Expert: Dr. Sharon A. Mitchell - 1/11/2011

Question
I recently sent a question to you about my son and possible autism symptoms. We had our evaluation today. My son's developmental screening results I will list below. Perceptual/ fine motor-13 month level,Expressive language-11 months,Gross motor-19 months, Social/emotional-18 months,cognition 18 months, receptive language 11 months, feeding-18 months,combined self- care 16 months. The team thought that our next step would be to see a developmental pediatrician to rule out pdd-nos or some sort of spectrum disorder. The team said that he showed a few red flags but also did some really great things also. My son will begin working with the team on his skills while waiting for an appointment with a developmental pediatrician. I think I might go crazy waiting for this appointment, a possible 4 month wait. Over the past few days my son, for the first time pointed at his ball and said "ball", I was so happy, he also pretended to feed his toy cow a cheerio, afterhaving been shown how the prior day.  I'm so happy to see progress since Ive been encouraging imaginitive play and pointing. Do you think this could be a signal that he is a late bloomer on the pointing etc. because I never showed him these things prior to his 18 month well visit, where the M chat indicated my son lacked these skills? Any input or opinion would be great at this point. I think feeling lost is part of this process, so any bit of advice seems to help so much. Anyway, I am trying to bring positive energy to him and his treatment and focus on all of the good progress that he is making. Additionally, I want to thank you for your past answer and for all of the resources you passed along to me. I especially love the link to Temple Grandin,was very uplifting and powerful. I plan to order one of her books..I can't thank you enough, and truly appreciate what you are doing for others on this site! Kristin

Answer
Excellent! You've had your appointment quite quickly and the results are encouraging. And, even better, while you wait for the next appointment, the team will continue to help you and your son. You could not ask for better service.

Let's look at some of the encouraging things:

- he pointed to a ball
- he said the appropriate word
- he showed pretend play feeding the cow
- he's just 19 months old, yet many of his scores are in the 16 to 18 month range - not bad at all

Please do not blame yourself. You did not cause this. And no, his lack of pointing is not because you did not consciously show him how. How many parents of toddlers do you know who wake up in the morning and think, "Today I must teach my child how to point"? Pointing with a child is something we do without thought and I would bet that you pointed out many things to him.

I know you're anxious about this next step, but let's talk about why. The very scariest step is in the very initial stages when you have that niggling feeling that perhaps something is not quite typical about your child. Then it's a hard step to actually talk to someone about it and make that first appointment. You've done all that, and you've done it while your child is far younger than most. This is wonderful.

Now, what is the worst thing that could come from the next appointment? What if the decision is that your son has autism, or PDD-NOS? You would have a name for the cluster of things that are a bit different about your child.

If he does receive a diagnosis, nothing really has changed. This is the same child you had when you walked into the office. This is the same little boy you love and enjoy.

Sometimes a diagnosis is helpful in that it opens doors to additional services. Having a child with an autism spectrum disorder is not the end of the world. And, an ASD diagnosis does not set limits on your son, nor does it predict how things will be for him when he's a young adult.

There is a book that you might find helpful, called Engaging Autism. It's useful whether or not your son actually has something on the autism spectrum. It's basically a way to play with your child, following his lead and helping his reach developmental stages. Take a look at it here: http://www.amazon.com/Engaging-Autism-Floortime-Approach-Communicate/dp/07382109...

Relax. I know that is easier for me to say than for you to do, for sure. But you're on the right track. You're getting help for your son and learning about his strengths and challenges and what you can do to help him.

All the best,

Dr. Sharon A. Mitchell
www.autismsite.ca