Expert: Dr. Sharon A. Mitchell - 7/8/2010

Question
I have a three year old son whom I am wondering if he has autism.  He has always flapped his hands when he gets excited about things.  He does not interact with other children his own age unless they are family.  He has been in a kids class at church since he was born and he still cries when I leave him and when we do get him to stay in class he only plays by himself or one other boy he has known for years.  He gets frustarated very easily and punches himself in the head when he is angry.  He does not like to try anything new.  We recently went on vacation and he just kept asking to go home saying he missed his bed and house.  Anytime we try to get him to try new things he just screams that they are stupid and punches either himself or whoever is holding him. We had to just put him on kiddie rides at an amusement park because he screamed if the ride was not a car. He kept saying he only wanted to ride cars.  He did like the other rides once we got him onto them but it was a fight every time.  He will not make eye contact or talk to people he doesn't know (this includes family sometimes). Not sure if I should be concerned or if this is just his personality.

Answer
While it's impossible to offer an opinion without meeting your son, I do see why you have some concerns. The flapping alone is not necessarily indicative of anything but coupled with some other things you mention I think it is worth investigating whether or not your son may be developing differently. You might want to do some homework on your own first.

Autism and Asperger's fall under the umbrella term of Pervasive Developmental Disorders (PDD). Here is a quick, free, online checklist you can do to see if your son developmentally has shown some of the signs of having an autism spectrum disorder: http://www.childbrain.com/pddassess.html

At this next link you'll find the diagnostic criteria used in diagnosing autism and Asperger's: http://cdc.gov/ncbddd/autism/hcp-dsm.html

I know it's not always easy to think back to how your child functioned a couple years ago but at this link you'll see a list of milestones most children achieve at certain ages: http://www.firstsigns.org/healthydev/milestones.htm  The same website has an excellent video glossary that shows clips of kids at various ages who are typically developing and those with an autism spectrum disorder. Accessing the video library requires that you sign up, but it's free and carries no obligation: http://www.firstsigns.org/asd_video_glossary/asdvg_about.htm

Here is another site that shows pictures of kids with autistic behaviours: http://autism.lovetoknow.com/Slideshow:Autism_Behavior_Checklist~5

If after you look at these sites you still have concerns, talk to your physician. Show him the results of any checklists you have done, and write out your observations as to why you feel your child may not be developing typically. A diagnostician will rely heavily on what you say. There is no one definitive test for autism; diagnosing is done more on observations and data gathering.

The television network NBC has a show called Parenthood. Portrayed on the show is an adolescent boy, Max, who has Asperger's. NBC allows you to watch episodes for free on this website: http://www.nbc.com/parenthood/

Here are some of the facts I'd suggest you mention to your doctor, along with the results of the above informal checklists:

- even though he has attended a kids class at church for three years, he is still not comfortable there, cries and does not relate to the other children
- punches himself when angry
- flaps when excited
- prefers routine and dislikes anything new
- lack of eye contact
- unusual conversational pattern

I know this is a scary step. You already have concerns. Investigating this will either do two things - put your mind at rest that all is well, or confirm your suspicious that something is different. If it's the latter, then you are doing all you can to help your boy. Being aware of his pattern of strengths and weaknesses puts you in a far better position to be his champion. You'll also be helping the school system to help your son.

Sharon A. Mitchell, B.A., B.Ed., M.A., PhD candidate