Expert: Catherine Ridenour - 12/3/2007

Question
QUESTION: I am worried about my son. Initially I was doing research on why my son is
not putting sentences together and everything came back as autism being a  
possibility for that.

My son has been pretty distant lately, he does like to be alone for a little bit
but does join in when we all have fun and play around. He does not like to
share and says no a lot , he will throw tantrums when we dont understand
what he wants or dont do what he wants. I am able to snap him out of it but
some days he will have them more and some days less. I noticed he is getting
his molars as well, the last time he was getting molars I noticed he changed a
bit as well and then got back to being not as sensitive I guess would be the
word.

He likes cars so much and trains as well, he will always find them in a picture
or movie. He so far knows about 110 single words and has great
pronounciation but only sometimes combines 2 words together. If I tell him ,
he will do it but not much on his own. Sometimes I see that he tries..and he
might say one word I understand with a whole bunch of other jibberish mixed
in.

He does make eye contact and can look at a book with me and point out
things and tell me what they are. He seems to put a in front of all the words ,
like a dog , a cat, and he might point to a dog and say a cute ..Is he just using
eccholalia? When he wants something he just makes one word demands or
will bring things to me or make me follow him. He does seem to make
connections for ex: if he sees a star he might start singing twinkle twinkle
little star..or will see a dog and say dog and then the name of our pet. He will
copy me in play and likes pekaboo a lot. He loves playing with my oldest
daughter but not much with the baby, he just says baby and might go give
her a kiss once in a while.

What could I do to help him with language at home? I had our third baby
when he was 15 months old and never had the time to spend with him as
much as I should. I feel incredibly guilty for that, as if I might have not done
enough for him.

Is there way too many red flags to pass it off? My husband talked late as well
and had trouble with reading and writing, he says he was diagnosed dislexic.
Could there be a link there?

Thank you
Elina



ANSWER: Hi Elina,

I think you can relax. Second children, boys in particular, talk later than firstborn children. Two word sentences can come around age 2 but some kids don't get them going until age 3 and are perfectly normal.

As to his lack of interest in the baby, well, babies are boring to two year olds. The baby cannot play with him right now. It is ok that he likes trains and cars. Singing "Twinkle Little Star" when he sees a star is a sign he fully understands the connection, that is also good.

Don't let your guilt make you see things. You can do much for his language during normal daily routine. Talk about what you are doing. If he uses a one word command like, "cookie!", encourage him to say more by asking a question. "Do you want to eat your cookie with milk or water?" You may get a one word answer, but it is the interchange that is important. Model the sentence, "you want a cookie with milk." "I want my cookie with coffee."

Tantrums are normal for two year olds. I am a firm believer that what gets attention is reinforced. By that I mean, ignore tantrums and they will eventually go away. Teething makes kids cranky. It is normal for them to be less communicative when cutting teeth.

So, enjoy your family. I think everything will be fine. Of course, if he does not show progress over the next year, you should bring it up with your doctor. But, for now, I see no red flags.

Best wishes,
Catherine

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

QUESTION: Thank you very much  Catherine
May I just add a few more things about his behavior just to give a better idea
of him.
He can count to 10 and does recognize the numbers and colors as well, he
did learn that from baby tv. Would that be considered memorizing  and not
understanding ? He didn't seem to be interested in talking much until he
turned 23 months , that is when out of the blue he started repeating what we
where trying to teach him ( one word words).

He also know's the shapes , square, triangle..etc I never taught him that. If he
sees a triangle he might say "house", should I try to correct him or is that
fairly normal?

Is making a connection important in ruling out autism? Can you maybe
explain to me why that is?

Again thank you,  you have been very helpful.

Elina

Answer
Hello Elina,

I think you are dealing with a child who is a visual thinker. While many who have autism do this, so do many who do not have autism. He is using pictures to think rather than words. To teach him you are going to have to use visual cues as well as words.

When he says house in response to seeing a triangle say, "Yes, houses look like triangles. This is a triangle." That way, you acknowledge that he is right and you give information. You can even draw a simple house made of a square with a triangle on top then identify the shapes that make up the house.

Use his ability to say numbers to count objects. Count triangles, "Look Bobby, three triangles, one, two three. Can you count the squares?" Be patient. He is only two. His attention span will be short. Making connections is an advanced thinking skill. He may just not be ready, yet.

Is there other behavior you are not telling me about? Does he rock, flap his hands, bang his head, spin objects, act deaf? Does he have a fit if there is a wrinkle in his socks or refuse to wear certain textures of clothing? Does he reject food that is of a particular color or texture?

I'm not hearing truly autistic behavior, only concern about the pace of his verbal development. I agree that he is a little behind, but comparing him to his older sibling may be  causing more concern than necessary. I think your oldest child is a girl, yes? Girls talk much sooner, in general.

The main job of a toddler is to explore and play. The learning comes from experiencing the world and interacting with family members. When he is three years old, find a pre-school that meets three days a week for a few hours so that he can interact with other children and an experienced teacher. If he is still having problems at that time, the teacher will certainly spot it.

Now, having said all that. If you are so worried that you are losing sleep over it, take him to a specialist and find out for sure. Better to know now than later. If he's ok, it will give you peace of mind and if he is on spectrum, treatment can begin right away.

Best wishes,
Catherine