Nineteen Month Old - Autism/PPD NOS Question

[CT529]

We have a nineteenth month old son who we’ve been concerned about for several months. He was saying three of four words a few months ago but now has lost that ability. In addition, he rarely responds to his name. I know these are two classic red flags for Autism/PDD NOS.

Couple notes of interest on our son. He seems to be very social -- will look you in the eye when you have his attention (will maintain solid eye contact --- not just a fleeting glance), does not seem to exhibit typical autism behaviors (no constant lining up of toys, stacking of blocks, preoccupation with wheels on a car ----- plays with toys appropriately --- does seem to engage in some pretend play like talking on the phone, etc), no major repetitive movements although he will occasionally move his arms up and down and will walk on his toes. His motor skills seem good ----- can feed himself  hold a pen and scribble, throw a ball, etc.

We’ve had him evaluated at Early Steps and at this point they did not feel he was on the spectrum. We also had his hearing checked through a pediatric ENT (interestingly enough when they took him in the sound chambers he responded (turned his head to the appropriate side) almost every single time they whispered his name. The ABA therapist who is working with him says he is very atypical for a child to be on the spectrum given his social skill sets.

All that being said, I don’t know what else this could be other than autism or PDD NOS and so I'm assuming a “worst case scenario” and have him in six to eight hours a week of therapy (ABA).  He has begun to say a few words again since beginning therapy (mama, go, bye) a few weeks ago and has started to wave and say bye fairly regularly.

I guess my question is realistically could this be anything other than autism/ pdd nos given the lack of response to his name and the regression in language and if so what might it be?

[Rachel Thompson, Ph.D., BCBA]

As you know, autism is characterized by deficits in social and language development and the presence of repetitive behavior. It sounds like you are primarily concerned about language development and that your son seems to be on target in the other areas. ABA therapy can be useful for children with and without autism. I assume that you also have a speech therapist involved. If not, I would recommend that you seek this type of support as well. Also, a speech and language pathologist would be able to assist in diagnosis specific to language difficulties.

[benjiaudi]

My 20 month old son has some similar characteristics and I am just now looking into possible Autism. He does look us in the eye but does not maintain that eye contact. He will respond to his name most of the time, but when asked to do something, he usually stares off into "space" and won't follow through. He seems to be in his own little world, however he does play socially with others. He has no words other than da-da and ma-ma sometimes. He says buh-buh for just about everything and will say uh-oh sometimes. We are in the process of having him evaluated for speech/OT for food/oral aversions. He will only eat crunchy food and nothing with any type of soft/wet textures. We've been told that he quite likely has a sensory disorder, but I'm wondering if it could be more, possibly on the Autism spectrum. Any thoughts/suggestions?

[CT529]

Dr. Thompson-

Thanks so much for your response.  We do have him in both ABA therapy and speech therapy at this point.  I guess the thing that's concerning to me is the lack of response to his name (although he does seem to be getting nominally better at this) and the fact he was saying three of four words (Hi Dada, Baba, Mama).  

Since beginning ABA therapy two weeks ago he has begun to say a few words again and is waving Hi and Bye fairly regularly.  

I guess I always assume autism or pdd nos as I know he has two classic red flags for those conditions.  Do you see children with these symptoms that go on to simply be diagnosed as temporary development delays?