Expert: James Michael Roan - 5/4/2007

Question
Hello,

I am concerned that my 21 month old son has a developmental delay. I am not really clear on the differences between Autism and other disorders like ADD, Aspers, etc. I was hoping to get your expert opinion.

He babbles a lot, but only a few discernable words like said like bye-bye, dawg-dawg (for doggie), apple, etc. Sometimes he will say these words a lot during the day and other times he will not. He does not really say mama or dada to us. Although he will say mama, mama walking around the house and sometimes say dad when I initiate "where's daddy". He knows a couple of things like "do you want to go out", "where's daddy", etc.

He makes good eye contact with my husband and I and is very affectionate with us. He likes to be tickled, laughs and smiles a lot. He loves the dog, chases her and plays with her. I took him to the doctor for a rash and noticed he made good eye contact with the doctor as well and smiled at him.

He is generally shy with others and does not play with other children as much I would like. He goes off on his own and plays by himself at the playground. He likes the wood chips on the ground more than the rides at the playground.

In general he plays like a mad man. Runs around a lot, climbs on everything (up/down the steps) inside the house and out. When playing at times it is hard to get his attention. If you call his name he may not respond. Sometimes he cries other times he will look.

He has temper tantrums when he doesn't get his way. This includes crying, screaming, lying on the floor and sometimes banging his head. They range from mild to severe.

He doesn't point, but kind of waves at things with his hands. He raises his arms to be picked up and makes gestures to things. He claps when happy and does do the arm flapping when excited.

He is very difficult to feed. Only I can feed him anything substantial while watching TV. He'll self feed crackers, pizza, etc., but no spoon/fork. He can easily go all day without eating at day care.

Sometimes it is hard to get him to sleep as well. He wants to keep playing. He does nap/sleep well once you get him there.

Sorry for the long-winded e-mail. I have no one to talk to (except my husband who is sick of hearing about it!)and appreciate you taking the time to read this.

Answer
Hi Mary;

In autism, we are most concerned about social awareness, social development, and social interactions. I suggest you download off the internet the Modified Checklist for Autism in Toddlers (M-CHAT) http://www.firstsigns.org/downloads/m-chat.PDF It  provides a risk estimate for autism. Also download the scoring instructions at http://www.firstsigns.org/downloads/m-chat_scoring.PDF If there is any risk noted then do two things:

1. If you live in the U.S., make a special education referral to the school district in which your child lives. They are responsible for the assessment of children 0-21 years of age, and if they qualify for special education, responsible for education and related therapies.

2. In addition to the special education referral, take the M-CHAT to your child's pediatrician and ask for a referral to a multidisciplinary team expert in this area. Again, if you live in the U.S., you can go to the autism unit at a university near you, or a Children's Hospital.

It's absolutely essential to get the right diagnosis and appropriate services going right away.

If you like, I can help you interpret the results of the M-CHAT. I am not sending you off into another direction, just that the M-CHAT asks the really important questions and then I can take it from there.

Kind regards,
James