Expert: Valerie Herskowitz - 7/9/2011

Question
My son is 9 months old. In most respects he’s doing great, but there are things I’m worried about.  He is a very healthy child, has never been ill, he is still breastfed now, but eats solids too. He is tall and very strong, and very very active. He always loved nursing, being close to me, being held and cuddled.  Up  to I think 6 months he would not be left alone and play alone- he wanted to be with someone all the time. Now he often plays on his own, but also very often will demand being picked up by me. We have a very strong bond and the same goes for him and my husband.  If he is with us, he is also very good with strangers too- he smiles back when smiled at and is very interested in people and faces.  He recently started being a little shy when he is around strangers, but provided he is with us, he will adjust quickly and interact with them too – by interact I means look at them, smile, show excitement , reach for them.  So I would say socially and emotionally he is a great, loving kid and I see no problems here. He is extremely smiley, more than other kids I think and loves playing pat-a-cake and peekaboo and lots of other games- he laughs and smiles when we do it. So that is all good. He is also excellent in terms of his motor development, he is crawling like crazy, sitting, pulling himself to standing and walking when held by the hand, manipulating objects, feeding himself fingerfood etc.-everything he should be doing. He is very active and very curious, likes when we’re reading books to him, especially when we use funny voices.  He is not hypersensitive to anything, doesn’t flap his hands, does not show any asymmetries in movements , has good eye contact.  We’re co-sleeping, because he does not want to sleep alone, he wakes up quite a lot for his age for company and nursing,  sometimes checks if I am in bed with him and falls asleep touching my arm etc.  I do not consider this a problem though. Now, the problem is that firstly he does not respond to his name that well. He improved recently, but when he is paying attention to something else, there is no way he will look at us- we could be saying his name or making other noises like clapping etc. –he just does not pay attention at all.  But sometimes he will respond, when he is currently not doing anything interesting or when he does not expect us. But most of the time I would say he just ignores what we say, unless he wants to interact. He started babbling when he was 6 months, but just for a couple of days, because then his motor development became very intensive and he became very quiet for some time. He started babbling again (and hasn’t stopped) when he was 8 months.  He does not seem to understand a lot of language, sometimes he expects certain things to be said when we’re playing and giggles in anticipation.  He might understand drink and maybe ‘no’, but I’m not sure about that.  But the biggest problem is he never imitates us, he never tries to communicate anything by sounds, gestures or looks. We know he wants something when he is ‘moaning’ and when he wants to be picked up he starts climbing on me.  It seem as if he didn’t understand that he could communicate something with his body or voice. When he is babbling, we try to imitate him, but he doesn’t seem to get that and ignores us. He will smile back beautifully when smiled at, but that’s it- he will not make a sound, gesture or other facial expression in response for something we did. When I point to things in a book, he will follow my finger with his gaze. When we play pat-a-cake, he will position his hands correctly, but will not clap on his own.  
Is he just developing at his own pace,  ‘being a boy’, or should we suspect autism?

Answer
Hi Lena

Because he is babbling, I'm not that concerned yet. You should be vigilant to be sure he continues to develop.

Right around 9 months, you should be looking for what we call jargon behavior. This is kind of like babbling, but with intonation. Sounds like he is really talking but in baby talk. If that doesn't develop within a month or so, then write me back.

You do need to watch to be sure he starts to understand and repeat your behaviors over the next few months. Again, write me back if you don't see this developing in a month or so.

Just a tad too early to tell from what you have written