Expert: James Michael Roan - 6/7/2006

Question
My son is 22 mos. old and has had a preoccupation with ceiling
fans and spinning toys from a very early age.  When he 1st
enters a room he will call our attention to fans by pointing, then
will watch them with open mouth and both hands moving as if in
an open-fingered "parade wave" (the whole lower arm moves
from the elbow).  The first thing he tries to do with any new toy
is spin it like a top.  Puzzles and blocks are favorites, not to
build with or fit in their places, but to spin on the floor.  He does
play with other toys, and particularly loves anything musical.  He
communicates with us with words, gestures and eye contact.  
When he gets very excited he trembles all over and waves his
arms.  My husband must ask me every day if I'm sure he's not
autistic.  Should we have him tested?  (I know this is a difficult
question because you cannot observe hiim.)

Answer
Hi Alison;

I think you should have him tested. Please remember, that many children now being found to be on the autism spectrum are quite high functioning. The fact that your son communicates with words, gestures, and eye contact tells me he is either not on the spectrum at all or is high functioning such as is found in Asperger's Syndrome.

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 1,293 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 your son'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 if he has autism, high functioning or other. You are also welcomed to discuss the results with me first if you like.

Kind Regards,
James