Expert: Jene Aviram - 1/13/2012

Question
My 27 month DS has just been approved for EI due to speech and social delays. He would not have been approved for just speech but since there were other things I think the speech was also approved.
His pedi suggested an eval at his 2 year checkup because he wasn't putting any words together. Since then he has started and has has a mini word explosion. Pedi said he is not too concerned that DS has ASD. But I am. Maybe I'm reading too much into his quirks but I feel like there might be something other than a delay going on.
Here are my concerns:
DS is a complete loner. He would rather walk the perimeter of a playground than play with the kids. He refuses any circle time and generally he stays away from the crowd.
He avoids eye contact. He can be a whirlwind in a new place. He needs to touch everything,open every cabinet. I have home on more of a lockdown so not so much here.
He used to spin alot. Also crawl around with his head rubbing the floor.
I've seen him toe walk but only a couple times.
He lines up things in the bathroom. It's the only time he does that but almost any time he is in my bathroom he empties the drawers and lines up the things he finds there.
He is a bolter. I cannot keep him near me in public. He either bolts or wanders off.
He has lots of single words and some phrases but no pronouns. He's the only 2 year old I know who nevers says "mine!".
He bangs his head any time he doesn't get his way.
He licks walls and windows sometimes.
He used to spin alot but hasn't much lately. He also had a very strong affinity for spinning thing.. now he's obsessed with robots!
He was very late in pointing but does point. He is engaging but only when it's stuff he likes. I think he would still point to those things if nobody was with him.
Some background:
He had IUGR due to placental insufficency and weighed 4"10. He hit all of his milestones on the farthest end of normal without actually being late.
If you met him he'd seem pretty normal to you. He's tiny and hyper and runs away but he isn't totally antisocial and plays with puzzles and is interested on his environment. Maybe he just has these tendencies. I guess all will unfold in time. We get an ISP from the learning center this week so we'll see.
I wonder about things that are red flags for Autism, are they not considered red flags if they reslolve..even if the did them for a while?
Thank you! BTW, the EI coordinator and learning center recommend he have ST for 2hrs/week and developmental therapy 4hrs/week.

Answer
HI there,

I'm not entirely sure what your question is.  I believe you're asking if a child presents red flags for autism, but no longer continues those behaviors, should we still be concerned?  Is that correct?  Please clarify if you are asking something different and I will gladly respond.

With regards to the question above, being on the autism spectrum involves many characteristics and behaviors.  Two people with the same diagnosis may behave in a completely different manner.   Behaviors in people on the spectrum typically evolve and change over time.  So the answer is yes, we would still be concerned... even if some red flags are not present in a child any longer, he/she is likely to still have many other behaviors which are associated with the autism spectrum.

Your son sounds rather delightful and I can tell that he is really smart.  You are clearly a great mom, who is on on the ball and who I have no doubt will do anything to help your child progress.  Parents like you are the ones that help their children go a long way.  You'll see that he will make great strides and a year from now, you'll be amazed at how far he's come.

Almost everything you mentioned are behaviors that are commonly found in children on the autism spectrum, and I presume that is why they are suggesting developmental therapy.  What state are you in?  Do they have ABA (applied behavior analysis) in your area?  What type of professional does developmental therapy and what does it involve?  That's something I'd like to know if I were in your shoes.  Is he going to get an evaluation from an OT (Occupational Therapist)?  I ask because he has many indicators of sensory integration disorder.  Some examples are spinning, licking objects and lining up items.  You'd be amazed how much a good OT can help with this.

There is an article on this site called "How do you know if your child has autism?"  that you might find interesting.
http://www.nlconcepts.com/does-my-child-have-autism.html

You might find some great value in the menu options : The Greatness of Autism and Help for Autism at http://www.nlconcepts.com

I think it's great that you have sought help for your son.  The sooner he starts therapy, the faster he will make progress.  I wish you only the best of success and happiness.  Let me know if I can be of any further help.

Jene Aviram
http://www.nlconcepts.com