Expert: James Michael Roan - 10/8/2007

Question
My nephew does not seem to engage with anyone other than his parents, nanny, and sometimes his older brother.  He doesn't make eye contact, and will often physically turn his head away if someone speaks with him.  He also, from a very early age, seems to be mesmerized by TV or videos (which he is unfortunately, in front of quite often).  His favorite activity seems to be to take things out of drawers or cabinets.  He will hand them to me or someone else, but it appears it's only one way; he doesn't take them back or respond if for instance I ask him to hand me something.
My brother and sister in law said that he's beginning to talk, although I haven't heard him say any words.   They have not expressed any concern, other than often apologizing to family members, etc, that their son is tired, or in a bad mood, etc, when he doesn't engage.

I have lots of nieces and nephews, cousins, etc, and my own two older children.  I've never had this type of worry watching any of them before.  My primary questions are:

1.  Does some of what I described sound like early warning signs?
2.  If so, should I take the risk and let my brother and sister in law know that I'm worried?  I don't think they will react well, but if it means that they have him evaluated, and something can be caught early, I would be willing to put myself on the line if it's the right thing to do.

Answer
Hi Chris;

Your description does have me a little worried. I suggest you go to my web page and download the M-CHAT and its scoring instructions. If you nephew fails the M-CHAT, meaning he is at risk for autism, share your concerns with your brother- and sister-in-law. Suggest they complete an M-CHAT and take those results to the child's pediatrician for further review. Be sure to mention to them that you've read early intervention means everything; the earlier the better. It can make a huge difference in his life if they act right away.

The M-CHAT and scoring can be found at: www.autismspectrumdisorderfoundation.org

Kind regards,
James