Expert: James Michael Roan - 9/12/2006

Question
I see a subtle difference between the way my 28 month old son and his peers interact with people.  For background, we're lined up to meet with developmental pediatricians, and are in a communications class with our county but would appreciate your opinion in the meantime to hopefully put my mind at rest.  

My primary concern is that my son doesn't really look to people to gauge their reactions and engage - his receptive language is excellent (follows directions) and his expressive language is somewhat "stilted" (many borrowed phrases but usually in context and his needs are expressed.)  He does want me to be around him ("Mommy, play with playdoh") but more bc he wants me to do for him rather than actually play, e.g. "make a fish" but after I do it, he doesn't look at me to see how I feel.  I also want to add that while he doesn't ask questions, he can answer who/what/where questions.

Re this difference in the quality of 2 year old engagement, my question is whether this can be in the range of "normal" behavior and chalked up to personality.

Thanks for your thoughts.

Answer
Hi Elizabeth;

I would say your son has delayed social thinking and perhaps low social interest as well. If he is on the autism spectrum, it would most certainly be on the high functioning end near Asperger's Syndrome. He's too young to diagnosis Asperger's, but there are some things you can do to help him along in the social thinking domain:

1. Work on concept development as he grows.
2. Work on "why" questions.
3. Purchase emotion cards from a speech and language (online) catalogue or ask him to play a game with you around what your facial expression means keeping it simple.
4. Work on getting him to develop the knowledge that others are thinking about him and how to tell "what" they are thinking. (see Michelle Garcia Winner's web site).

If you want to look at the behaviors specifically associated with autism, then download the M-CHAT from the Internet at:
http://www.firstsigns.org/downloads/m-chat.PDF

Then download the scoring instructions at:
http://www.firstsigns.org/downloads/m-chat_scoring.PDF

Not only will this give you a quick reference, you can use it to help develop the behaviors that it describes that should be but may not be present in your son. Write me back if you have questions about the results.

Please keep in mind there are many children with low social/cognition that don't have autism but who need intervention to help them along.

Kind Regards,
James