Expert: Dr. Sharon A. Mitchell - 1/4/2011

Question
Hello,
In a few days my 19 month old will be evaluated by Early intervention. We filled out the (CHAT) during our 18 month checkup and discovered my son lacked imaginative play and pointing according to this test. While waiting for this evaluation I have so many unanswered questions. Some days I look at my son and believe he is perfectly normal on others I see signs and symptoms of autism. My son, over the past few weeks has increased his vocabulary a great deal. Babbling and trying to sound words has increased. My son does not point for attention but will imitate me pointing once in a while. My son does not always answer to his name but will always listen if I tell him "no". I am hoping this is a good sign? I guess my question is would this count as him answering , in a way? Or is it only answering to their name? Also, my son plays with his toys correctly, he will put a horse in the barn,pretend read a book, would that be considered imaginative play? Thanks so much in advance, any info would be so appreciated!!! Kristin

Answer
Hello Kristin,

You and your son are lucky to be receiving excellent care and having an evaluation with Early Intervention people quickly.

Filling out the CHAT is a good start. The CHAT looks at a number of areas of development apart from imaginative play. Unfortunately there is no one definitive test for autism. They diagnosis is made based on observations by caregivers, checklists (such as the CHAT) and the experience of professionals.

At the following link is an online screener you could take, based on your knowledge of your little boy. This is in no way a definitive test for Pervasive Developmental Disorder (PDD - the umbrella term under which everything in the autism spectrum falls). http://www.childbrain.com/pddassess.html

I can hear your unease. Just the thought of autism is frightening. But don't forget that autism is a spectrum disorder. Some people are so severely affected by the autism symptoms that every area of their life is impacted. Others with autism have much milder symptoms and lead independent lives. Have you heard of Temple Grandin? She's likely the most famous person in the world with autism. Take a look at her website http://www.templegrandin.com/

First Signs is an organization devoted to helping people recognize the early signs of autism. Here are some of the red flags: http://www.firstsigns.org/concerns/flags.htm Here are some of the hallmarks of typical development: http://www.firstsigns.org/healthydev/milestones.htm This next link has a video glossary of typically developing kids along side children with an autism spectrum disorder. You need to register to take a look at the videos, but it's free and without obligation. http://www.firstsigns.org/asd_video_glossary/asdvg_about.htm Looking at these before your son's appointment might help you understand some of what the professionals will be looking for.

Also before you go, it might help if you learn a bit about the difference between speech and language. Here's a site that will give you some information: http://www.asha.org/public/speech/development/language_speech.htm

Another section of the website of the American Speech-Language-Hearing Association details the speech/language skills typical for a child of your son's age. Near the bottom of this page this give suggestions for things you can do to aid in your son's language development: http://www.asha.org/public/speech/development/12.htm

Yes, it is a good sign that your little guy listens when you tell him "no". It's also encouraging that his babbling and words are increasing as is the type of play you describe.

Whether or not your son has an autism spectrum disorder, the help of an early interventionist can be invaluable. She can show you ways to play and interact with your child that will help his development.

Although it's a worry, you have nothing to lose by keeping this appointment. Perhaps your fears will be put to rest and you will be told that your son's development is on par with others of his age. Or, if it is felt that he's showing some autistic tendencies, you are in a great position to get the assistance that will help you and your child.

Best wishes,

Dr. Sharon A. Mitchell
www.autismsite.ca