Expert: James Michael Roan - 6/15/2006

Question
Sorry I asked you the same question twice, but I didn't think the first question went through.  Anyway my son seems to be ok with some kids his age but he prefers not to play with neighborhood kids - he would rather play by himself!  But what is unusual is if 2 of his friends from church are sitting where we can see them, people around him do not bother him - but if he dosen't see them he gets highly upset and we usually will have to take him out till he calms down.  His cousins that are a little younger he gets upset with very easily also over what seems to be nothing!  He will start crying that he wants to go home!  And you can tell he is really upset - it doesn't seem to be an act.  If we go say to a playground and there are other kids there his age - he will get upset and come over to me and I will have to tell him that it is ok to play with them they are nice and I will be right with him.  Once I explain things to him he will be alright for a little while!  This is why I am worried about him starting kindergarten this year - he has been going to the same class with only about 6 other kids for the past 3 yrs - and once he gets to kindergarten he will be in a class of about 22 other kids!  I just hope he can handle this adjustment!  Let me know what you think - and thanks again for any info!
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Followup To

Question -
I have one more question to ask you about some symptoms of autism - my 5 yr old son has a lot of social issues that really concern me.  I'm not sure if they have anything to do with autism or not.  He has a submucous cleft palate and a hearing loss along with low muscletone.  He is currently diagnosed as developmentally delayed but I have a lot of questions about his social issues!  He does not like to leave my house, I can't take him shopping if I think its going to be crowded because he thinks people are following us and waits till people walk past us to go, he also constantly asks why people are looking at him and he gets really upset if someone sits in a chair that he was sitting in. I can go on and on but I have no idea what is going on with him.  Do children with autism show any of these symptoms at all or is it totally something else.  I am going to call Childrens Hospital in Phila but I wanted to know right away what you thought of these symptoms!  I have been trying to get him diagnosed for the past 4 yrs now.  I know something is not right - I just wish I knew how to help him!  When I read about the hand flapping I thought that this may be the answer but I am still not seeing anything about all the other symptoms he is having!  Thanks for listening again and any input will be greatly appreciated!  Thanks again!   Connie

Answer -
Hi Connie;

These social behaviors ring of extreme ego centrism, that is the sense that the world revolves around him. It does imply an extreme inability to take the perspective of another, which is observed in children with high functioning autism or Asperger's Syndrome (AS). AS is difficult to diagnose out of the context of the quality of your son's social interactions with other peers. How does he play with others his age? Please provide detail.

Kind Regards,
Jim

Answer
Hi Connie;

Your son is a bit of a mystery. I am beginning to think he has many of the same social issues as a child with Asperger's Syndrome. Children with AS suffer from a lack of "theory of mind." This term coined by Dr. Simon Baron-Cohen at Cambridge University, refers to an individual's ability to infer the thoughts, emotions, and intentions of other's based on reading the eyes, facial expressions, and body language of the other. Good theory of mind skills are essential for predicting the behavior of others. It is essential for making and keeping friends, and, it is necessary for holding a conversation. Without basic theory of mind skills an individual is unable to "predict" the behavior of others. Lack of predictability results in anxiety, insecurity, and mistrust of others.

I suggest you download the Australian Asperger's Scale off of Tony Attwood's web site. It may provide you and I more clues.

Kind regards,
James