Expert: Valerie Herskowitz - 2/15/2011

Question
Hi, My son will be turning 9 months old in two weeks and I would like your professional opinion of what I may be dealing with. Since birth I had a gut feeling that something wasn't right. Poor eye contact, extreme colic, Gerd diagnosed @ 6 weeks old, smiled late 9 weeks, hypervigalent to surroundings. and just myself having an overwhelming fear that something was just not right. (I also have a 7 year old boy that is NT yet could have some ADHD issues#. @ six weeks of age his cooing was great back and forth with us. Then after his 2 month old shots #which he did not tolerate well at all fever, extreme irritability, and questionable seizure like activity# all cooing subsided. #We are holding off on vaccines @ this time.# He, never and still does not like to be held close or in cradle position or like cuddles. He has been seen by Early Intervention @ 4 months of age and qualified for special Ed 2xweek based on psychologist observation @ that time. I am going to just list my concerns #his pros and cons# know to make it easier.
pros. responds to name most of the time
     smiles appropriately only with close people me husband grandma
     babbles a little bah bah bah when initiated by us
     has good eye contact when not being held
     follows me around and wants to be socialized with
     checks in with mom with eye contact @ times when with therapist or playing.
     show some joint attention
     sometimes appears to me as being NT
     enjoys peek a boo
     cons
         poor eye contact when being held will avoid looking at you unless you are working hard to engage him
         does not enjoy being held close and rocked will resist
         and arch and fuss
         doesn't show excitement when his brother comes home from school or I come home from work #maybe he will flash me a smile#
         can be very fussy not a very happy baby
         will stare at lights/fan sometimes obsessively keeps looking back at them over and over
         does not seem to have protective reflexes will fall from sitting position like a log and sometimes will even just throw himself backwards
          loves music will rock and flap arms with excitement
          is very hyperfocused at times
          very hard to get a chuckle out of him
          will immediately awaken when transferred from car seat to crib #does not just lay on shoulder and stay sleeping. He will wake up and straighten up to avoid close contact
          has good days and bad days
          has a mobieus mouth
 Well, that is most of it. It is so hard to paint an accurate picture of him with words. He also has been seen by neuro @ 4 months of age and his exam was normal. Also he was seen by a developmental ped @ 4 months of age and was dx as developmental delay social and expressive language. I am so tired of trying to figure him out and my husband is not very supportive and my mom thinks I am a hypochondriac. I would love to turn a blind eye and take a more wait and see approach However, I know that I have to be his advocate and that I don't want to look back and say I "should of, could of, would of". If he does have any type of autism does he sound more mild to you? since he does engage and have some good traits? Does early Intervention really help? How early can he get an accurate diagnosis? I am very scared and sick to my stomach sometimes when I think of him possibly having autism. And I would appreciate your answers to some of my questions In addition to some guidance. Also please forgive me if I rambled a bit and seem unorganized in my writing. I work nights and I just finished my work week and I am extremely exhausted. Thank You so much for providing your expertise.
 Also his motor skill appear to be OK. Oh one more important question if he does have an autistic issue will it progress over time or will it remain stable and be optimized with early intervention?

Answer
Hi Susan

I'm glad you are being vigilant, because it does seem to me that your son is having some developmental delays. I would definitely take him back to the developmental pediatrician or EI because he is not showing appropriate verbal skills for a 9 month old. A child of your son's age should be babbling A LOT. In fact, right around 9 months of age, the babbling often turns into a jargon speech, which is babbling with intonation. Since you are stating that he is only babbling a little and only when initiated by you, that is a red flag. There are other red flags for developmental delay as well stated by you in your letter. So don't delay. Get him so services as he can absolutely be optimized with EI.