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Child Behavior (Expert Forum)
18 Month Old Development Behind?
Answered by
Kevin Kennedy, Ph.D. - Child and Adolescent Psychotherapy, Family Therapy, Crisis Intervention
Harvard Vanguard Medical Associates
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
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18 Month Old Development Behind?
by pbersha, Sep 19, 2006 12:00AM
Hello:
My wife and I are concerned about our 18 month old's development. He is our second child, and has been behind on many milestones. At first, we were not so worried, because his older brother walked late (15 months) and spoke late (18 months) - but is now a very active and incredibly verbal three year old. However, we hare becoming more concerned.
Some worrying signs:
We have tried teaching him signs since he was 15 months, and the only ones he has mastered are "more" and "book" (his older brother knew 40 signs before he began speaking)
He only recently began pointing at 17 months. He can sometimes point to body parts - head, mouth, nose, but sometimes not - it seems to come and go.
He is very interested in imitating sounds, voice inflection, and even song - but does not initiate communication, or reference words with objects.
He crawled at 11 months, but did not begin walking consistently until 16 months.
It has always been difficult to read even simple books to him - his attention seems to wander. He is very interested in making pages turn, less interested in what's on the page.
He was saying "Da" since 1 year old, but has not expanded on that into "Mama", "Dada". (He just recently began saying "More" when signing "more")
His attention seems to fade in and out. - while playing, or eating, he will sometimes seem to stare into space for several minutes, and it will be very difficult to bring him out of it. Calling his name, and even loud claps near him only occasionally work.
While autism is obviously a big concern, he does not seem to have many of the common symptoms - he is happy to be held, he recognizes both his parents, he laughs and shows emotions readily. The most puzzling thing seems to be the variable nature of the behavior - he simply seems much more alert and interactive some times than others.
He has been seen by a speech therapist, who commented that the issues seemed much more cognittive than physical. In her words, he appears to slip in and out of "joint reference" relative to objects and his environment. He is scheduled to meet with a developmental pediatrician in the next few weeks.
We have been reading recently about how in some children milk and gluten products some time do not break down properly, and result in opioid components in the bloodstream. I'm not sure if this is considered a mainstream theory, but it does seem to fit with some of the things we are seeing.
Can anyone help with any theories, suggestions, or other help?
Thanks!
My wife and I are concerned about our 18 month old's development. He is our second child, and has been behind on many milestones. At first, we were not so worried, because his older brother walked late (15 months) and spoke late (18 months) - but is now a very active and incredibly verbal three year old. However, we hare becoming more concerned.
Some worrying signs:
We have tried teaching him signs since he was 15 months, and the only ones he has mastered are "more" and "book" (his older brother knew 40 signs before he began speaking)
He only recently began pointing at 17 months. He can sometimes point to body parts - head, mouth, nose, but sometimes not - it seems to come and go.
He is very interested in imitating sounds, voice inflection, and even song - but does not initiate communication, or reference words with objects.
He crawled at 11 months, but did not begin walking consistently until 16 months.
It has always been difficult to read even simple books to him - his attention seems to wander. He is very interested in making pages turn, less interested in what's on the page.
He was saying "Da" since 1 year old, but has not expanded on that into "Mama", "Dada". (He just recently began saying "More" when signing "more")
His attention seems to fade in and out. - while playing, or eating, he will sometimes seem to stare into space for several minutes, and it will be very difficult to bring him out of it. Calling his name, and even loud claps near him only occasionally work.
While autism is obviously a big concern, he does not seem to have many of the common symptoms - he is happy to be held, he recognizes both his parents, he laughs and shows emotions readily. The most puzzling thing seems to be the variable nature of the behavior - he simply seems much more alert and interactive some times than others.
He has been seen by a speech therapist, who commented that the issues seemed much more cognittive than physical. In her words, he appears to slip in and out of "joint reference" relative to objects and his environment. He is scheduled to meet with a developmental pediatrician in the next few weeks.
We have been reading recently about how in some children milk and gluten products some time do not break down properly, and result in opioid components in the bloodstream. I'm not sure if this is considered a mainstream theory, but it does seem to fit with some of the things we are seeing.
Can anyone help with any theories, suggestions, or other help?
Thanks!
Doctor's Answer
by Kevin Kennedy, Ph.D., Sep 20, 2006 12:00AM
, Sep 20, 2006 12:00AM
You have already taken the most important step. That is, you have arranged the evaluation with the developmental pediatrician. The early signs are that your son does not display autistic disorder. He certainly does display a range of developmenatl disorders in the context of a family history that is positive for such disorders. The pediatrician can help to pinpoint your child's status in the various spheres of development. Only then will it be feasible to design services to address his developmental delays. Early Intervention will definitely be in order.
The fact that he likes to sit in your lap menas nothing. The emotions as well. That is a huge myth about Autism.
Get him into see a dev. ped. and get him into early intervention.
Good Luck.
Heres CDC warning signs from their website for a 12 month old.
Developmental Health Watch
Alert your child's doctor or nurse if your child displays any of the following signs of possible developmental delay for this age range.
Does not crawl
Drags one side of body while crawling (for over one month)
Cannot stand when supported
Does not search for objects that are hidden while he or she watches
Says no single words ("mama" or "dada")
Does not learn to use gestures, such as waving or shaking head
Does not point to objects or pictures
Experiences a dramatic loss of skills he or she once had
I do have one question that may contribute though, do your children stay at home or are they in day care? This may make a difference in development.
Either way, I do not think that your child not pointing is amything to get too worried about. As long as you have taken the steps to take him to the doctor, you will be in good hands.
1) His mom stays at home with him, he does not go to day care
2) There is no near-family history of developmental disorder - (although his grandfather has a cousin diagnosed with Aspergers)
3) He has been milk-free for about a week, and we have seen some some very interesting changes. Much longer attention span, much better ability to interact with objects together (follow a finger pointing to an object, for example), and a LOT of mimicking of sounds / inflection, and even a few words. This could all be normal development, but we think it is highly likely that substituting soy milk for milk in his diet is contributing this. After consulting with the Pediatrician, we may elect to go Gluten-Free as well.
He has been seen by a speech therapist, who commented that the issues seemed much more cognittive than physical. In her words, he appears to slip in and out of "joint reference" relative to objects and his environment. He is scheduled to meet with a developmental pediatrician in the next few weeks.
We have been reading recently about how in some children milk and gluten products some time do not break down properly, and result in opioid components in the bloodstream. I'm not sure if this is considered a mainstream theory, but it does seem to fit with some of the things we are seeing.
Two points, your son does seem to me to be on the spectrum, and the fact that there is Asperger's in the family is another reason. Just because your son is affectionate, laughs and shows emotions readily has nothing to do with autism. All autistic children, even the lowest functioning, show emotion and affection.
You stated that he seems more alert and interactive at times than other times. This is classic LD or ASD. We took our son off milk at the age of 26 mos and saw a remarkable difference in just a week. Gluten didn't seem to effect him. I think you are asking some very good questions and you seem to be approaching this situation with very good scepticism. There is a lot of quackery out there in terms of ASD, be very careful.
The Speech Pathologist is a very good source of information on development. A developmental pediatrician is even better. Whatever they tell you, keep in mind that you are catching this early and with the right amount of intervention, you'll see quick results. If you get a diagnosis of ASD, skip the denial part and concentrate on intervention. Good places to start are Verbal Behavior, probiotics, RDI, and vitamins. Never, ever let your child spend time by himself, keep him engaged and demand no less than you would if the child was "normal".