Expert: James Michael Roan - 2/26/2007

Question
Question
My son is an only child with a stay at home mom.  He seems to have reached most of the normal developement milestones.  He finally started walking on his own at 16 months after a long time of cruising.  He is not talking though.  he babbles with many different vowel and consonant sounds and uses inflection.  He babbles in sentences but no words we can recognize.    He will sing with his available "language if prompted at times. that's one concern.  The other is that , at times he does funny thing with his arms and hands,bending them in certain ways or examing them like he isn't familiar with them.  Not all the time but once he does it daily.  He loves his story time at night, at least 30 minutes.  He brings us books constantly to read to him.  Sometimes he'll sit or stand with us while we read the whole book , sometimes a page and he's off to something else.  He will share cheerios with us at breakfast.  Hold them out until we eat them from his hand.  He loves stacking blocks, butting things into bags and boxes, and stacking his several sets of nesting cups.   When he's doing it he often yells YEA! when he finishes.  He'll give us hugs and kisses (touching nose to nose) to us and his stuffed animals.  He loves for us to chase him and he loves to chase us when we run by him.  He points at things that interest him and follows a point if we tell him to look at something.  Smiles freely and truly seems playful.  He will pretend to brush his animals teeth, wipe up his tray like mom...wipe his own nose, ear,toes and mouth when asked.  Most times if i ask him to point to first momma, then dada, then himself he will do so with one finger.   We have EI scheduled for his speech.  Does it sound like he could be on the spectrum because of the speech and the arm and hand things?   

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Answer
Hi Bill;

I must apologize for not answering sooner. I was preoccupied with a situation that could not be helped.

I do not diagnose over the Internet. Your son certainly does NOT have autism, however, it is possible that he may have a high functioning form of autism known as Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) or Asperger's Syndrome (AS). These two conditions are really the same one. It is too early to reliably diagnose PDD-NOS or AS, but the general features that I observe in 3 and 4 year olds is a tendency to show a highly focused play following their own agenda, which usually excludes other children unless they need that other child to for a purpose. They rarely smile during play. Because this population of children are so high functioning, they only stand out as odd or different in the school setting when around other children. Nothing you have reported though alarms me. Just the arm thing and the "possible" obsessive-compulsive practice of stacking and packaging.

If it tuns out to be AS, it is nothing to be too alarmed about in any case.


James,
My son was reviewed by the EI folks and found to have fairly normal developement except for speech where he had the speech of a 11 month old.  Since the EI visit He has begun to raise his arms to be picked up.  He is now 21 months old.  The EI folks have give him a speech therapist who it seems will be teaching mostly my wife and I.  He still seems to examine his hands alot.  Mostly when he's being changed and does not have something to play with?  Any ideas if that's a problem or just preverbal behaviour.  He also will occassionaly arch jhis back while walking it looks weird so i just am not sure what think. I have to admit that i am scared to death about the autism thing.  He has never been one to show emotion though he will run to us if he hurts himself and offer us a kiss ( nose to nose) if we ask.  I shoewd him how to hug and he does that occasionally when asked.  We have scheduled a hearimg test.  He is babbling a little more and will say mama, nana, dada when asked but not on his own.  Is there ever a time when we are out of the woods as far as autism developing or becoming more prevelant?  Does it sound like I  Should  stop looking on the internet for reasons for his occasional symptoms?  Thank you so much for your time!   

Kind Regards,
James  

Answer
Hi Bill;

In autism spectrum disorders we are really looking at significant social delay, which can take on the appearance of anything from social avoidance to social aversion. Social development and language development are intertwined: A delay in one area creates a delay in the other. Intervention at this age should be focused on early language/social development. See if you can locate a school (private)  that offers this. You may have to look for this under a speech and language pathologist. You can also put together something yourself with an undergraduate/graduate speech and language therapist. I will refer you to Michelle Garcia-Winner's web page: www.socialthinking.com for some ideas.

I don't think you'll find anything on the web describing the back arching and hand thing, but you can try. My suspicion is that your son has some degree of developmental delay.


Kind Regards,
James