Expert: Valerie Herskowitz - 8/26/2010

Question
Hi, I just have a question or two about autism and signs and signs of autism. I have a son who is 4 years and 8 months old who seems to show some signs of autism, but I am not sure, as I really have no experience with this. I have thought about these signs, as they come along, but it wasn't until the other day when I started writing them down. When you look at this issue piecemeal, it is sometimes easy to chalk it up to "all children develop differently." But when I started writing these things down, it seems like a much bigger deal all of a sudden...
1) he has trouble focusing on tasks (even small ones)
2) he bites himself when he is aggravated
3)doesn't make a lot of eye contact
4) he stutters sometimes and communication and expression is difficult
5) he doesn't interact with other children (except his older brother, and even then it is mostly just watching the older brother play)
6) has temper tantrums and at times he hits the walls when he is angry
7) slow movement (it doesn't matter whether he is tired, or fully awake)
8)doesn't really acknowledge when people are speaking to him (even childcare workers that he sees everyday)
9) doesn't return simple gestures, such as when we are out somewhere and someone smiles at him, e doesn't return the smile like most kids do. Or when someone is talking to him, he doesn't respond and usually hides behind me
10) doesn't hold (or start) conversations with others
11) doesn't play make believe, or engage in "pretend play"
12) chews on his fingernails constantly
13) his fine motor skills are shaky at best. As I have said, he is 4 years and 8 months and has trouble using his fork/toothbrush/pencil properly
12)he is often completely unresponsive (sometimes I have to say his name up to 8 times to get him to acknowledge that I am even speaking to him
13) he is not easily understood when he speaks
14) doesn't catch balls 9 out of 10 times (shouldn't he be doing this at his age?)
15) doesn't make up stories or participate in reading activities, such as pointing to pictures and commenting on them (unless specifically asked)
16) he doesn't copy shapes, letters, numbers (when I draw something on a paper, even as simple as a triangle, he can't copy the picture... it doesn't even remotely look anything like a triangle... or whatever it is I am drawing)

Any help on this, advice suggestions comments would certainly be helpful
ADDITIONAL INFORMATION
When Bray was a baby he retained fluid in his ears and this prevented him from hearing properly for a while. He had tubes put into his ears and started hearing. Although he was behind some, I didn't quite worry about it much because I thought that he would catch up and all would be well. As of now, Bray attends speech/language therapy and has for a little over a year. But I am not sure how much progress he is really making as I do not see much difference from before he started going.
When he was a baby (11 or 12 months) I took him to early steps and they told me that there was nothing wrong with him. Then as he got a little older his childcare teacher gave me a pamphlet to FDLRS and they told me that he did need help, and as I stated before, it doesn't seem to be helping (in my opinion.)
He has a doctors appointment next week, and I am going to ask for a referral to a specialist to test him for autism and the spectrum disorders, but as a parent, anxiety about this is killing me, so I was wondering if anyone here could help me out with some knowledge/information.
Any help would be appreciated.
Thanks
Windi

Answer
Hi Windi

I think you are doing the right thing. And the sentence you said in the first paragraph is exactly what I would say. Individually, these behaviors aren't earth shattering, but together they are concerning. So get him to a autism expert for diagnosis purposes. And he seems to need a great deal more than just the little speech therapy that you are giving him. He needs more speech (maybe re-evaluate with whom as you are not seeing much progress), occupational therapy and social skill therapy. I am always available for consultations if you want me to help you put together an effective home intervention program. Just let me know and good luck.