Expert: James Michael Roan - 10/23/2007

Question
I have a 25 month old son who is developing in what seems a normal way.  He enjoys playing with other kids, attends a home day care, plays with cars, trucks, trains appropriately.  He is affectionate and likes to be held, read and sung to.  He is very coordinated. He communicates well and can let me know what he wants and does not want.  He labels people and animals in pictures and books.  He has a brother (11 months old) and will give him toys and brings me diapers when I am changing him.
The things that concern me:
He rocks: only when he is in his crib to go to bed.  I did this as well as a child so this is not a huge concern. Sometimes he will rock in the car when he is tired.
His echolalia: He repeats what I say.  Sometimes he will repeat my questions.  He also doesn't answer the question "What is you name?" He will either scream or say "baby" (refering to his younger brother.)He has answered his own name (Michael) only a couple of times.  He also will praise himself when he does something good. He will say "good boy" after he puts a puzzle together,etc.  He also will say "hold you" when he wants to be picked up. Mainly because we ask him, Do you want me to hold you?  

These are my main concerns.  I really appreciate this service.

Answer
Hi Kara;

I lost my email just before I sent it! This sounds more like a speech delay than autism. In autism we are looking at social development, which includes sharing and imitation related behavior. Does he play peek-a-boo? Echolalia is part of normal language development. I have provided the most recent set of red flags for autism below. If you still have concerns, then go to my web site at: www.autismspectrumdisorderfoundation.org and take the M-CHAT. If he fails the M-CHAT, then immediately take it to your pediatrician and request a referral to a team of autism specialists. They can usually be found at Children's Hospitals or at autism centers at local universities. Also call the special education department at your school district and have them set you up with Early Intervention services at no cost to you. They will assess and provide relevant services as needed.

The red flags are:

6-12 Month Markers:

·   Infrequent eye contact
·   Failure to orient to name
·   Does not smile in response to smiles from others
·   Social and emotional passivity
·   Fixation on objects

By 12 Months:

·   Poor or no eye contact
·   Failure to orient to name
·   Poor imitation
·   No babbling by 12 months
·   No gesturing by 12 months

By 16 Months:

·   No single words by 16 months
·   No pointing to objects or events of interest in an effort to share

By 24 Months:

·   No spontaneous two-word phrases
·   Loss of any language or social skills at any age

You are also welcomed to discuss his performance on the M-CHAT as well.

Kind regards,
James