Expert: James Michael Roan - 3/8/2006

Question
-------------------------
Followup To
Question -
My story is long. When my DD was a baby she seemed to be developing normally. Until around 6 mos. she wasn't rolling or trying to crawl and she still made 3 mo. old noises. She didn't walk until she was around 15 mos. old. And she didn't start to talk until she was about 18 mos. old.
 What really scared her Father and I was the major temper tantrums for no reason out of a clear blue sky. She would come up to us and make a noise at us, like eh-eh-eh. and we would look at her 'what do you want dear?'. The next thing we knew she was on the floor kicking and screaming at the top of her lungs. there were times that she literally jumped straight up into the air and fall backwards in a raging tantrum.  These tantrums would last for 2-3-4 hours. It depended on how upset she was.
To this day she still throws tantrums but,now some of them are more of a silent tantrum where she will stop talking to you and seem to sulk. There are the others there too, the ones that has her screaming and now running off down the street.
She says that she hates not feeling happy like the rest of the family.  She wants to know what is causing her to feel this way. I really don't know where to turn and I thought that someone like you might be able to help my husband and I clear up some of this mystery.
Thank you sir for reading this letter.
   Sincerely, Lynette Richter
Answer -
Hi Lynette;

I need more information please. How old is your daughter now? Is there a family history of depression diagnosed or undiagnosed? How is her sleeping pattern? What is her normal energy level like? Does it go dramatically up and down? Does she ever appear truly happy? Please provide me with as much information as you are willing to.

Kind Regards,
James
~~~~~~~~~~~
Dear James,
I forgot to mention that there is a family history of Autism.  My little brother didn't start talking until around 5yrsold. M husband's family has alot of autism in it. There's one uncle that fits the symptoms of autism but, when he was little they didn't know what autism is. 2-3 of his other uncles children have autism.
 She sleeps really well.  There are no problems there.  Her energy level is good. It doesn't really go up and down.  She does appear truly happy most all the time. I have found out that she does better when I have her on a strict 'No additives' diet. When she was 3 months old, a growth showed up on the right side of her head slightly above and behind her right ear. It had  all these little blood veins running all over it. I took her to a pediactric  doctor at about 6 months old. He told me it was a blood filled growth that should disappear by the time she was a yr and a half to 2 yrs old.  It didn't diminish until she was about 5 and just recently you can't really tell where it was unless you are me and know where to look. I just barely checked her head and there seems to be a small indentation where that thing was.  My husband and I thought that maybe some of her problems were related to pain from that growth. but, we never knew what to do.
Please let me know if you need any more info.
Lynette

Answer
Hi Lynette;

In autism, we are most concerned about social awareness, social development, and social interactions. To begin with, 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 daughter 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 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 you like, you can first share the results with me and we can go from there. I am looking for details regarding eye contact, social smiles, pointing at objects of interest to share with you, levels of verbal and nonverbal communication, etc.

Kind Regards,
James