Expert: Valerie Herskowitz - 7/15/2011

Question
Hi Valerie,
I know that you can't give a diagnosis online but I was just looking for some validation that I am going down the right path.

My daughter is 18 months old and I have had concerns for her for quite some time. I found it very difficult to get someone to listen earlier due to her young age but when she was 16 months old I just couldn't ignore it any longer. I will run through some of my concerns.
- Often doesn't respond when being called, even if I am right next to her and saying her name over & over again.
- She has no recognizable words yet, she does babble alot
- Does not seem to understand what we say to her, for example if I ask her to go to daddy she doesn't even look in his direction so is not understanding that is dad.
- Doesn't understand simple instructions
- Doesn't gesture or point
- Doesn't follow my gaze or if I am pointing at something will not look in that direction
- Lack of eye contact, although she does make contact sometimes
- Has never been a cuddly, affectionate child
- Has no real interest in toys, she does play with them sometimes but would rather just pull everything out of the kitchen cupboards & drawers. She does love music.
- Very active
- Not a big eater & a bit picky
- Doesn't sleep through the night
- Some head butting
- She doesn't mind being around other children but she doesn't    play with them. She does play with her sister sometimes and will laugh & smile when I tickle her etc.
- She loves adults, particularly men, almost to the point of it being odd. For example she doesn't really know our doctor but was wanting to sit on his lap.
- Some hand flapping, head shaking & tippy toe walking but not to excess.
- Bowel problems. She has never done solid poop's this was one of the first things I raised with my doctor & she has since followed a lactose free diet but not much has changed.

Their are a few other things but I am feeling a little frazzled and confusing myself but they are my main concerns

Now I will run through what I have done so far.
She has had a few ear infections and since I knew that would be the first thing they would look at I had her hearing checked at 16 months. She did have glue ear with a mild hearing impairment. According to the doctor it was probably not enough to affect her development this much. She has since had grommets inserted but nothing has changed.
I have also booked her in for assessment with a Speech Therapist and have been referred by my GP to a pediatrician who I will see on the 26th of this month.
Like I said at the beginning, I know you can't diagnose but I was just wanting to know if you think the possibility of a ASD diagnosis being made is reasonable and what I can do to start helping her now as the waiting time for services where I live is very long.
Also do you agree that the Glue Ear couldn't have affected her to this extent given that she is so young?
When I was pregnant with her I had a condition that carried the risk of her growth being restricted & although I raised concerns towards the end of my pregnancy I was ignored and she was born overdue & very small. Could this have had an effect on her also?

I do have 2 older children who were both very well spoken and affectionate as toddlers so I noticed at a very young age that she just was not like them. I know you can't compare as they are all different but the differences were so big that it made me worry. I am sorry about the length of this letter but I just needed to vent all my concerns. Thanks for listening

Georgina

Answer
Hi Georgina

I am a speech pathologist and therefore am not allowed to diagnose autism, however, I can tell you that you have a child that is displaying issues that are VERY CONCERNING. She has many many issues that I would call red flags for suspecting a developmental disorder such as autism. So I commend you for being on the right track in terms of being concerned.

Now as far as what you have done. It's hard for me to say as you don't live in the states so I don't know exactly what you have in terms of services.

I would not say that the ear issues have caused the developmental delay in as much as it is a common occurrence with children who have been diagnosed with autism. I don't know about the birth weight, however. I suspect this is not related.

You have other children, so you KNOW your daughter is not on target. It is obvious to you. I wish that you had a developmental pediatrician in your area to take her to for a diagnosis. If not that, do you have a psychologist or neurologist who specializes in this?

First things first. You must work on her communication. I highly recommend that you begin with a visual system of communication like the  PECS program. It has a high success rate.

BTW I do private consultations to help families work with their children at home, so if you ever want to set that up, you can email me at info@valerieherskowitz.com.  I use Skype.

Keep in touch and let me know what happens