Autism/22 month old speech

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QUESTION: Dear Sharon
You have been very helpful in explaining autistic behavior at various ages.
My son is now 22 months old. For 5 months I was convinced he is not on the spectrum because he has become more and more connected.
But...we are now 2 months away from the BIG 24 month deadline for 50 words AND two word phrases, and I am getting panicked again.
My son has 55-60 words, mostly nouns, plus one social word bye bye, and 3 verbs (eat, sit and kick). He is not putting two words together yet other than very occasional "kick ball" or "sit down". This could be simple delay, but I cant help but worry
I am very worried because I know lots of ASD toddlers can label objects, but can't communicate functionally.
In addition, my son has wonderful 3 point joint attention some days, and very sporadic at others. For example, when entering the mall, he would stop and checks back with me every 5 steps of the walk. Then some days, he might take off and run and run and look at the stores, and not turn for me in half an hour. I know autistic toddlers have lower than normal joint attention, but I am having very hard time measuring the "frequency" of his JA.
Here is some more info.
My son requests by pointing. If he wants milk, and I offer water, he will shake head for no, and point the milk..sometime he will say Ba as well (bottle).
He will point to 10 body parts or many objects on request. I wonder if pointing on request is some form of joint attention too?
He understands many words, follows many simple commands, and can sort objects by function (animals v. Lego blocks). His sorting is in no way restrictive or rigid.He claps for praise, waives bye bye, initiates silly games with us, etc.
He has no sleep or food issues, and he seems to respond appropriately to the world.

Please help...everyone says signs are very subtle...so how do you know? Do you count the joint attention episodes? Do typical kids have joint attention all the time?
I have SLP, pediatrician and school psychologist all think he just needs time.

ANSWER: Hello again Julieta,

From what you've written, I agree with your SLP. pediatrician and school psych.

Even though your little boy is approaching his 2nd birthday and you've read the # of words most two years have in their vocabulary, these are guidelines. It's a rare child who would have exactly those number of words under their belts. Your son's expressive language skills are in the ball park.

Many children this age who DO have autism, despite good vocabularies, might show only rare joint attention while it sounds like your son demonstrates this as part of his normal day.

If I knew your boy only from your description, the word autism would not enter my mind.

I would suggest you relax and enjoy your wee man. He sounds delightful and you're already doing so many good things for him. In another year, then again as he's approaching school age, if you are still concerned, talk to your SLP/pediatrician/ed psych more then. But for now, I think you can safely relax.

I hope you have a great time at his 2nd birthday party.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much! I guess I have been worried about his joint attention because he doesn't do the conventional "showing" of toys anymore. He went through a 2 month phase of showing us his toys all day long, then through a phase of sharing his food. Now he doesn't show us anything.
The examples of him sharing would look like this: he touches the stove, I tell him NO, he turns, looks at me, "argues" in baby jargon to express displeasure, and starts to touch the stove in slow motion fully aware that he will get punished! Next day he will happily run to the stove, and check on his way, happily giggling and anticipating to get scolded.
When he plays, he doesn't invite me. I have to watch though...if I pretend to fall asleep, he will, within 5 to 10 minutes, come and try to open my eyes or push me...until I am fully responsive. Or if I play with some very undesirable boring toy in the other corner, he would immediately come, steal my toy and run away...the toy becomes instantly very valuable.
Do these examples show the right joint attention even if he doesn't show or share his toys?

Answer
These things sound to me like the typical antics of a mischievous, lovable two year old boy. He wants your attention and your participation, something many moms of kids with autism would give their eye teeth for.

But your worrying aside and just delight in this awesome wee lad.

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Dr. Sharon A. Mitchell

Expertise

Sharon can help with parenting and educational concerns. She has worked in teaching, special education, counseling and consulting for over thirty years and gives workshops to educators and parents on working with kids with autism spectrum disorders. Sharon speaks from both the education and parent points of view, having an adult son with Asperger's.

Experience

Sharon has spent decades as a special education consultant with a school district and autism consult for the province's Department of Education, giving workshops and individual consults. Currently she works as regional autism consultant for a health district in between teaching university classes. She is an Amazon bestselling author or a series of novels, each depicting a child who has an autism spectrum disorder. Sharon's Master's thesis looked at the long-term outlook for persons with high functioning autism and Asperger's. Her Doctorate focused on strategies to help those with autism spectrum disorders.

Organizations
Website at http://www.drsharonmitchell.org and sits on Autism Today's Panel of Experts (www.autismtoday.com)

Publications
Author of "Autism Goes to School" - a novel about autism that that became an Amazon bestseller. Get this Amazon bestseller free at http://www.drsharonmitchell.org. In the next book, Autism Runs Away, Ethan is only in grade one and already has been kicked out of one school due to his tantrums and pattern of running away when in a panic. Now in a new school his mom remains glued to her phone, waiting for the call to tell her that they don’t know what to do with a child who has autism. Sara is about to learn if this new school is up to the challenge. (https://www.amazon.ca/Autism-Runs-Away-Book-School-ebook/dp/B01FCYQ7DC). Autism Belongs is the 3rd book. Manny's life has shrank to the confines of their house. His parents are desperate not to rock his world because the aggression has gotten to much worse. Where will this lead? Is there a chance that Manny could actually belong out in the world? You bet! Get a free sample at https://www.amazon.com/Autism-Belongs-School-Daze-Book-ebook/dp/B0184ZQMI6. Book four, Autism Talks and Talks, is about a 12 year old girl who has Asperger's. She's bright, inquisitive, highly verbal, but lacks social skills. Try a free sample at https://www.amazon.ca/Autism-Talks-Book-School-Daze-ebook/dp/B01IIUZH3S Book five, Autism Grows Up features Suzie, a bright, twenty-one year old whose life collapsed after she finished high school. Now, she lives in her mother's basement, spending nights on her computer, afraid to broach the world outside their door. Autism Grows Up is found at https://www.amazon.com/Autism-Grows-School-Daze-Book-ebook/dp/B01JB8QW3U. Prefer a boxed set? Get the first 3 books bundled together at https://www.amazon.com/Autism-Box-Set-School-Books-ebook/dp/B01KBEHJ08. Co-author of Amazon.com bestseller, The Official Autism 101 Manual (http://autism101manual.com/).

Education/Credentials
B.A. in Psychology, B.Ed. in Special Education, M.A. in Educational Leadership PhD. in Psychology Management, specializing in autism.

Awards and Honors
B.R.A.G. Medallion for the novel Autism Goes to School - Book 1 in the School Daze Series. (http://www.bragmedallion.com/medallion-honorees/2013/school-daze-autism-goes-to-school). Like Autism Goes to School, the third book in the series, Autism Belongs, also ranked #1 on Amazon (http://www.amazon.com/Autism-Belongs-School-Daze-Book-ebook/dp/B0184ZQMI6). Manny is not like other children. He doesn’t talk. He doesn’t leave the house. His parents desperately try to arrange their world so that Manny does not get upset. Because, when he does, well, the aggression was getting worse. At ten, Manny was becoming difficult to handle.

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