Expert: Dr. Sharon A. Mitchell - 2/7/2011

Question
Hello, I have a son 4 years old who was diagnosed with ASD he is very high functioning and also have a daughter 19 months old, she is not talking, no words, just babbling and says mommy to me and to other people too. She doesn't say daddy or my sons name or milk or any other word or attempt to words just sounds. She points inconsistently she listens I think she understand everything but it is hard to say because she does not talk, she follow simple instructions but inconsistently.  I am concerned because the neurologist say she has ASD because of the genetic risk but the Early Intervention phsycologist said no she is ok just late talker. I am concerned because in my son case he was ok socially until he was 2 1/2 years old, he pointed less and respond less to his name but otherwise both have speech delay and w sitting.  Also occasionally my daughter stares and play as his brother throwing things in the air.  I am making my case with early intervention but they are ignoring my request based on his evaluations. She just qualified for Speech Therapy because the therapist saw an obvious speech delay. OT and Psych said was average but no words. Any advise would be really appreciated.

Answer
It's confusing, Carmen, when you receive differing opinions from professionals. But part of the reason for the disagreement is because it may be harder to recognize the characteristics in a child as young as your daughter.

While autism is not an inherited disorder, there is a genetic component and since you already have one child with an autism spectrum disorder (ASD), you have a slightly higher chance than other parents of having another child with a similar diagnosis.

Some children who have autism are late developing spoken language or do not communicate orally ever. Some children who do NOT have autism also may have delayed or even absent spoken language. So, your little girl's delayed language alone does not mean she has an ASD.

According to the American Speech-Language- Hearing Association, between the ages of one and two most children are developing these expressive language skills:

- Says more words every month.
- Uses some one- or two- word questions ("Where kitty?" "Go bye-bye?" "What's that?").
- Puts two words together ("more cookie," "no juice," "mommy book").
- Uses many different consonant sounds at the beginning of words.

You can read more about this here: http://www.asha.org/public/speech/development/12.htm

But delayed language is only one of the diagnostic criteria for autism. Kids with autism spectrum disorders (ASD) have a triad of impairments - the communication involvement, social impairment and repetative/restrictive behaviors.

At the following link you can see some of the red flags for ASDs: http://www.firstsigns.org/concerns/flags.htm If you're a person who takes in visual information best, you might prefer to watch these short video clips of children who have and don't have an ASD: http://www.firstsigns.org/asd_video_glossary/asdvg_about.htm You must register to see the videos but there is no cost or obligation.

It's excellent that your daughter is already receiving speech and OT services. Whether or not she will eventually have an ASD diagnosis, these are helpful therapies.

This may not be what you want to hear, but for now, does it really matter if your daughter has a diagnosis or not? Part of the reaon some parents seek a diagnosis is so that their child may access services. You already have the appropriate services for your little girl.

Whether or not she has autism, this is still the same child you have in your home and love. The strategies that are helpful for a child with ASD certainly will not hurt a child who does not have autism. Since your son does have a diagnosis, I presume that your household is already organized around strategies beneficial to him. By this, I mean things like keeping to a routine, posting a visual schedule to let the kids know what will be happening during the day. Social stories will be helpful for both children to let them know of upcoming events and what will be expected of them. Assuming that your kids take in what they see more readily than what they hear will cut down on frustrations all of you may feel.

Best wishes,

Dr. Sharon A. Mitchell
www.autismsite.ca


It's excellent that your daughter is already receiving speech and OT services. Whether or not she will eventually have an ASD diagnosis, these are helpful therapies.