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Monday, December 22, 2014
Is My Toddler Exhibiting Signs of Autism?
My son is 2 years 11 months old. Up until about four weeks ago, he seemed fine. Perhaps a month or two behind where his sister was at that time, but he walked and spoke within a reasonable range. Today he walks well (runs all over the place, actually!) climbs stairs and playground equipment, and laughs quite a bit, especially when chased or tickled. The other day when I walked in he said to me ‘Daddy, I drawing with Nanny!’ That’s a good example of his speech, sometimes a little mixed but generally understandable. My worries concern two things. First is his sometime inability/refusal to respond to his name. He’ll be playing (maybe pushing a toy truck back and forth) or in his car seat, and my wife or I will call him, and he keeps looking away as if he hasn’t heard. If we sit him down and look at him (his eye contact is good, not great) he will eventually respond, but it’s tough. Also worrisome is his occasional -- perhaps I view it twice a day -- hand flapping or finger movements. Some places I read say it could be a symptom of autism, other places say almost every child does it. He babbles about the same -- two or three times, saying `Goo goo` sort of speech, but 95% of the time he’s speaking words that we all understand. Otherwise he seems to play well with others, points if asked, and is good at speaking, walking and eating (he uses a fork). He also has affection for his sister -- the other day he took an extra piece of cake to give to her. I know that a definitive answer can be given only after observation, but I was wondering if you think I am overthinking all this and he’s just in a phase -- he is, after all, just 2 years, 11 months, and this hasn’t been going on for long -- or not. There is so much conflicting information. (Last item -- his grandmother, who used to teach grade school, visited the other day for a few hours. Her response – he’s a little quirky, but probably fine. But keep an eye on him.) Again, thank you so much.
As you have already noted, your son is displaying a few behaviors that are often seen in children with autism spectrum disorders. As you also note, he has a great deal of normal behavior that strongly suggests he does not have a spectrum disorder. Finally, as you are aware, making a diagnosis via the Internet is difficult if not impossible, and direct observation would be needed.
From the detailed description you provide, I would tend to agree with his grandmother. Your son sounds pretty developmentally normal. Some of the behaviors he displays are probably variants of normal (most kids this age will flap their hands briefly when excited, for example). Many of these behaviors will also respond to the type of management you are already encouraging, such as reminding him to look at you when you are speaking, etc. You mention that some of these are recent behaviors and may be a "phase", and that also is true.
If these behaviors increase or worsen, instead of improving and lessening, it would be appropriate to discuss this further with your child's pediatrician.
Daniel Coury, MD
Clinical Professor of Pediatrics and Psychiatry
College of Medicine
The Ohio State University