Expert: James Michael Roan - 3/2/2006

Question
My son just turned 2 on 2/28.  He doesn't speak very much and has been tested for hearing impairment and auditory neuropothy, which were both negative.  He doesn't interact well with other children, but has no problem with adults or playing with adults.  I have been trying to get information on Autism, but it seems like some things he does and some he doesn't.  Are there any KEY behaviors that I should be looking for?

Answer
Hi Kathy;

Primarily, you should be looking for socially related behaviors. At 24 months, your son should be saying few words accompanied by nonverbal gestures and regulated eye contact. That is, he should at least point to what he wants, say it, and look back and forth between your eyes and the object (protoimperative). He should also have begun pointing to objects or events that interest him in an attempt to share that interest with you or others (protodeclarative). He should reach to be picked up, turn around when you come into a room and call him by name, etc. It is a good sign if he is genuinely interacting with peers rather than playing alongside of them.

There is something you can do right away that will other quell your fears or send you in the right direction. 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 was normed on 18,000 children in the UK and 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 you live. 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 the 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 to a Children's Hospital.

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

I am happy to discuss the result with you if they are ambiguous.

Kind Regards,
James