Expert: Valerie Herskowitz - 4/7/2011

Question
My 2 year old (29 months) just began seeing a speech therapist due to his speech delay - he enunciates very poorly, uses only 1 syllable words and only rarely 2 word sentences.  He seems to speak less now then he did at 18 months, although he does know about 40 words. He also has a few behaviors that seem odd, and we're concerned that there might be something else going on besides the speech delay. When sitting, he frequently will flap his arms and legs for several seconds, then begin again after a few minutes.  He does this repeatedly all day.  He also has odd ways of showing affection, such as grabbing and squeezing my hand.  He likes to do the same behaviors in a pattern, such as "kissing" noises followed by "raspberry" - these always go together, also giving a high five always is followed by a "fist bump" and he will want to do it again and again. He has very specific ways of playing, he will want to do the same thing over and over, such as crash 2 cars together, or I always have to be the green train and he is always the blue. Do you see any causes for concern? He can follow directions sometimes and is loving, he doesn't have any of the atypical emotional responses usually listed in lists of autism symptoms.  Thanks for your time.

Amanda

Answer
Hi Amanda

You are right to be concerned. Given the language delay and the odd steriotypcial behaviors as well as the obsessiveness he displays, I would highly advise that you take him to see a developmental pediatrician. Developmental pediatricians understand what goes on with these things. His behaviors coupled with the language delay could mean a developmental delay such as autism.

In addition, you mention that he follows direction only sometimes. Does your speech therapist work on his language processing as well as his expressive communication? Make sure this is not overlooked.

Keep me posted