Expert: Dr. Sharon A. Mitchell - 3/31/2007

Question
my husband and i have been talking back and forth about the possibility that our 22 month old son Logan has autism.  here is our story: Logan was a very happy and fairly healthy baby. He smiled lots, cooed at us said lots of words. He was late walking for the average baby at 14.5 months but it didn't bother us he was happy crawling and we were encouraging him so we knew it wasn't a big deal. Around 18 months Logan was doing very well...he was even saying wuv you when he went to bed.  It was at 18 months that we moved to a new city, i went back to work and Logan was with his first full time babysitter. I was also 7 months pregnant. After the birth of our daughter brinlee when Logan was 20 months old we noticed a decline in his milestones. He stopped talking and used only about 5 words(dad, out, bath, no and yeah) and was still walking on his tippy toes although we noticed when he concentrated he would walk flat footed. He was always jumping (on the bed, on the floor wherever he could find a safe place to jump it seemed), he would flap his arms when he was excited, he wouldn't play with the other kids at his daycare and he always lines his toys up which sent up a big red flag. he loved listening to music and dancing to it, and he is a very affectionate child. He will hug and kiss you. He sometimes will and sometimes wont answer to his name, and people that he sees a lot(myself, my husband, my dad and our close friends) he will go running to when they come in the door and grab there hand to show them things. he points although not always with his pointer finger sometimes it will be his middle or his whole hand. He will come get you to take you to show you what he wants or if he wants you to play with him. he will make eye contact with those people but not with strangers. His daycare teacher thinks he is just shy, but we are worried. On a side note he had a lot of ear infections as a baby and  is always flicking his ears. We have an appointment for him to see our family Dr next week but his secretary said most like he will have to be referred to a specialist to get testing done.  Could he be autistic or might it just be a hearing problem? if you need more info please let me know and i can give you more details.
thanks
Ashley  

Answer
There is a possibility that what you're seeing is autism but it could be a host of other things as well, including a variation of normal development. Investigating your son's hearing is a good first step along with a general medical check-up.

It's not unusual for parents to notice some degree of regression on the birth of their second child. Kids can also lose some previous skills when they are put into new situations, such as a day care, a new home, etc. But generally, over time, the previous skills return as everyone settles in.

Some of your concerns are centering about your son's use (or lack of use of language). Below are a few websites that can help you sort out what is within the normal speech/language parameters for a child your son's age. Armed with this information, you can then speak to a public health nurse, pediatrician or speech/language specialist.

http://www.asha.org/public/speech/development/child_hear_talk.htm

http://www.comeunity.com/disability/speech/milestones.html

http://www.ldonline.org/article/6313

Even without professional guidance, there is a lot parents can do to help their child's developing language skills. You'll find some suggestions here:  

http://www.asha.org/public/speech/development/Parent-Stim-Activities.htm

http://www.hsdc.org/News/Speech/encourage.htm

If you're concerned, I think you should speak to a Speech/Language Pathologist (SLP) to get the best advice.If you live in the United States, you can find a local Speech/Language Pathologist through this site:

http://www.asha.org/proserv/

In Canada, try here: http://www.caslpa.ca/english/profession/find.asp

For other countries and general information on finding SLP help, check out this site:  http://members.tripod.com/Caroline_Bowen/find-slp.htm

Speech/Language Pathologists are trained not only in speech and language development but in pragmatics those social niceties we all need to learn in order to communicate effectively. This includes learning who to talk to and when to pay attention to the fact that that person is a stranger.

Not every child with autism flaps their hands and not every child who flaps has autism.

There are specific symptoms associated with the various autism spectrum disorders. You can read about them and diagnosis here:

http://www.psychiatry.emory.edu/PROGRAMS/autism/pdd.html

And in more medical detail here:

http://www.nichcy.org/pubs/factshe/fs20txt.htm

Here is a short, free, online checklist your could look at to see if you think your son is showing characteristics of Asperger's Syndrome:

http://www.udel.edu/bkirby/asperger/aspergerscaleAttwood.html

Here's a checklist on characteristics of autism:

http://www.hmc.psu.edu/psychiatryservices/child/outpatient/autism/Revised%20Auti...

These checklists are not definitive and do not mean that your child has or does not have autism. They may provide you with some information that you can take to your doctor, though.

Sharon A. Mitchell
www.autismsite.ca