Expert: Catherine Ridenour - 12/27/2007

Question
My son Tim is 38 months and I have appointment with a specialist but I am anxious to know what can it be.
Here are all details that may help to give hin a diagnostic:

Started to be concerned about him at 15 months when he wasn't walking yet. He walked at 17 months.
18 months he had a good vocabulary-12 words
2 yr old - 2 words sentence
Until last month his eye contact was good , although kind of starring at people (blank) then I just noticed he avoids eye contact with strangers and becomes nervous , touching his eyelashes . Repet: that just started about a month ago.


Social
Shy with strangers, doesn't talk to them or say his name

At the library doesn't participate in games with other kids but likes watching them .
Sometimes he withdrawns from me and his siblings (4 yr old boy / 20 month girl) , goes in another room and reads books or plays music or just lays down in the bed . When I go there , he says "Sad mommy" .
At inapproppiate times he says "scared mommy" .

Communication
Doesn't always answer questions properly (how old are you - Luke) , doesn't communicate much but has
4-6 words sentence sometimes words are unclear
Sometimes gibberish words
Sometimes talks to imaginary people

Behavior
Lines up cars/animal toys but doesn't get upset if I remove any of them and this is not consistenly
Throws up ripped paper towel or newspapers (also leafs,light toys,any small parts)
Sings same song over and over , sometimes humms
Little imaginary / pretend play
Not excited about opening gifts for special occasions and not interested in new toys , but later he may play with them.
Touches his eyelashes when stressed or tired
Takes off running in stores,parks
Plays a lot numbers and ABC puzzles
Plays a lot musical toys
Fascinated with musical notes from songbooks


In the past used to:
Be fascinated by number plates, switches and a moving ball hanging from the ceiling in the garage
bang his head on me when I said NO .
Open/close doors / light switches
Cry when praised (it happened only 2 times)



Positive Signs
Good academical skills--average or above average for his age
Knows almost all letters, shapes, numbers to 10 ,can count to 10 in two languages , sings nursery rhymes
Doesn't flap hands
no spinning ( only when there is music )
no rocking
no echolalia
no sensitive to noise
Responds to name
He is ok if we change his routine
Plays well with siblings
Tells me about his achievements ,interests
very affectionate
likes touch

Answer
Hi Letitia,

I am not sure if there is a problem, or not. Some of these behaviors could be part of a disorder but he could just be a genuinely shy, introverted personality.

Talking to imaginary people, at his age, is not uncommon. Three to four year old children do not differentiate between "real" and "pretend".

I know you are anxious but I think I will defer to the specialist on this one. There are no glaring indications of autism but you are right to get an evaluation of you are worried. You know him better than anyone.

Best wishes,
Catherine