Expert: Valerie Herskowitz - 1/26/2011

Question
Could my daughter have autism, or is her behavior normal? She is 28 months old. She smiles and laughs frequently. She sometimes initiates play with me. She'll play with her older sister if initiated. Makes great eye contact with family, not sure about strangers. She doesn't seem to play with other children her age, not even her brother, sometimes doesn't seem to acknowledge them. Only has a vocabulary of 18 words tops. Doesn't put words together. Rotates her hands around at times for no reason. Walks on tip toes occasionally. Has frequent meltdowns, with screaming fits over little things or for unknown reasons. Likes to spin in circles often. Interacts by herself almost all day. Watches Dora over and over again, very difficult to get her to watch anything else and she used to looooove spongebob.  Twirls my hair anytime she is near me, to the point of hurting me and she just laughs when I try to express to her that it hurts. Sometimes if I try to cut her food up while she has her plate, screaming fit ensues to the point where she tries to throw or push her plate away, other times it doesn't seem to bother her. Most of the time I feel she seems normal, other times, during odd fits, and when I notice how she can't communicate well, I begin to worry.  Is she just spoiled and speech delayed, or could she possibly be mildly autistic? Oh, and I don't know if this is related, but she has done this odd thing for quite a while that her doctor has blown off as nothing. She sometimes, for no apparent reason, as if excited or angry, opens her mouth and fingers, tenses up and kind of trembles or shakes slightly. Any insight would be greatly appreciated.

Answer
Hi Crystal

Yes there seems to be some issues and red flags:
1. language delay- a child of that age should have a lot more language
2. social delay
3. watching the same thing over and over
4. the twirling hair thing
5. screaming fits when you are cutting her food

There is something going on. Possibly autism spectrum disorder. Get her evaluated immediately by a good developmental pediatrician or child neurologist.

Then get back with me and we will plan from there