Will only pretty much go to immediate family but is now beginning to warm up to other people.  He will not go to his grandparents for a cuddle but will curiously go up to them on his terms and smile at them.

Does not throw tantrums and is a great eater.

Loves to explore his environment.

Will not stand still when I try to read to him and is not interested in books

Used to kiss me when I asked him to but now shoos me away (I can be annoying when I get in his face I admit that)

Does not point

Understands no and smacks me back if i try to discipline him(so he does understand it)

Grunts and tries to get my attention

Not big on eye contact with strangers and other people but okay with direct family

Can bounce a ball and is interested in playing with balls

At times I feel he has gone backwards with some of his milestones but his behaviour seems so stubborn it is like he wants to do things on his terms.

Likes to watch tv and smiles and responds to favourite cartoon

Enjoys outdoors and loves going for walks in stroller and visiting new environments

Not afraid of swinging up high or roughhouse activities

Answers to his name but at times will completely ignore me

Brings toys to me and wants me to play with them by putting them in my hands

Understands when I ask him to bring things to me

Doesnt really role play but can play with his toys such as stacking blocks making leggo and he loves organising things, putting this in buckets, putting things in holes and then looking where they have gone



He is not big on cuddles because he doesnt like standing still but he will come to mum and dad and put his arms out so he can be held

Not very interested in other children

Likes exploring ie turning on lights, power switches etc.
Gives hi - five when I ask him.

I try to socialise him by taking him to playgroup and swimming lessons and he seem to like those things
Sorry to ramble on but I am really concerned.

Thanks

A

Answer
Hi Anne
I know you are very worried, so I wanted to write to you right away.
I am wondering what the health nurse saw that made her think autism. Obviously, he does have a language delay. Children at the age of 19 months should be saying more words. How does he tell you what he wants? It's concerning that he grunts to get your attention rather than pointing. Other red flags:
1. Having an interest in turning on the lights-does he do this a lot?
2. Doesn't like cuddles so much
3. lack of interest in other children
4. doesn't always come when his name is called
5. your feeling that he has regressed
6. low eye contact
7. is annoyed when you try to kiss him

I'm also glad you are getting his hearing checked.

I think you know in your heart of hearts that he is having some difficulties as you have another child to compare to. Also, it's not unusual that children with autism are early in their walking and physical skills.

But with that said, you need to check things out at a specialist like a developmental pediatrician or a pediatric neurologist who is an expert in autism. I can always take a look at him for you and give you my opinion (I do consults on Skype), but I won't be able to diagnose. If you want me to see him, email me at info@valerieherskowitz.com