Expert: Catherine Ridenour - 6/21/2011

Question
Hi Catherine, im wondering if you could answer a simple question.  My son is 3 years old and has no diaganosis as of yet.  His evaluations came back and he is on the fence, he has autistic tendencies but some are not.  He will be getting speech therapy and ot therapy weekly starting in september.  He talks ok, but has a hard time communicating when asked something and usually repeats what was asked. I know this is a strange question, but he sings everything in the car like if we are going somewhere or he is holding something ex... "im going to grammas house, and this continues until we are there, he has been doing this alot lately, he usually bangs his head back in his car seat while singing... is this something related to autistic behavior or just him being a normal happy child?  There are so many strange comical things he does and obsessions he has its hard to tell...

Thank you,
Michele

Answer
Hi Michele,

Since autism is a "spectrum" disorder, meaning that it ranges from classic, severe autism all the way to mild Asperger's syndrome there really is no line where one can say a child is or is not affected. I think he has enough tendencies to say he is mildly autistic. Whether or not your son's behavior is labeled autism is less important than his getting services to cope with the issues. Speech therapy is a good thing.

Repetition is a normal part of early childhood. Most children have a favorite story they want to hear over and over. They like routines. There is comfort in predictability. Lots of three and four year olds sing almost constantly. But the clues to autism here are the head banging and the repetition of questions. You mention obsessions, too.

Many kids on spectrum have an auditory processing disorder. I believe they repeat things to run the information through a different part of the brain so they can understand it. For some, it is a habit they can be trained to drop or at least do silently. Others need it to be able to communicate. For now, ignore it and concentrate on getting a response that makes sense. Pointing out the echolalia (repetition of what is said to him) will only make him self conscious about it.

He is likely to have challenges in social situations. Most people with autism have little understanding that others have thoughts and feelings. Their own emotions change quickly, take them by surprise and are hard to cope with. They do not read other peoples' body language well so they take offense at the wrong things, or miss "the look" the teacher is giving them that would redirect them before they get in trouble. Look at pictures of faces and talk about the emotions they display. Happy, sad, mad, worried, scared. For autistic children, reading faces must be learned just like reading words.

Teach him how to recognize the sensations in his body that signal emotions. For example, hot face, clenched hands, tight tummy equal "mad". And directly teach him what to do when angry-- tell the person you feel angry and why, use words not fists. Find a quiet place to calm down. (self timeout) Go back and try again. Tantrums are common, and often intense, in these kids. Whenever possible, walk away from tantrums. What gets attention is reinforced.

Most importantly, enjoy his unique personality. Raising a child like this is a challenge but their perspective is often refreshing. He may be very bright despite his difficulties. Only time and love will tell.

Best wishes,
Catherine