Expert: Dr. Sharon A. Mitchell - 4/8/2007

Question
Hi, Sharon!  

I am the parent of a fifteen month old boy named Mark.  Lately, I have been having concerns over his development and having watched the recent oprah special, I wanted to see if I have any cause for concern.  At this time, Mark is still not walking, although he can crawl and stand up and get back down with ease.  He does not point at things.  He does not wave, although he does open and close his hands in an excited manner, but not as a greeting... just at random.  He is unable to clap.... instead he seems to shake uncontrollably when he gets excited about something and has done so since he was much younger.  He does not call me or my husband "mama" or "dada" but he can repeat it (if he feels like it and only IF) and it continues to be more of a "mamamamama" then a "mama" for the most part.  He does not say words, but SOMETIMES he will repeat us with what sounds like "light" or "bird" if we are looking at the lights or feeding the birds. He has also been able to repeat "yah" and "apoon"(a word we made up for when we put our foreheads together). He does not seem to recognize his name when we say it, but sometimes he will look at us if he is in the mood. He is able to play with his toys and loves to throw them with an attitude.  He has a definite sassy personality. He laughs and smiles at things or people.  He has great rhythm when dancing, shaking rattles or drumming. He makes eye contact and can give kisses and hugs.  He knows to make the "mmmmm" sound when he gives kisses.  He laughs at appropriate games we play with him and he LOVES to watch Nick Jr.  He likes to lay on his back and kick away as if he were still an infant.  He still LOVES lights and ceiling fans.  He hasn't had much interaction with babies his age, but has been able to play alongside them.  He loves older kids such as his aunt who is 11 or younger cousins of mine.  We think he knows what "Cheerios" means. He recognizes relatives that he sees often such as his grandmothers, who watch him a good part of the week.  Lately, he has been slapping things (even faces) and pushing things away that he doesn't want or like.  His sleeping pattern is very good.... he knows the bedtime routine at 9pm is: change the pamper and put on pajamas, get the bottle and blankie and fall asleep.  He never cries after he is done with his bottle or wakes up in the middle of the night.  He also takes an hour and a half nap every afternoon. It may be early for the terrible two's, but he is already showing his toddler status by whining, screeching or yelling.  Is this all normal for his age (some of the things I mentioned are not concerns.... they are just to give you an idea of what he can and can't do) or is any of this delay in behavior indicative of early detection? I would appreciate it.  

Thanks,

Marilyn

Answer
How delightful, Marilyn to have a child who sleeps well at night and takes a daily nap! But apart from this comfort, you seem to have concerns about your son's development.

Without directly observing your child it's very hard to give an opinion on if you should worry or not. My advice to you is to take your concerns to your public health nurse, pediatrician or Speech Language Pathologist.

But before you go, you may feel better prepared if you have first read up on the wide variations of what is considered "normal" for a child of your son's age.

Here are some sites that talk about typical physical milestones:

http://www.med.umich.edu/1libr/yourchild/devmile.htm

http://www.nncc.org/Child.Dev/ages.stages.12m.18m.html

http://parenting.ivillage.com/tp/tpdevelopment/topics/0,,4rwc,00.html

Below are a few websites that can help you sort out what is within the normal speech/language parameters for a child your son's age. Armed with this information, you can then speak to a public health nurse, pediatrician or speech/language specialist.

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 after looking at this developmental informaton,you're still 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

While an SLP might be one of the first professionals you want to see, a developmental pediatrician or child psychologist might also be helpful.

Below are two versions of a Checklist for Autism in Toddlers that your physician might use. It may be helpful for you to look them over to get an idea of what sorts of things a diagnostician may look for. The first link explains a bit more about the CHAT:

http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=128&a=2226

http://depts.washington.edu/dataproj/chat.html

http://www.utmem.edu/pediatrics/general/clinical/m-chat.pdf

Rather than worry, read up on normal development for your son's age. Then, if you still have concerns, seek out advice from your doctor, Speech/Language Pathologist or health nurse.

Sharon A. Mitchell
www.autismsite.ca