Expert: James Michael Roan - 2/13/2007

Question
My son was born 13 weeks early on 8/17/03, and came home on oxygen and apnea moniters 10/2003. In January of 2004 he was diagnosed with menengitis (spelling?) and was back at Childrens hospital for 2 weeks. Anyhow, he never learned to crawl until AFTER he started walking (at 18 months), and NEVER sat up until later on in life. Point is, he has been behind in everything since birth. I will break my question down into symptoms he is having now:

1. He does not speak at all. The only times we have got him to say something, is if we sit there and say "mama" or "dada" several times...even then he might not even say it at all. For awhile there he learned the word "BOOM!" and that is ALL he wanted to say, even when you asked him to say "mama" or "dada". He now, has quit saying that.

2. He is the thirstiest child I have ever seen. He seems obsessed with constantly wanting to have something to drink. When he drinks, he acts like its the first thing he has had to drink in years!

3. I cant get him to understand potty training. We go over it time and time again, and he just isnt interested at all.

4. He doesnt like affection very much. He will give "kisses" here and there, and will lay on your lap when he is tired, but otherwise he will pull away when you try to hug and cuddle with him.

5. 99% of the time you are trying to get him to talk, or if you talk to him, or if he is happy, upset, etc. he "growls". (It is that sound you make when you are clearing your throat). He is CONSTANTLY doing that.

6. He CAN start out playing with other kids, but almost always ends up playing by himself.

7. Sometimes you can call out his name, and then get louder, and louder until you are practacly screaming at him, and he acts like he cant hear you. (but sometimes if you say his name loud enough, he will respond). He passed all hearing tests at the hospital.

8. He does NOT communicate well. No pointing at stuff he wants, and loses intrest in things very fast. Example: At Christmas he will start to open a gift, but is too distracted by other things going on to finish, and when you try to get him to finish, he gets upset.

9. He is VERY hyper. He isnt so bad at home, but other places its awful. He can not sit still, and is constantly having to be told not to do things over and over and over. You tell him no, or dont do that, and he "growls" or yells at you.

My question is, what do you think? Could it be autism? Retardation? From him being born at 27 weeks gestation? My husband and I are becoming very frustrated with his behavior and development...we dont know what to do. He will be 4 in August and still isnt talking or potty trained. Please help!

Answer
Hi Amanda;

This may take a little time to sort out. Let's get started:

1. Have you discussed the thirst and throat clearing problem with your pediatrician? If not, you should.

2. There are many causes to the speech and related social delays. Let's get a better handle on this. If you don't mind, go to Accessspecialneeds.com and log into the free user service. Take the M-CHAT and ATEC. Before you score each page copy or PrintScreen and send to me at roanpsych@gmail.com so I can look at your answers.

3. Hyperactivity at this age is due to many things, most often a low working memory, which although it can be overcome later in life, presents a moderate barrier to learning. I don't suspect, however, it is totally responsible for the expressive language delay.

4. Is there someone (parent/grandparent, other) who has had a history of communication/social delay? Someone who may present as a little weird, socially clunky or rude? They would be the topic of discussion following family events.

You can respond to me further through my email listed above. It's easier to track conversations.

Kind regards,
James