Expert: Trey McGowan - 8/16/2007

Question
I have a two year-old grand niece who I am quite concerned about.  She is the only child of highly intelligent parents.  She is also the only grandchild.  When she was born, she was not interested at all in breastfeeding.  She started speaking late (18-20 months)and doesn't seem "connected".  Recently I saw her and she was basically uncontrollable, running everywhere while the mother and grandmother helplessly chased and became exhausted.  She refuses to sit in a stroller and does not sit long in a high chair.  She is an extremely picky eater.  I did not hear her say mama or mommy once during the 4 hours we were together, and she rarely looked at me directly or showed any interest.  I had brought toys wrapped as gifts and she only wanted to play with the wrapping but didn't seem to care about what was inside.  I don't think her family has a clue there might be something to have checked out.  What do you think?  Could this be autism??

Answer
Hello there, Cynthia!

As I have said so many times (and will certainly do so again!), I'm not a doctor. However, there are a few 'autistic cues' in the habits that you're mentioning. The delayed speech is a warning sign, while the lack of eye contact is another.

The stack you've given me, though, makes me wonder whether the first thing they should check for is ADHD. While yes, ADHD is common in ASD children, just ADHD in itself can cause a lot of these difficulties. The speech delay isn't one of them, but even neurotypical children will be slow in some things and precocious in others.

What I'm saying is that rather than raising the big 'A' alarm, I think you should suggest that they take the child to get checked for ADHD, and if the parents are amiable, bring up the possibility of checking for some other things. That way, you can bring it up without being alarmist, since autism ends up having such a terrible name a lot of the time.

If you want a checklist, here's what is used for ADHD.
http://www.cdc.gov/ncbddd/adhd/symptom.htm

Hoping that helped,

Trey