Expert: Valerie Herskowitz - 9/1/2010

Question
QUESTION: My little girl will be eight soon and she is really struggling.  She was born three months premature and weighed less than two puonds.  She has fought her hardest to fit in with normal kids ever since but she just can't.  She did not talk till she was four and did not talk well until five.  She has delays in fine motor, gross motor, speech, language, and lacking in social skills.  She asks questions like why don't kids like me or why won't they play with me.  She can not handle changes in routine and gets frustrated easily.  When she was younger she would bang her head, punch herself and now she bites herself super hard causing bruises. Eye contact is impossible and she can not complete a sentence without at least ten pauses at random.  She fixates on topics and even weeks or months later brings them up like a fight she had with some boy four years ago like it happened yesterday.  She won't eat without being forced weighs about 40 pounds and is 50 inches tall.  She can repeat phrases at random that are usually not time appropriate that she has heard people say in grocery stores, TV, or school. I asked a few people about autism and they are not professionals but told me that she is perfectly normal and could not possibly have autism.  I don't know what normal is but this just does not seem right for an eight year old little girl with no friends, bad grades, and large IEP.  Any advice you could give to me would be a great help.

ANSWER: Hi Sarah

Not to be sarcastic, but I can't imagine that medical or educational professionals think that an eight year old child with delays in every single area plus the fact that she abuses herself is normal. She most definitely is not perfectly ok. Please take her to a developmental pediatrician or neurologist for an opinion. She needs lots of therapy-speech, occupational, and behavioral. Time is a wasting... You must get extremely aggressive now if you want to maximize your child's potential.

But then you mention she has an IEP. So why would she have an IEP if everyone says she is normal? Something isn't jiving here.

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

QUESTION: She has the IEP because she has delays in speech and other areas.  They tell me that it is because she was premature and that with therapy she will just come around.  I have had her in early intervention programs since she was born.  I'm frustrated because I can see that she has huge potential and is incredible intelligent but all I'm getting back in feedback is that she is slow and I am pushing her too hard.  They tell me things like some children mature more slowly and when she is ready she will come around.  I was hoping you could take a look at the types of behavior she is exhibiting and let me know in your opinion if autism is a possibility.  I am searching for a developmental pediatrician but I am having a really hard time finding one willing to accept our health insurance. I want to help my little girl and I was hoping that an autism specialist such as yourself could tell me if I am atleast on the right tract.

Answer
Hi Sarah

She is certainly exhibiting developmental delays that are global in nature. My suggestion is that you take her to a pediatric neurologist-you should certainly have one on your health insurance and find out whether she is indeed on  the autism spectrum. I can't diagnose but I do think you are on the right track.

Let's say, she is diagnosed with autism. Then what will that get her? More public school services or private therapy services. Not knowing how you state operates, I am not sure what is available.

No doubt she has a lot of issues and she needs tons of help. I don't think this is a case of a normal child who is just a bit delayed-certainly not by your description. You should be pushing pushing pushing for more services: speech occupational and behaviorial therapy. I wish I could help you. If you want to do some consultations with me via phone, let me know, but I can't take the insurance as it would be indirect. But I am here if you want me to consult with you via phone.