Expert: Dr. Sharon A. Mitchell - 3/7/2007

Question
My stepson is 3 and i think he may have HFA, he is somewhat social and does'nt have any ticks as i would call them but he is very emotional and even is that way with strangers 2 people he never met before he ran up to them crying he loved them. He talks about himself in the third person and is'nt very comprehensive of things I call it the Amelia Bedelia syndrome takes everything way to literally, he's not really at his age level for a lot of things such as counting or abc's and he has a terrible speech problem. Every thing is his he says at times and at other times he says "i don't want it to be  orions (his name) no more." Could this be HFA?

Answer
It's often wise to pay attention to that little voice that's telling you something is not right. If you investigate further and receive some type of diagnosis for your child, then you have a starting point in learning how to help your boy be the best he can be. If you're investigations prove that he's operating within normal, expected bounds for his age, then you can rest easier.

Taking things literally and not understanding social boundaries can be characteristics of autism. Not every child with these tendencies necessarily has autism, though.

There are specific symptoms associated with the various autism spectrum disorders. You can read about them and diagnosis here:

http://www.psychiatry.emory.edu/PROGRAMS/autism/pdd.html

And in more medical detail here:

http://www.nichcy.org/pubs/factshe/fs20txt.htm

Here is a short, free, online checklist your could look at to see if you think your son is showing characteristics of Asperger's Syndrome:

http://www.udel.edu/bkirby/asperger/aspergerscaleAttwood.html

Here's a checklist on characteristics of autism:

http://www.hmc.psu.edu/psychiatryservices/child/outpatient/autism/Revised%20Auti...

These checklists are not definitive and do not mean that your child has or does not have autism. They may provide you with some information that you can take to your doctor, though.

There are 3 year olds who have language delays (including trouble with pronouns, and speaking of themselves in third person.

Within the autism spectrum disorders, kids may have some difficulty with pronoun use, self-recognition and imaginative play. Understanding of pronoun use can be enhanced through modelling, pretend play and through interactions with others, all activities which may not come easily to children with autism.(For example, here is some information: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1467-8624.2004.00819.x?cookie...).

While many young children go through a period in which they confuse some pronouns, most start figuring out our grammar and syntax rules on their own. We may inadvertently contribute to this confusion by the way we talk to toddlers; we often speak of ourselves in the third person ("Mommy is so proud of you" rather than saying "I'm so proud of you").

To get an idea of what is considered normal speech and language development for a 3 year old, take a look at sites like these listed below. 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 you're 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

Whether or not your son has autism though,it certainly does not hurt to seek a professional opinion. Then you will know if your son is in a typical stage of language development for a three year old or if some type of intervention may be helpful. Speech/Language Pathologists are familiar not only with speech (articulation) but in how children understand and use language for socialization and communication.

Sharon A. Mitchell
www.autismsite.ca