Expert: Valerie Herskowitz - 11/2/2011

Question
Hi
Our son is 12 months old and is having problems developing his pincer grasp.  He has seen the health visitor several times and at each occassions he fails to demonstrate a fine pincer grasp.  The health visitor is now referring him to see a pediatrician, and I am becomming more and more worried that he may be showing an early sign of autism.

In terms of other development I don't think there are any concerns.  He has been crawling on all fours since 11 months, can pull himself up and cruise around the furniture, has just started to use his walker on his own in a controlled fashion, clearly recognises us as his parents, is very attentive, cannot stop smiling and laughing, can clap hands and just recently has started putting both his hands above his head when prompted and looking at us all for recognition. He doesn't yet wave at us, but I think there is enough other joint attention to mean this is something he just hasn't learned.

He babbles a lot and can already say mama & dada, and seems to say other words such as "ba" (for his ball), "g" (for "gone" when he drops things, "ma" (when he sees out cat, Max) - I'm assuming the primitive way in which he says these words without the correct ending is just normal language development at this stage?  If you ask him where his ball is or the cat, he looksa round and points at them, and when out and about he points at everything and everyone.

In terms of play, for months he has been holding things, passing them from hand to hand, bashing them together and throwing them.  He isn't yet starting to play with toys properly (ie pushing cars around the floor) but is starting to show these signs.  He does, however, spend a lot of time picking toys up and putting them on top of items of furniture or over the edge of things like the bath - again, I'm presuming this is normal behaviour and nothing to be concerned about.

His lack of a fine pincer graps hasn't stopped him doing anything yet - he eats fnger foods OK (if not a bit clumsily) and in watching the way he holds toys he shows some form of a pincer grasp, he just can't seem to perfect the picking up of objects with the tips of his finger & thumb.  My problem is that knowing he is perhaps slightly delayed in one area, I find myself looking at his other behaviours and scrutinising them to look for other signs of problems which may not actually be there (hence the language and play points above).

Many thanks in advance for your answer.

Answer
Hi Dave
Whenever a child is possibly showing some signs of a delay, it is always best to get it checked out by a professional in the field of the area that you are concerned with. So, I would highly recommend that you take your son to see an Occupational Therapist who can access the pincer grasp issue as well as a speech pathologist who can determine if your child is on target for language development.

You are presuming that his behaviors are normal and nothing to be concerned about, however, that may or may not be the case. Being that he is only 12 months, I am not personally concerned about his minimal speech expression, but you would be wise to have a therapist check him out fully. What have you got to lose? It's good he is pointing to things when you ask him-that is a good sign. I don't see anything from your letter that is greatly concerning, but if I were you, I would let the professionals who can see him face-to-face tell you that. It will give you piece of mind,

Take care and let me know how it goes