Expert: Dr. Sharon A. Mitchell - 11/2/2007

Question
Hi
My daughter is 25mths old and I am panicking about her.She can speak only 3/4 words. She can sing some of Old MacDonald and trys Ba Ba Black Sheep.She has very good spatial reasoning. Doing jigsaws very quickly. She will observe the pieces before inserting them and rarely gets it wrong even when I jumble up the pieces for 3/4 jigsaws together.
I am concerned really because her sister who is 3 spoke early and well. Also she tends to prefer to play by herself. I have sent her to a playgroup with her sister where she plays alongside the others but doesn't actively engage with them.

She will sit at the table and draw and do jigsaws when the other kids are at the table.

She is never bored and never plays aimlessly. She will go from books to jigsaws to building blocks.
She has recently started to non verbally ask for help. she will bring a bag of blocks to my husband to help her build or she will bring me her cup for a drink. If I open the cupboard door she will get the OJ herself and take it to the sink to make the drink. She also brings me pieces of a jigsaw if she gets stuck.
She will pretend to use a phone correctly and babble into it and will sometimes imitate the wiggles dancing on DVD.
Her eye contact and general activity has improved greatly of late.
Any advice appreciated.  

Answer
It's just not possible to give you a good opinion without meeting your daughter.

But, from what you describe,your daughter is doing some things that are usually difficult for kids with autism.

Some good signs are that she is using some spoken language. She has meaningful, rather than aimless play. She wants assistance and interaction with you and her dad. She uses pretend in her play.

You don't mention how well your little girl understands and responds to your spoken language. I'm assuming since you did not mentioned problems in this area, that her comprehension is not a concern. Is she able to follow your directions?

There is definitely a variation in when children begin to talk. To get an idea of what is considered normal speech and language development for a 2 year old, take a look at sites like these listed below. Armed with this information, you can then speak to a public health nurse, pediatrician or speech/language specialist if you are worried.

http://www.asha.org/public/speech/development/child_hear_talk.htm

http://www.comeunity.com/disability/speech/milestones.html

http://www.ldonline.org/article/6313

Even without professional guidance, there is a lot parents can do to help their child's developing language skills. You'll find some suggestions here:  

http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm

http://www.hsdc.org/News/Speech/encourage.htm

If you're concerned, I think you should speak to a Speech/Language Pathologist (SLP) to get the best advice.If you live in the United States, you can find a local Speech/Language Pathologist through this site:

http://www.asha.org/proserv/

In Canada, try here: http://www.caslpa.ca/english/profession/find.asp

For other countries and general information on finding SLP help, check out this site:  http://members.tripod.com/Caroline_Bowen/find-slp.htm

Whether or not your child has autism though,it certainly does not hurt to seek a professional opinion. Then you will know if she is in a typical stage of language development for a two year old or if some type of intervention may be helpful. Speech/Language Pathologists are familiar not only with speech (articulation) but in how children understand and use language for socialization and communication.

There are specific symptoms associated with the various autism spectrum disorders. You can read about them and diagnosis here:

http://www.psychiatry.emory.edu/PROGRAMS/autism/pdd.html

And in more medical detail here:

http://www.nichcy.org/pubs/factshe/fs20txt.htm

Here's a checklist on characteristics of autism:

http://www.hmc.psu.edu/psychiatryservices/child/outpatient/autism/Revised%20Auti...

These checklists are not definitive and do not mean that your child has or does not have autism. They may provide you though with some information that you can take to your doctor, if you are concerned.

If you're worried, talk to your doctor. If you're wrong and she's typically developing, then your worries will be put to rest. If there is a problem with her development, then you can equip yourself with knowledge and the assistance so that your daughter can be the best she can be.

Sharon A. Mitchell, B.A., B.Ed., M.A.
www.autismsite.ca