Expert: James Michael Roan - 6/8/2006

Question
I would have to say that he failed 3 questions on M-CHAT but one of the failed questions is sketchy.  When it comes to being oversensitive to noise,there is just one particular noise that he anticipates and plugs his ears for and that is the garage door.  About a month and a half ago, we got a new door installed and we walked into the garage during the instalation, it was REALLY loud.  It startled him and now everytime we walk into the garage he plugs his ears.  He does the unusual finger movement every once in a while when he dances as he flaps and he sometimes seems not to understand what people ask him although sometimes I think he does understand but he can't articulate an answer.  What do you think James?  He already got a pyschologist saying he wasn't autistic but I really have my doubts.
-------------------------

Followup To

Question -
I was told that I should try to correct his behaviour when he flaps his hand or when he repeats what he is saying, then I heard that I should ignore the behaviour, what do you think?
-------------------------

Followup To

Question -
My 3 year old son just got diagnosed with expressive language disorder. I feel that he has some form of Autism but he hasn't gotten that label yet.  He seems to have days when he echos everything he hears and flaps his hand off and other days when he doesn't.  It is very frustrating because if he is having a good day the experts tell me he doesn't have Autism and therefore, I don't get the help I need for him.  He is social awkward sometimes and then there are days when he is "normal".  Is it possible to go in and out of Autism?

Answer -
Hi Celina;

We all have good and bad days and so do children with autism. Social skills go hand in hand with verbal skills. I see hand flapping in many children with mild developmental delays. What is important here is that your son get a definitive diagnosis either ruling autism in or out. If he does have autism, it is most likely in the high functioning range. 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 child 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. You are welcomed to discuss the results with me first if you like.

Kind Regards,
James


Answer -
Hi Celina;

Leave the hand flapping alone. It is (hypothesized)for emotional regulation. Echolalia can mean a lot of things:

1. It can be part of normal language development;
2. It can indicate a language delay in semantics; and,
3. It can be associated with autism when there are other related behaviors present.

In your son's case, I suspect his echolalia is related more to language delay than autism. How did the M-CHAT turn out?

Kind Regards,
James

Answer
Hi Celina;

As I may have mentioned earlier, many children are now developing less intensive behavioral symptoms of autism, which is misleading to many professionals who do not work everyday with these folks. I still recommend you take the M-CHAT to at least your school district and possibly a university autism team for a thorough evaluation.

Kind Regards,
James