Expert: Trey McGowan - 9/20/2007

Question
I have a 2 year old (26 month)cousin whom I think is showing signs of autism. He does not talk at all...only really makes one sound..."eeeeee" and does not care to make eye contact with anyone. He was a late walker, started walking at 18 months. He doesn't respond to his name unless called by his mother. He generally ignores anyone's effort to get his attention, even taking his arm or turning him towards you will not gain his attention or gaze. He likes to sit alone and concentrate on one task such as fitting a buckle together (thats what he was doing the other day) For a good 10 minutes I sat with him and talked to him, trying to help him, and he did not look up at me even once. He seemed to not even notice that I was there.
Here is the problem...what is the best way to bring this up to his mother (my aunt)...she seems to think he "will talk when he's ready" and "he's just really focused"...she is the kind of person who would probably be in denial over this. I don't know what to do...if he really is autistic,I know he needs to start getting help. Any advice?  

Answer
Hey there, Cris!

I had to take a little time to walk around and think about this one. The hardest part about answering this question is that it really involves 'understanding how your aunt works'. And unfortunately, other than your telling me that she's the sort who could be in denial, I don't know her well. So I'll put a BIG SIGN up here that says 'Your mileage may vary' before answering the question. Simply put: not everyone would react the same way.

My first question (and this can be rhetorical if you like; I don't *need* a reply if you want to simply keep it to yourself) is: is this her first child? If it is not her first child, sitting down with her and asking her about her others might be very illuminating. It's possible that she's had this issue with children before and handled it. And if it *is* her first child, then the biggest issue may well be not only denial, but no way to compare her child to another one. It's also not easy to admit that your first and only child has a disability, whether it's physical, mental, or developmental.

Now that I've given the brief look at 'How to see things from her angle', taking the chance to broach things with her might be best done with some education materials. The first thing you can do is perhaps give a look at some of the questionnaires and diagnostic tools online. Some examples:
http://www.childbrain.com/pddassess.html
http://www.wired.com/wired/archive/9.12/aqtest.html (it's a self-diagnostic, so you'll have to adjust it to a third person view)
http://groups.msn.com/TheAutismHomePage/autismquestionnaire.msnw (an aid for the doctor rather than a specific diagnostic tool but it can be revealing)
If the test comes up with a lot of high (or low, depending on how you look at it) scores, then bringing it up with your aunt straightforwardly is probably the best thing. Voice your concern for your cousin, and bring along the information for her that you have found. Make certain that you are *supportive* in this, though. Not accusatory. Try and think of it this way: you are not doing this because she is wrong and you are right. You are doing this because you have concern for your cousin and would like her to see why you are concerned. By not making it a direct challenge to her, it makes it a lot easier for her to handle. And by showing that it is because of concern and love for her and for your cousin, she is more likely to accept the help.

There is a chance that in the end, she may continue to see that things are going well when they aren't. If this is the case, I suggest that you offer forward the information you've found and discreetly stand back. Prepare to be there for if things get worse, or if she needs the information again (or more of it), but try not to push violently. Touch bases now and then. Keep tabs on how things are going. Show your support for her and for your cousin. In the end, that support is the best thing you can offer. I'm not saying you can't disagree with her. In fact, if you do so, feel free to say so. But disagreements shouldn't cause fights. In the end, fights will make things more stressful, both on you and on him.

I'm not a doctor, so I can't simply look at the child's description and say 'You're right', or 'You're wrong'. However, I don't know right now if it's important that I do. I think it's more important that you do, indeed, get a feel for how to bring the concern up with your aunt. And doing so in a manner that shows concern and education (and *NOT* accusation) is my #1 suggestion.

Hopefully that suggestion helped you out! If not, or if you need more information (or more detail added) feel free to reply. Good luck to you!

Trey