Expert: Valerie Herskowitz - 3/6/2010

Question
Hi Valerie

I am a clinical social worker and up until about one month ago I had no concerns about my son being autistic.  I did have some concerns about his lack of language and the fact that he seemed so happy to play alone that I brought up to our pediatrician at the 15 month appt.  He said that he had been routinely screening and did not have concerns.

At the 17 month exam (we had to go in early) the pediatrician spent about five minutes with us total and after asking me if my son had language yet (he did not) told me that we needed to see a developmental ped and when I pressed he said he was worried about autism because of poor eye contact and the fact that my son does a repetitive motion.  (He jumps up and down and slaps his thighs often).  In my gut I felt that autism was not the right fit and got a second opinion.  We switched to a new pediatric practice that is home based.  The doctor used to be the chief of ped at a major hospital and has seven children with autism in his practice.  He came to our house and spent 45 minutes with our son and said to put off the assessment for three months.  He felt that our son was very kinesthetic and shy and that the repetitive jump did not appear like typical autistic stereotyped behavior.

I should add that our family has been under extreme stress for the past year.  My husband was laid off and just recently got a much needed kidney transplant.  Also, our son suffered from terrible exzema and horrible allergies.  His nose never stopped running for six months.

My concerns:  No language, rarely points, no clapping and the jumping.  On the other hand, he at times makes great eye contact and has good joint attention.  He is a great sleeper, eater is highly adaptable and likes to be held and cuddled. He lifts his arms to be picked up, grasps for objects, is physically coordinated, feeds himself, enjoys playing with a variety of toys, is well attached to me.  Sometimes he seems more checked out then others.  I am pretty sure there are some sensory issues going on as he seems really stimulated (thus the jumping) by rugs and patterns, loves to swing, jump on the trampoline and be upside down.

We found out that his hearing is near normal but that he had chronic nasal obstruction and his adenoids 1/3 enlarged.  We have taken him off all dairy with great success and he is on steroids to reduce the inflammation.

Sorry.....here comes the question.  We started him in speech therapy two times per week with a CCC-SLC.  She has over 10 years experience and works with kids on the ASD.  After our first session she told us that she does not think our son is on the autism spectrum.  She said that he may have some sensory issues but that he has wonderful joint attention, great eye contact with her and is trying to be social and communicate.  She has maintained this same position at every session.  She has seen him melt down and observed the jumping and still states that she does not see autism.

I am under so much stress that I don't know what is my gut and what is my own depression/anxiety and obsessive thinking right now.  I guess I am asking if a Speech Pathologist should be someone I listen to.  My husband keeps reminding me that every professional we have seen since the first pediatrician has told me that they don't see autism.  He thinks I am just under so much stress I cannot process all of this right now.

We are on the waiting list for an appointment with CA regional center for early intervention.  It will be about three months before we get an assessment. I guess I am asking for your opinion, should I trust in the speech pathologist and pediatrician and give our little guy sometime to get his allergy/nasal issues under control or  should I be pushing harder and paying for an assessment now?   As I mentioned, we are already paying out of pocket for speech therapy (including occupational therapy) two times per week and plan to continue to do so.  Also, we will see an allergist/immunologist next week and the ENT and pediatrician again in two weeks.

Thanks so much for your time and suggestions!

Answer
Hi Kim

I would recommend you call me-954-980-0134. I would like to talk with you rather than just type out an email. I know you are under a great deal of stress. I think if we talk for a little while, things may become more clear for you.

Valerie
954-980-0134 (my personal cell)