Expert: Jene Aviram - 8/26/2010

Question
Hi, I have a 4 year old son. He will be 5 in January. I noticed some things about my son at a very young age. He had problems as an infant retaining fluid in his ears. Once the tubes were put in, he could hear fine. Still I thought that something was still wrong so I asked his pediatrician and she referred me to "early steps" here in Florida. They told me that nothing was wrong with him. He goes to daycare and his teacher there noticed some things too, she referred me to FDLRS. So I took him there and they evaluated him, and they said that he has some developmental delays (but mainly speech and language.) He has been going to speech therapy for over a year now, and i don't notice a whole lot of progress.
The other day I was researching some things on the computer and I ran across the word autism, and some of the traits hit me. It's one thing to notice this or that at a different time, and it is easy to chalk it up to... "well, he is just slower in that area" but when I started writing these things down, I was surprised at how many things there were.
So here is my list, can you tell me what you think of it? Please help, I don't think that speech therapy is doing anything really.
1) he has trouble focusing on tasks (even small tasks)
2) he bites himself when aggravated
3) he stutters sometimes and has difficulty expressing himself
4) he doesn't interact with other children (except his brother) he can play in the same room with them, but never WITH them
5) has temper tantrums on occasion and hits the walls when he is mad
6) SLOW movement, and it doesn't matter whether he is tired well rested or any other time of day
7) doesn't acknowledge when people are speaking to him, and doesn't respond to simple gestures (like smiles) by returning the gesture
8) doesn't hold conversations or start them, it is always a simple answer
9) he doesn't really "pretend play"
10) chews on fingernails constantly
11) his fine motor skills are very lax, he has a hard time holding his fork/toothbrush/pencil properly, uses his fingers a lot to eat food
12) he is often unresponsive completely, sometimes i have to say his name 6 or 8 times before he even acknowledges that I am speaking to him
13) he doesn't talk much and when he does, he is not easily understood
14) doesn't tell stories from picture books, not much interaction unless prompted
15) has trouble copying shapes/letters/numbers from paper, even when they are drawn out for him, he cannot even remotely copy the image. Example, the triangle sure doesn't look like a triangle. Doesn't draw stick figures. When he colors, its just all over the paper, and when he tries to write letters, same thing.
I don't know what to think, but at his age, I know that he should be doing these things. 9 out of 10 times when you throw a ball to him, he cant catch it, and when he was in t ball, at the end of the season he was still running to third base instead of first base after he hit the ball. It had been explained to him numerous times and by different people that he has to run to first, but always to third base (just not catching on)
So any opinions would be greatly appreciated and considered. He has an appointment next week to get a referral to a specialist, but I am an anxious parent and would like some outside opinions on this.
Thanks so much

Answer
Hi,

I think you are doing the right thing by seeking an opinion from a specialist.  I hope that it's someone who specializes in developmental disorders such as pdd nos, adhd, autism etc.

I think it's a really good idea to print out this post and take it with you, since it's easy to forget once you're in an appointment.  Make a list of all your questions too.  And video tape in behaviors in your son that are hard to explain, so you can show the specialist.

I would like you to read two articles.  One of them is called "How do you know if your child has autism?"  It was written most for children up to three years old but think back a bit.  Either a lot of it will hit home, or you'll feel completely at ease.  You can find the article here.
http://www.nlconcepts.com/autism-howdoyouknow.htm

Something else I recommend you read is "How do you know if your child has sensory integration disorder.  You can read that right over here.
http://www.nlconcepts.com/autism-saleweek.htm

One can't possibly diagnose over the Internet but from the little you've written in your post, your son does display many characteristics that are synonymous with pdd-nos.  Of course, whatever it is that he might have, he is clearly very high functioning, but a little bit of help from a professional will go a long way.  Speech therapy is important and I think you should continue it.  But it's not getting to the heart of the matter, and once you find the therapy that does, you'll be amazed by the speed of improvement.

I wish you great success and I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com