Expert: Dr. Sharon A. Mitchell - 1/26/2011

Question
My son is 16 months old and is babbling alot, but has only said dada and mom for words.  He does not point with his finger, but he does with his whole fist.  He is very active and has met the physical milestones on time.  He is very loving and makes great eye contact, but still hasn't really spoke yet.  He understands very well, will follow 2 command sentences with no gestures.  Why won't he point with his finger and does this mean anything?  When i try to teach him, he shakes his head no.  Is this typical?

Answer
You mention a lot of positives. He babbles, his physical milestones are fine, he makes eye contact, is affectionate, says a couple words and responds to what you say to him.

According to the American Speech Language Hearing Association, between one and two years of age typical children understand language well enough to:

- Points to a few body parts when asked.
- Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").
- Listens to simple stories, songs, and rhymes.
- Points to pictures in a book when named.

The following are expressive language skills most kids have by the end of their second year of life:

- Says more words every month.
- Uses some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?").
- Puts two words together ("more cookie," "no juice," "mommy book").
- Uses many different consonant sounds at the beginning of words.

Your little guy is at the younger end of acquiring these skills, at just 16 months of age.

If you go to their website at http://www.asha.org/public/speech/development/12.htm you will find suggestions of things you may do to enhance your son's receptive and expressive language development.

His lack of pointing seems to concern you. When you read him a story, will he point to pictures when you ask him to? Will he follow where your finger points? These are skills that you could practice with him.

When you read about autism, you will learn that many of these kids don't point or respond to points. ut if that is the only symptom that you notice in your son, I would not leap to the conclusion that he may have autism.

First Signs is an organization dedicated to helping people recognize the early signs of autism. At this link you will see more of the critical milestones: http://www.firstsigns.org/healthydev/milestones.htm

You may find interesting these videos of typical vs autistic children. To view them you must register, but there is no cost or obligation:  http://www.firstsigns.org/asd_video_glossary/asdvg_about.htm

I hope this is of some help to you,

Dr. Sharon A. Mitchell
www.autismsite.ca