Expert: Dr. Sharon A. Mitchell - 4/18/2007

Question
Like Luke, the 23 month old with speech delay, I noticed that my 24 month old had a significant speech delay. He is pretty much non-verbal.  He only uses 3 to 5 words on a regular basis.  I had him evaluated by Early Steps. They told me that he had a receptive and an expressive language delay and he qualified for services.  
I have become more concerned because my son also flaps his hands and has started hitting us when he gets angry. He also throws himself backwards. He also does not look people in the eye much. He does not pretend to play with dolls or stuffed animals, but like Luke he does like to play with the phone.  He also used to wave and say Bye-Bye but has stopped. He also doesn't use 2 word phrases. He doesn't imitate me or my expressions.  My son also like Luke is very affectionate.  He like to give hugs and kisses.  Should I still be concerned that my son might have Autism?  Your answer to Luke mom was very fague.

Answer
If you're worried, I think that's reason enough to pursue your concerns.

Since you've read my reply about Luke, the 23 month old with speech delay, you will have noticed the links that give information on language development that is within the typical range for two year olds. That, coupled with the Early Steps information tells you that your concerns are grounded, at least language-wise.

Contact Early Steps is a good first step. Have you talked to them about your concerns that your boy may have more than just a language delay? With their experience, they might be able to observe and tell you if they are seeing any signs of autism.

From what you describe, some of your son's behaviors could be due to his frustrations in communicating his wants and needs. The services he'll be receiving should help him learn to express himself and do it in a more appropriate way. But hitting and throwing himself backwards aren't necessarily signs of autism.

Likewise, your concerns about lack of eye contact, decrease in spoken language, lack of pretend play and facial expression imitation are not definitive pointers to autism but are red flags, depending on your son's cognitive and developmental level.

If you're worried, seek help. Talk to your pediatrician, or public health nurse. If they assess him and feel he's fine, then your mind will be put at rest. If they suspect something in the autism line, then you will have been proactive in getting early help for your boy.

Sharon A. Mitchell
www.autismsite.ca