Expert: James Michael Roan - 5/16/2006

Question
My son was 3 the end of March and is very imaginative and loving...however, I do have some concerns that maybe he has some form of autism.  He is extremely interested in space, loves to play with his rockets and astronauts, making them land on planets, etc...he loves to watch anything with planets, etc.  He also loves music and of course will play trains, ball, run around outside and other "boy" activities.  He spoke early and well and uses his verbal skills now as most kids in his preschool the same age appear to do.  He asks for what he wants but does meltdown over things and whine.  He can go from Jekyll to Hyde in 10 seconds flat.  Sometimes I wonder if he's putting things together in his head the way he should be at this age or if he just is choosing to not cooperate sometimes.  He does have a listening problem, in that I know he can hear me but he ignores simple instructions like put your shoes on or come eat breakfast until it's "loss of privilege" time (he loses his space toys for a day, etc).  Is this just normal 3 year old, test-the-waters behavior?  The fixation on space and the not hearing are the things that are red flags to me right now.  What are your thoughts?
Thank you.

Answer
Hi Traci;

I don't really see anything here that alarms me. Selective attention is quite common in all children! In autism, we are most concerned about social awareness, social development, and social interactions. I suggest you download off the internet the Modified Checklist for Autism in Toddlers (M-CHAT) http://www.firstsigns.org/downloads/m-chat.PDF It was normed on 18,000 children in the UK and provides a risk estimate for autism. Also download the scoring instructions at http://www.firstsigns.org/downloads/m-chat_scoring.PDF If there is any risk noted then do two things:

1. If you live in the U.S., make a special education referral to the school district in which your son lives. They are responsible for the assessment of children 0-21 years of age, and if they qualify for special education, responsible for education and related therapies.

2. In addition to the special education referral, take the M-CHAT to the child's pediatrician and ask for a referral to a multidisciplinary team expert in this area. Again, if you live in the U.S., you can go to the autism unit at a university near you, or a Children's Hospital.

It's absolutely essential to get the right diagnosis and appropriate services going right away. It's always better to be safe rather than sorry. It only takes a few minutes to fill out the M-Chat and to score it.

It is true, that many children with high functioning autism/Asperger's Syndrome often have a narrow range of interests that dominate most of their play time. Dinosaurs, science-related projects, and astronomy often top the list. The description you gave me also can suggest giftedness. In any case, if there is any doubt follow through with my advice on the M-CHAT and please let me know of any other concerns not articulated in your first email.

Kind Regards,
James

Kind Regards,
James