Expert: James Michael Roan - 8/5/2007

Question
Hi James,
I've written to you several times in the past re: my son but not much in the last few. My son is now 28 months. Here are the latest developments. He was working with early intervention for speech, special ed and occupational therapy since 12 months. Special ed was discharged at 22 months and speech discharged this month. He is pretty smart. Picks up concepts fast, knew colors very early, huge vocabulary. He speaks in complete sentances and can carry on 3-4 exchanges in conversation. He can answer questions and will say for example "I don't want to lay down with dadda, I want to lay with you mommy". Another would be "I want to go to the store because I want to get a present." So, as you can see he is making logical connections and language is advanced.
He has become much more social but can still be shy at times. He loves kids a few years older but I see my friends kids being the same way. He has also definitely expanded who he will socialize with (new people, distant relatives) and doesn't cling to me nearly as much as he used to. So that bring me to the "autistic concerns". He is behind in both his gross and fine motor skills (he is recieving OT a few times a week for this). This has greatly improved with vitamin therapy as we discovered he was vitamin D deficient. He has sensory issues where he does flap when excited, holds his arms and hands in odd postures (double jointed), he is absolutely obsessed with noses and will tense up and push his nose against yours and say "nose". This is by far my BIGGEST concern because it is just so odd and it really does seem as if he cannot control himself from touching noses and is overtaken by something while this is going on (almost like a tic). I wouldn't say he does it to complete strangers but once he is comfortable with you he will go for the nose. Both my husband and I have OCD on both sides of the family. Could we just be looking at OCD? Occasionaly he will talk about the same subject. This summer it has been the rides at the boardwalk because he loves them so much. About once or twice a day he will talk about the rides for a few minutes.This is not, however, the only thing he can talk about. He can tell me what he had for lunch at school and what he did on the playground. Sometimes the pragmatics are a little off. For example, he ask me what color something is to engage me rather than say "mommy this is red". I don't know if this is such a big deal though. Anyway, my family has commented that since we found a medical cause for his constant illness, lethargy, and diminished social desire and that it has been treated, we have seen huge changes. He no longer gets sick, he has more energy, has put on weight and is MUCH more social. The language was always there. It is really just the OCD and sensory things that still concern me. I know they say advanced language can be a concern but there are kids at his school who are the same as he is so he probably just high side of normal for langauge. Does he still sound sub-clinical Aspergers to you? By the way, when playing with another kid his age there are big smiles, social imitation, and desire to play. Sorry for the long e-mail. There are the autistic traits but other things to contradict them.

thanks, Kate

Answer
Hi Kate;

It doesn't sound at all like autism. It would be hard to rule out subclinical Asperger's until he's older, however, if he "enjoys" interaction with peers rather than solely pursuing his own agenda I would not really be concerned about subclinical Asperger's either.

He sounds very intelligent and social. I'm sure he has inherited some mild OCD behavior. That's quite common. I really don't think you have anything to be concerned about.

Kind regards,
James