Expert: James Michael Roan - 7/28/2006

Question
Hello..I have a few questions about a child I have babysit throughout this summer.  He is a neighborhood friend of my children and has lived nearby for 2 years, so I have seen his development from age 2 to now almost 4.  He will be 4 in October, and has very delayed speech, repeats simple   phrases over and over again..such as, if he wants a popsicle, he will follow me around the house and repeat over and over the word "popsicle" no matter how many times I answer him.  He also doesnt seem to understand or comprehend much of what I say.  If he does something he is not allowed to do, I get down to his level and have him look me in the eye when I talk to him, but he seems to have trouble making eye contact.  I will say "look me in the eye" and he looks up and right, or when he tries to look me in the eye, his eyes kinda roll around in his head.  He also points alot lately and grunts. He also prefers to play alone, but when he does play with other children he cries alot and is very easily frustrated. His development seems way behind my 4 year old daughter, yet his mother has only mentioned a delay in his speech, but I see much more.  
I feel he should be evaluated, but am hesistant to mention this to his mother.  What do you think about his behaviour and what steps should I take?
Thank you so much for any help you can be.
Alexandra

Answer
Hi Alexandra;

If he does have autism early detection and thus early intervention is KEY to his future development. Other than the eye contact problem, the behaviors you described could easily fit within the boundaries of a significant receptive and expressive language delay.

Approaching the parent is a delicate issue. For the child's sake you should address your concerns with her. Either she or you can download from the Internet the M-CHAT.  The M-CHAT is an effective screener for autism for children aged 18 months to under 4 years of age. Remember, if there is a slight risk noted it could be due to the communication delay and not autism.


http://www.firstsigns.org/downloads/m-chat.PDF

Then get the scoring guide here:
http://www.firstsigns.org/downloads/m-chat_scoring.PDF

If there is any risk noted, you can contact me again to discuss the results. I would not tell her you scored his behavior on your own. It might send her through the roof. It is a dreadful shock to a parent to even consider their child may have autism.

Kind Regards,
James