Expert: Valerie Herskowitz - 11/29/2011

Question
I'm the mother of 4 kids 2 boys a girl, then a baby boy. My eldest son who is 6 has HFA and is currently mainstreamed with an aid in 1st grade. My second son has some mild developmental delays of which he is receiving minimal intervention for, my 3 year old daughter was recently dx with pdd-nos (thou I will say she was previously tested by a different doctor and was found to be within normal ranges# And my youngest son is 9 months old. I'm very well versed in testing and developmental lingo and  def know my way around and IEP...in other words with is not my first rodeo and I know what to look for in regards to autism red flags. My youngest is a very social baby, always smiling and seeking us out. He rolled over, sat up and crawled in typical and timely fashion but I notice some oddities that I'm not sure are typical. For intense when sitting he clenches his fists #when not playing) and holds them up by his shoulders. Sort of in a tactile defensive way I guess. He reaches for toys and plays on the floor with his hands open, he crawls typically and his hands hands flat and open on the floor...but when they are unoccupied they remain in his "default" position...up and clenched. He's also very uncoordinated with them..has difficulty holding his own bottle, can not form the pincher grasp, flaps his (whole arm not just his hands) when excited or mad and will hold them clenched, up and bent back like it's his natural position. He enjoys being held and seeks me out (all day long!) to hold him...but he resists my attempts to mold him to my body unless very tired. As stated be is very social and expressive..smiles appropriately and make great eye contact and joint attention....but he's not clapping and his upper body gets stiff when I attempt to clap for him. He sat up early but was inconsistent in his ability to control his balance sitting until now...he's been rocking on his hands and knee's since 5 months but didn't coordinating crawling until just now. He still startles at loud noises and seems bothered by them. he plays peekaboo appropriately but sometimes lacks the enthusiasm one would expect (my husband say this is because I insist on playing it 50 times and he gets bored..maybe true.) I had him evaluated 2 weeks ago and was told he was fine (with the exception of his self help skills which came out at around 5m) and didn't qualify for any further intervention at this time. they mentioned that he was tactile defensive but otherwise fine... But I'm not so sure. All of my previous children have been found to have some form of developmental delay and I fear he might be the same. Do you think my "mom radar" is oversensitive and reading into something that's not there because of my previous childrens experiences or should I start banging down the door of my local CDS?? Any thoughts? Please forward my question to someone else if you feel they could better answer it...thanks.:)

Answer
Hi Liz
No-I don't think you are being too oversensitive. You have 3 other children with some sort of developmental delay. There is a good possibility that the baby will have something as well. So no, I don't think you are being too sensitive.

I can't answer you about the hands-but you should be very alert and aware to everything this child does. I would keep a very good log of all behaviors both good and bad.

I am not saying that the baby will have an issue. But he is certainly at a higher risk. And catching something early would be good.

Someone has already mentioned tactile defensiveness. And you mentioned his overt startle. So I would be hypervigilant to sensory issues at this point. Again, I don't want to give you any impression that there is a problem-just something you should watch.

Good luck and keep me in the loop.