Expert: Jene Aviram - 1/13/2011

Question
I have a 2 year old daughter with a speech delay.  At 24 months she could say about 5 words.  Now that she is 26 months her vocabulary has grown to about 65 words with speech therapy.  We have only been in speech for about 2 months but she seems to be taking off.  I am worried about autism because I have heard so much about it and want to be sure I am not missing anything.  She doesn't put 2 words together yet.  I have attributed this to the fact that she is a new talker but am still very worried.  She points to things she wants or is interested in and will sometimes bring things to me.  She is very lovable and loves to be held and cuddled.  She makes good eye contact with everyone here at the house but when I take her out she seems to shy away from making eye contact with strangers.  She didn't make eye contact with the speech therapist for several weeks but yesterday she ran up to her and gave her a hug so I'm hoping she's coming around.  If my daughter wants something that is too high to reach she will take my hand and lead me to it and point.  I have heard this is a sign of autism.  She seems interested in other kids.  I just started her in a toddler gym class and she seems to enjoy being with other children.  She is always trying to play with her older brothers and will often try to do the things they are doing.  She doesn't seem to have a big interest in dolls but if you give her one she will feed it a bottle but then usually is quick to put it back down.  She likes to sit on my lap and look at books and will often point to pictures but doesn't like it when I try to read the book to her - she has to be in control.  She doesn't have any repetitive behaviors.  I am worried because her speech delay makes it seem that she is set up for autism.  Do you think she sounds autistic?

Answer
Hi Stephanie,

I can see right away that you're a proactive mom.  It's great how far your daughter has come with speech therapy.  One cannot possibly diagnose over the Internet but you have said a lot of encouraging things about your daughter.

"She points to things she wants or is interested in and will sometimes bring things to me."  This is a great sign and often atypical of children on the spectrum.

"She doesn't have any repetitive behaviors."  A great sign.

"She seems interested in other kids.  I just started her in a toddler gym class and she seems to enjoy being with other children.  She is always trying to play with her older brothers and will often try to do the things they are doing."  This again is extremely encouraging.

After all, the hallmark of autism is a social disorder, these are the things we look for.  Lack of speech does not have to be associated with autism, and very often isn't.

On the flip side, she has a couple of red flags such as poor eye contact with others and control issues.  If I were you I would ask for a comprehensive evaluation.  Tell them you are concerned about autism and ask for a psychological evaluation.  You could also ask your pediatrician for a referral to a neurologist for psychologist who specializes in childhood disorders such as aspergers, autism, adhd etc.

I am certainly not suggesting your daughter has autism, on the contrary, I think you will receive great peace of mind after these evaluations, but I'm also one that would never ignore red flags, because why not get your daughter help if she qualifies?  That way she will catch up to her peers faster.

In the meantime, there are a couple of other things you can do.
I recommend you read this article called "How do you know if your child has autism?" It might help you put things in perspective.  You can find it right here.
http://www.nlconcepts.com/autism-howdoyouknow.htm

I recommend you do the MCHAT.  Don't peek, answer the questions and when you click"should I be concerned" it will tell you which questions are the real indicators of autism.
http://www.nlconcepts.com/autism-mchat.htm

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

Jene Aviram
http://www.nlconcepts.com