Expert: James Michael Roan - 7/30/2006

Question
hi,

i have a 23 month old son that i am worried about.  i was watching my 1st sons home movies and realized my 2nd son is not at the same level in speech.  i know we should not compare, but it did get me looking on the net for actual standards of speech for certain ages.  the 2 that stood out were at least 50 words in vocab and 2 word sentences by 2.

My son has about 50 words i can actually write down and know he uses.   he learned and used a new one today, slushie.  he does not put any 2 words together except 'where's daddy' or 'where's brother?'.  

i then noticed once he flapped his hands and once got on his tip toes.  i know i am sounding paranoid.  i had a friend tell me autism is when a kid does normal kid things exceppt on steriods.  

he does play nicely alone but also loves to play chase with dad and brother and hang out in brothers room looking at all of his toys.  he loves to build with blocks but also loves to throw them around and make a big mess.  he pretends on the phone, pretends combing hair with a brush and same for teeth.  he sometimes makes a roaring sound when he plays with cars but these are the only "pretending" i can think of.

great eye contact.  he doesn't always respond to his name, but he has a twinkle in his eye or a smile so i know he is ignoring on purpose.  I have not seen him use any sort of finger poiting.  i noticed in the online test you guys suggest that that was a big deal.  if i ask him where the light is he looks up at the light, but no fingers.  he knows his grandparents in picture and he will come get my attention and run to the fridge, try to open the door as he says 'Ba"  or "more" (if he already has his ba in his hand.)  he tells me if he wants cheese, yogurt, cracker, ba, but only with 1 word.  when we say it is bath time, he runs to the bathroom saythin "bath, bath"

he understands very well.  i will tell him to go get brother or go get your bottle (a sippy cup we still call  ba) and he does.

when he gets angry he bangs his head.  this has decreased since we have been influencing this behavior with light discipline.  

i hope i am not rambling.  i've tried to go over the main points.  i hope you can ease my mind or point me in a direction.

thanks

concerned mom  

Answer
Hi Kris;

I'm sorry, I hit the wrong button and sent you the wrong message! I'll do my best to answer your questions. Please remember, I am not diagnosing here.

My first response, without observing him is that he has a  small expressive language delay, which frustrates him, and hence the behaviors you are seeing as a result.

His low pointing may indicate a simple social delay. In fact, I see tip toeing, and flapping in children with some degree of developmental delay. I suggest you read through the M-CHAT you referenced in your email and report to me specific areas/questions he failed, if any.

I suggest you first download the M-CHAT from here:
http://www.firstsigns.org/downloads/m-chat.PDF

Then get the scoring guide here:
http://www.firstsigns.org/downloads/m-chat_scoring.PDF

Keep in mind that pointing is a social behavior, a desire to share an object or event that the child finds interesting or noteworthy with someone he cares about. Does your son bring objects such as toys, or food to share with you? In autism, the core deficit is really a significant social delay; either low social interest and even an aversion to others. I do not think you have anything to worry about.

Kind Regards and enjoy him!

James