Expert: James Michael Roan - 8/13/2007

Question
I am bewildered! My husband's has a 3 year old grandson that is developmentally delayed. At 16 months old, he didn't make ANY sounds or babble, nor did he crawl.  He finally walked by age 2.  He spoke basic one word sounds by age 2. Now, at age 39 months, he speaks only 1-2 word sentences. If he is hungry, he says "eat". He says the dogs name. He says "hurt" if he hurts. Having had two children of my own, I know this is not right. His eyes are very large, appear droopy and sometimes "vacant".  He still wears diapers and is not potty trained. He eats with his hands. When he is mad, he sometimes bangs his head on the floor. The family seems in no hurry to have him evaluated. I feel sick that he should be starting kindergarten in 24 months, and don't think he can improve by then. I am also upset that doctors he goes to for colds, etc. haven't noticed his lack of development. What should I do, alienate the family and advocate for the child, or keep quiet? How should I approach the mother? Thanks!!

Answer
Hi Kristi;

This a common, but very difficult position to be in. I suggest you ask permission to refer him to his school district's Early Intervention program for a complete evaluation. Contact the special education department. It is free and will clear the air. You will have a clear conscience while still advocating for the child. The delays sound borderline. If you suspect autism, go to my web site at autismspectrumdisorderfoundation.org and take the M-CHAT. Contact me with the results and we can go over them. As far as speech delay, he sounds somewhat delayed but not severe.

Kind regards,
James