Does Autistic or just Inattentive.

Hello, My son is 3.5 years old and has attended preschool since he was 15 months. He used to have frequent tantrums between the ages of 2-3, now less frequent and mild.   Responds well to time-outs. Excellent gross and fine motor skills. Developed normally.  No speech delay as per the Speech Pathologist he saw yesterday. But his social language, starting conversations and keeping them going is a bit poor. The speech pathologist says he has a marked problem with eye gaze, which is why we suspected autism, and although he worked well on all tasks with her, he was very distractible during transitions. Also, he talks at you not with you, and does appear self-centered relative to peers in his class, and emotionality at times. He tells me that he just does not want to talk but I have seen him awkwardly try to integrate in groups of children and then he backs off and plays alone for 60% of the time. He must have some frontal lobe issues attention and shows autistic behavior such as humming while he eats and poor eye contact etc,  Not toilet trained, does not seem to be due to stubborness. Some days he is so "present" and other days he is inattentive, zoned out and we cannot get his attention.  His teachers don't know what to make of his behavior. He is like TWO different KIDS! Always usually pretty flexible, not food issues.   No stereotypical stuff like hand flapping, perseveration or spinning.  His formal evaluation with a Developmental Psychologist is in a couple of months, but I just wanted to get some feedback before that.  He really loves affection and books, any cartoon that is on TV, puzzles, music as well as his parents and grandparents attention.  Oh and when we are at the park he always seeks to interact with another kids his age and plays really well, up to 45 minutes with the kid sometimes, until when the child begins to demonstrate his better mastery of words, then my son starts to put his attentions elsewhere on the playground.  Help!

[Kevin Kennedy, Ph.D.]

Remember that your son is only three and a half. Sustained attention and well developed interactional or conversational skills should not yet be in his repertoire. Perhaps part of the issue is your expectations. In many ways he is acting like most three-year-olds. You don't even have to be thinking of frontal lobe skills at this age. He is simply too young. None of what you describe indicates autism, nor does it indicate inattention (at least in the problem sense). Yes, his language and social skills may be a bit delayed, but he's got plenty of time to catch up.

[lianabanana]

He is sometimes echolalic when he is tired.  Meaning, he will repeat the question back to you exactly as you ask him.  Not questions he is used to hearing like "do you want some milk", but rather, he will echo questions like "what did you do today" then i would say "no, i am asking YOU what did you do today at daycare" then he will say "ya"...and so on. But this is usually at the end of the day.  Is it normal for a 3 year old to be echolalic everyday?
Thanks again!

[Kevin Kennedy, Ph.D.]

No, I would not say it is normal in the sense that one would expect such behavior. But, if he displays this behavior only when he is fatigued, it is not much of a concern.

[lianabanana]

A related discussion, UPDATE DIAGNOSIS From Nov 2010 post  "Autistic or Just Inattentive" was started.