Concerned friend

[Brooke87]

My friend has a 18 month old daughter who is very underweight for her age; 17.5 lbs.  She is not walking, only recently started crawling, shys away from children/adults and covers her face with her arm with any loud sounds or fast motion.  She is saying a few words very clearly, as to repeat you, but is not communicating much besides that.  I am in fear that she may be autistic (to note: I believe her father has Asperger's Syndrome) but I do not know how to go about bringing this up to her parents, as they do not acknowledge that she has any issues or is developmentally behind.  I do not want to alarm them, by bringing this up if there is no need to, but if this does support my observations, I would appreciate any advice on this matter.

[Rachel Thompson, Ph.D., BCBA]

Your friend's child should receive a developmental screening. I am particularly concerned about her delayed motor development. Many parents avoid seeking professional advice for fear of their child being labeled. Also, many parents are advised to wait to see how children develop on their own. We know that healthy children vary in their development, but we also know that early intervention is very effective. Therefore, I encourage families to share any developmental concerns with their pediatrician and to get recommended screenings. I assume that the child visits her pediatrician regularly. If so, I would expect the pediatrician to pick up on these developmental issues. If for some reason this process has not worked, I recommend that you try to address this subject in a supportive way.

[Brooke87]

Thank you for reply.  I will google echolalia and do some research.  Yes, she has been for regular check-ups, but I also believe that they are mis-informing their doctor, because they do not want to acknowledge any developmental delays.  The words that she does speak are very clear, but are repeated words.  Besides that, I have not seen her communicate her needs/wants/emotions.  We are very good friends, which is why I find it most difficult to say anything but her parents are not the easiest people to speak to as they are very private.  Thanks again.

[Sally44]

She may/may not be on the spectrum, only assessments and observations can decide that.  
If she is repeating things said to her, or is repeating things from TV/DVDs etc whether it is words or songs or sounds then she might be echolalic.  Google echolalia and autism and see if that sounds similar.
Covering her ears at sound could be Sensory Integration Disorder.  Many, if not all, individuals on the autistic spectrum have sensory differences which range from mild to severe (quote by Temple Grandin).  An Occupational Therapist should assess for this and put together a programme.
The sooner any therapies are started the better the outcome.
Rather than bringing up 'autism' would it be possible to mention echolalia or sensory integration disorder as something you came across whilst on the internet and thought it reminded you of this child?  It is a very difficult subject, and it does depend on how close you are to your 'friend'.  Has the child been for regular check-ups with the paediatrician to make sure she is meeting her developmental milestones?
Usually the first professional to assess any child is the Speech and Language Therapist because most of these children have difficulties with speech and social interaction.  If her speech is poor then that could be an avenue you could bring up because all children need sufficient communication and language skills for nursery and school otherwise they won't be able to communicate or understand what is being asked of them.