Expert: Valerie Herskowitz - 4/6/2010

Question
QUESTION: Hi there,

I am getting increasingly concerned about my 13 month old little boy and his development. He has always been a lovely little baby, a bit colicky in the first few months but after that generally always happy and smiling, very social with everyone, a real joy to be around! I love him so much it hurts and although I have spoken with his GP about my concerns, I have yet to ask for a referral to a specialist as I keep getting told everything is fine.

I started to worry when his gross motor skills were always at the end of the developmental scale. He didn't sit properly until 8 months, crawled at the end of the 10th month and is still cruising around furniture at almost 13 months. He won't stand without support and refuses to push his walker, sitting firmly on his bottom and crying when I attempt to help him. He doesn't use certain hand gestures to communicate with us. Specifically, he won't wave hello or goodbye or point at anything, and I have been repeatedly doing these gestures for months and months. I have been reading to him from birth and he doesn't seem to pay a lot of attention to the story and pictures unless it has flaps and material he can touch. He doesn't point at pictures. All he wants to do is open and close the book and hold it himself.

He does clap hands (since 8 or 9 months) and will clap his hands in the correct part of the song, "If you're happy and you know it clap your hands". He also places his hands on his tummy when I ask "Where's your tummy?" (but doesn't point at it - just places his hands there).

The other thing I also worry about is his lack of affection and stranger anxiety. He doesn't like to cuddle or kiss me or his Dad and pushes us away when we try even after he has fallen or is very upset. He shows hardly any stranger anxiety and people always comment on what a happy baby he is, letting anyone show him attention. Occasionally if I'm upstairs and he's downstairs with Daddy he may call for me and start crying but that's about it.

Everything else is on target developmentally. He likes other children and will play alongside them and even with them, he uses the pincer grasp and has since he was very young, he loves playing with his soccer ball and all his toys and doesn't seem to favour anything in particular. He loves the TV remote and can turn the TV off and on but doesn't hold a mobile phone to his ear or anything like that. If I ask him to bring me a toy he will do it and he imitates facial expressions constantly.

He doesn't cry very much. When he wakes up in the morning I hear him through the monitor laughing and babbling and playing with his teddies. The only times I have seen him cry his little heart out was when he was younger and colicky or when he hurts himself or another child is crying. And then as I was saying before, I try to comfort him and he pushes me away.

I did some research online and saw that lack of gestures and affection can be a sign of autism and now I'm worried sick about my gorgeous little boy. I have expressed my concerns to my partner (who has 4 other children, this is my first) and he tells me that kids aren't textbooks or internet articles and I'm overreacting. I have also expressed my concerns to friends and family members who also tell me I'm being paranoid. And also our GP (doctor).

Are they right to tell me this? I look forward to hearing from you.

Many thanks.

ANSWER: Hi Amy

If it was me, I would be worried enough to take him to see a developmental pediatrician. Only a person that has that credential will be the right one to evaluate a child of that age. Since he is young, many professionals won't know what to look for and tell you not to worry. But it is curious why he isn't bonding with you. You didn't mention his speech. Is he saying any words yet or looking at you when you call his name? I'd be curious about these things as well.

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

QUESTION: Thanks for your reply. He is saying Mama, Dada, his own name, bottle, book and work. He babbles constantly and looks when I point to something or say "where is daddy?" etc.. He does turn when his name is called most of the time. I do feel as though I have bonded with him but he's just happy to sit on my lap and allows me to kiss and hug him for a short time but then always pushes me away. On the other hand, he's always smiling and interacting with me so I guess that in itself makes me feel loved. But I do wish he would give me hugs and kisses.

Answer
Well the speech sounds good for a 13 month old-make sure it continues to progress-a few new words each week. If you notice a slow down or regression, you should let me know. Let's put it on hold for 3 months. I would recommend you journal his progress each week so we can see how it goes, Please get back to me then