DOCTORS please read this & help me! Please!

Hi, I think my sisters son might have aspergers, or perhaps selective mutism- or maybe both?  Jake is 4.5 now and just started preschool almost 8 months ago.  He will not speak at school to his peers or teachers.  As a baby Jake didn't hit any of his milestones.  He didn't walk until around 18 months and he didn't speak (even one word) until around 2.  My sister did put him in speech therapy and the therapist told her that her son was a perfectionist and that he didn't like to try to say words until he could say them perfectly.  Later they moved so the therapy stopped.  Even now (at 4.5) he prefers to gesture, nod/shake head, or use one word answers.  He seems very shy.  If someone asks him a question he just smiles and looks down, or laughs.  Once he warms up (to family) he will answer with one word if you ask him to "please use his words."  He does understand everything- he can follow directions very well, and in stories he understands plot lines, who the good guy vs bad guy etc.  He seems to be intelligent as best I can tell.  He is also social.  He will come up to you and poke you with a toy & giggle (like it's a game) or come up to you and hold up a toy.  He will never say anything, he'll just kind of wave it at you and wait for you to say, "Wow, what's that you've got there."  Then usually he would not answer unless his Mom tells him to.  If he did answer it'd be one word - like "dog" or "book" etc.  He plays with his brother and his cousins.  His play is usually side by side, but sometimes he'll play a game WITH the other child (like they both hide under a blanket together and laugh etc).  Rarely will he talk during play- ex he doesn't say things like "your turn, or come over here etc" instead he says things like "gah gah gooo gooo" (or other nonsensical phrases or word combinations).  When his cousins talk to him- ex. Jake will you come outside and play with me please?" he'll usually just stare at them blankly, as if they are not talking at all.  As for school, his teachers have notified his mom that he's not speaking to anyone.  My sister rewarded him special treats if he would talk, and for a few weeks, while the treats continued he did say a few words, but then when my sister stopped the special rewards, he stopped talking again.  My sister says he's just shy and goofy.  She says it's just his personality.  I am literally worried sick it something MUCH more serious.  Jake is very socially awkward... it's not just the lack of speech... he has an awkward gait (he walks with his toes pointing out), and when he gets really excited he walks on his tip toes and hand flaps.  I don't think my sister notices this.  I stayed with her for a week recently and I only would see him do it a few times a day... usually when he was running around being "silly."  He kind of hums when he's doing it.  He is also a very picky eater.  He cannot eat a cracker with a burnt spot... he checks food for imperfections before eating it.  He is also deathly afraid of flying bugs (nats, flies, bees etc).  When he sees one he completely freaks out, his facial expressions are very extreme, its as if he is being electrocuted.  Lastly I will say this child is very loving.  He loves his baby sister and his Mom so much.  He will sit and hand the baby toys and coo at the baby- it's so sweet.  He will loving kiss and hug her etc.  
Okay- so am I going crazy or is there something to all this??

[genera123]

sounds like autism   when a child goes inside themselves.  they are very very intellegent people.  almost like doogie houser the 15 year old medical doctor on t.v.   by the standing on the tiptoe flapping the hands around its almost like an episode.  i would tell your sister to seek help from a neurologist to get help for him.  sometimes kids with autism dont have enough time in the small little world for normal children activities cause they are so wrapped up in other more adult things.  they seem to forget about potty training or other issues like brushing teeth and so on .. my sisters kid had asperger and when he has an episode he throws desk around the classroom.  he litterally hit the teacher with his fist and he is only 10 years old. they have a difficulty controlling anger.    good luck anyways.

[sun2810]

he has aspergers syndrome. i know because i have it. i also couldn't walk at the age children usually do. i started to walk when i was three and a half. i am disabled. i have lax muscles, weak ligaments, flat feet, bow legs and I sit stand and walk with an arched back. 99% of people (adults and children) have chronic constipation in the bowls. that is where you are prescribed medication for the rest of your life. and all of your life you will suffer with constipation. 33% with aspergers syndrome suffer with depression. i am one of them. your sister's son dosn't have selective mutism because if he had that he would never smile, never laugh, or ever play with you or go up to you. he will just sit there in his own little world. so i am 100% sure he has aspergers syndrome. i have all the symptoms he has. i flap my arms, i don't speak to strangers often, i speak to my family and i don't make eye contact. i also get frustrated quite alot and scream and hit myself. as i grew older i calmed down. i still hit myself but not as often. every person with aspergers syndrome is different and can be extremely smart and have a high iq.you should get him tested for aspergers syndrome. if the results are positive speak to your sister about putting him into a special needs school where he will be understood by the teachers. other children will be just like him so he will make good friends and no one will bully him. if he is put into a public school he will just get bullied by the other children. he may not put his hand up in class. then the teachers will pick on him and he won't know what to say. some teachers will force him and they will not understand his condition, so he will get really frustrated and throw things and hit people. ask the specialist about an autism awareness card. i will be getting one soon.they are meant to be very good.for example:if he gets lost he can show a shop assistant or a police officer the card and they should understand without him having to explain himself alot. i hope i have helped. can you tell me what happened. thanks. can you also add me as a friend.

[megankrause]

Thank you guys so much for responding!  My sister doesn't see any of this at all & refers to him as stubborn or goofy.  I don't want to force the issue, maybe she is not ready to mentally deal with it?  Either way, I think early intervention is important & I hope she will do something soon.  If another flapping episode presents itself in my presence I will say something & I will definitely update!  Thanks again!!