Expert: Catherine Ridenour - 10/22/2011

Question
Hi Catherine, I have written before regarding my son who is now coming up to three and awaiting appointment for a formal diagnosis of autism.I have had a real hard time excepting this as although he has many symptoms of autism and it is clear that there is something going on with him, I just begin to except that he probably has autism and then he'll do something that completely throws me and leaves me doubting it again.
The main things that make me doubt a diagnosis are as follows;
1. His speech has suddenly improved and he has begun to say a few sentences such as, where is daddy,wheres gone,on a light,go outside,get out,wash it hands etc and he now says around 80 words.
2. He has started to point
3. He has began to engage in some simple imaginary play[very repetitive however and like short snippets]
4. On one occasion he talked jargon into his juice cup, as if using it like a telephone.
5. He loves and thrives interaction although always on his terms.
I feel confused as I have read that children with autism do not engage in pretend play and would you expect a child with autism to make as much progress in their speech at nearly three.
Some behaviours however appear to be increasing which include persistant hand flapping and toe walking and strange tic like movements like shoulder shrugging, body squirming, tapping his back etc. Much of his play is also very repetitive and he tends to do the same things all the time, it's like he gets stuck on things. This seems to be more prevelant the older he is getting.
Other symptoms include poor eye contact when we interact with him although he gives good eye contact when he interacts with us.
Difficulties getting his attention, he will often ignore us even if we call him.[did not respond to name at all until two years].
Severe rages,inapropriate reactions to stress and excitement,sensitivity to sounds,textures,too physical with people and interacts inapropriatly with people, does not like it when children approach him,sometimes sounds like he has accent or speech has pauses in wrong places, for example will say hello and then a few seconds later will say the name.repeating words or parts of songs over and over,no sence of safety and very poor receptive language.
However much of the time he appears normal,loves to interact although always on his terms,laughs, smiles, loves rough and tumble play.Likes cuddles on his terms.
Could you please advise, does it sound like he could be autistic as the speech therapist and doctor at the child development centre feel strongly that he is likely to have autism, however do you feel that his recent progress is likely to change his pending diagnosis or is it still likely.Please advise.Thankyou in advance for your time.  sharon

Answer
Hi Sharon,

It's good to hear from you again.

As you know, the symptoms of autism vary from child to child. I would say, given the behaviors that you notice in terms of repetition, hand flapping, etc. that a diagnosis of autism or Asperger's syndrome is still quite likely. His inability to interact with others is another key feature.

That he is making progress is a wonderful thing. He is getting some useful information from the world and that makes it more likely he will benefit from all the interventions available to a child with this diagnosis.

Imaginative play is not that uncommon in high functioning autistic individuals. As you've noticed, he does it alone, mostly and on his own terms. What you are seeing is his intellect peeking out. There is a mind in there that wants to participate in the world!

Do go get the evaluation. Accepting that your child has a challenge does not mean giving up all hope of a nearly normal life. With the label, he qualifies for special help to continue his progress.