Expert: Dr. Sharon A. Mitchell - 5/20/2011

Question
Hi Sharon,

My daughter is 26 months old. She is a very intelligent and happy child but I read about Asperger's syndrome info on the web and a little concerned whether she shows signs of the same. Her behavioral characteristics are as below:
Excellent speech: Vocab of more than 500 words, can speak original sentences using 4-5 meaningful words, can correctly use words such as "I ,me, mine, now, first".
Knows all her colors: 10-12 different ones. Can say and point them out if she sees them
Knows most shapes: 10-12 different shapes, including hexagon, diamond, pentagon, octagon, can say and point them out if she spots them e.g. the octagon shaped stop sign.
Alphabets: Knows both upper and lower case, can sing ABC song
Sings several different nursary rhymes
Numbers: Recognizes numbers can can count to 50 (actually could even go higher but gets bored after a while). Can count specific objects e.g balloons in a picture (upto 15)
Animal sounds: Can make 18 animal sounds
Body parts: names and points to 15 body parts
Pretend play: Very good at it. e.g feeding a doll/teddy bear, making pretend food, eating from a toy plate and offering me one etc.
Joint attention: Very good. Loves to read books with me. Extremely fond of reading. Can remember specific books.
Good memory: Remembers people names, events. Able to tell me about her day at the daycare.
Interest in puzzles: Loves doing puzzles. Can do 6-7 shape jigsaw puzzle meant for 3+ kids.
Interest in children: She prefers company of older kids, may not always interact with her peers, she does look at babies/peers at stores or on the road and sometimes may even say hi but would prefer to play with 3 or 4+ old kids, especially girls.
A bit shy: Takes time to warm up to strangers, but once she gets to know them then she is very loving and affectionate
Not much interested in physical activites: Would prefer to sit down with a book or puzzle than go play on a slide/swing.
Extra sensitive to some sounds: Hates the sound of smoke detector, does not cry but makes a face, points to it and complains to us. Sometimes gets scared of thunder or fluttering birds.
Low muscle tone: She had low muscle tone so we underwent some PT sessions, she has shown vast improvement, still working on going up and down stairs/climbing ladder without support, riding cycles but she will catch up with her peers.
Overall she is a very bright, sweet child but do you think there is cause for concern? Should I get her evaluated? Thanks very much for your help.

Answer
Based on what you've said, I agree. She does sound like a bright, sweet child. And no, again just going by your description, it does not sound like she has characteristics of Asperger's. Many children who do not have autism spectrum disorders dislike certain unpleasant sounds. Your daughter's reaction to the smoke alarm is not that of someone with extreme sensory sensitivities.

I would not be too concerned that your little girl is not gravitating toward other two year olds. At that age, many toddlers are in the parallel play stage where they may play alongside but not necessarily with another child. Those socialization skills appear a little later. It's a good sign that she does enjoy the company of other preschoolers. If her play skills continue to concern you, you could ensure that she has exposure to others her age through play dates, day care, readings at the library, etc.

Of all that you described, my biggest worry would be over her low muscle tone, but that is something you are already addressing and you have seen improvement with her physio sessions. I think you are already doing the things you can to help your daughter and, unless there are other aspects that worry you, no, I don't think she needs an evaluation for autism or Asperger's.

Best wishes,

Dr. Sharon A. Mitchell