Expert: Catherine Ridenour - 10/20/2007

Question
My sister has twin boys and they are 27 months old.  They are still not talking.  They used to say a few words, but have stopped saying those few words.  There have been times I wondered if they were deaf, but remembered how they have responded to sound before.  I can walk into their room and say "hi boys" really loud and they don't even look up. They walk on their tippy-toes when they get excited, they flick their fingers and swing their arms around, they make a fist and squeeze really hard and tighten their arms up and get really stiff.  They don't make even contact, or if they do it's very little. It seems like you can't interact with them, almost as if they are in a different world.  They are able to point to something they know in a book when asked.  They always seem withdrawn, and just content to be with eachother watching tv.  My gut tells me something is wrong, and I believe they have Autism.  The problem is their parents are in denial...they think their speech is just delayed.  But I see alot more going on than just the lack of verbal communication.  They will be 3 in July and I fear they still wont be taking then, they dont even attempt to say words even when you are repeating them. I don't know what to do, but I know something needs to be done before they are 3yrs old. I don't know if my feeling is correct, maybe they aren't autistic, that's why I'm asking what you think.

Answer
Hi Trish,

While it is common and "normal" for twins to develop their own private language, it is not "normal" for them not to use language at all. Delayed speech is a serious developmental issue in any child. We learn most of our language by the age of three. This is a hardwired biological fact that cannot be ignored.

Your descriptions of toe walking, flapping behavior, acting as if deaf and lack of eye contact are consistent with some kind of autistic disorder.

Try to get a pamphlet from a pediatrician that describes the signs of autism. Give it to the parents and tell them that you only do so out of love for them and your nephews. I know you really have no power in the situation, but do keep trying.

Better to wake them up now and have the boys get the treatment they need than to keep quiet and have to say you knew it all along when they are finally diagnosed at school.

By the way, 2 year olds should not be watching television more than an hour a day. If this is being used as a babysitter, the boys are being cheated out of the interaction they need to develop language and social skills whether they are autistic or not. Toddlers need to be exploring the world through interactive play with their parents and each other.

Best wishes,
Catherine