I have a 3 yr old (born 12/31/02). She was delivered by c-section 2 weeks early, but was still 7 lbs 9 oz. She was jaudiced, but no other real problems. Development went quite well until about 6 mos ago, when I realized that her speech was probably not where it should be. My pediatrician and other professionals said that it was most likely because everyone in the family (including her older sister) spoke for her. She did not need to verbalize much to get her needs met. We have been trying to get her to talk more, and she is doing better. Mostly one or two word sentences. Says, "Hey look" "Got an owie, Mama kiss it?" or "What's that" "Hey give that back it's mine" (comes out very clear). Uses "Please" "Thank you" and "You're welcome" at appropriate times. She does do a lot of "rambling" and it generally pertains to Dora or Blue's Clues (she will do a monologue from parts of the shows) with no real precipitator. (I should add she has probably watched more than her share of Blue's Clues and Dora.) She will answer yes or no questions, follows directives with no problems, sometimes very complex. She knows her ABC's, identifies shapes (including hexagon and octogon), can write her numbers to 10 periodically, can identify her numbers through 20, can count to 20, draws exceptionally well (according to her pediatrician), knows all of her colors, and throughly enjoys sports (any form of playing ball, but especially soccer) and does amazingly well. I might add that she does not play any structured setup of soccer, but does kick with both feet and dribble the ball with her feet all the way across our huge backyard. She also pitches and catches very well. I had her screened at our school for 3 yr Pre K. They immediately picked up on the speech problem and because she did so well on the other areas, they started using words like "splinter skills." She does do echoing, but seems to repeat the word until we say it back to her (almost like a form of acknowledgement). She enjoys being with other children, is not a picky eater (actually quite the opposite), maintains eye contact, is very affectionate. They want to have her evaluted by a child psychologist, do an IEP, and possibly put her in the special education room of the Pre-K in the fall. I disagree. I think she is language delayed, but not autistic. They (the school teachers, etc) seem to be pushing this, and I am very uncomfortable that they are so quick to label her based on a 45 minute screening. My pediatrician saw her yesterday and did not feel that autism is the appropriate "label". He feels that language delay is a problem, and she should be evaluated for that. My husband and I agree and are following through with that. I am wondering, are the teachers/evaluators seeing something I'm not, should I be concerned about possible autism; should she be evaluated further. My doctor said that University of Iowa Hospitals have a very good department, if we want to pursue that. Thanks so much
Had you not mentioned the notion of autism, nothing in your description of your daughter would have directed my attention to such a diagnosis. It sounds like your daughter is generally proceeding quite well in relation to development, with the sole exception of a bit of delay in language. Even in this area, she seems to be closing the gap. I fully concur with the recommendation for her to undergo a Speech/Language Evaluation. There is no indication she requires a special education program, though she may benefit from speech/language therapy. That will be clearer after the evaluation.
The more full-range evaluation won't hurt, it's simply not clear that it is necessary. And your daughter cannot be placed in a special education arrangement without your approval. If the special needs evaluation proceeds, it may well be that an IEP is developed solely for speech/language services, and that would be fine.
Has your DR checked her ears. My niece had a speech problem at the age of three (this is when it was discovered) and her DR found that her ears were blocked by fluid and she needed tubes, the fluid muffles everything so it was hard for her to understand. The tubes released the fluid and then she went to speech therapy 3 times a week and this was done right at ther pre school. I definitely would not have thought autism from your description. Follow your gut feeling and do not let strangers over diagnose your child. If speech is an issue and IEP is a good thing s long as it is just for speech but she should definitely stay in a regular class not an ESE class. Fight for what you think is right, keep her in mainstream classes not special ones those will hold her back. SJe seems very bright and enjoyable to be around. Good luck.
My daughter has just been diagnosed with autism (2yo) and my eldest son has (17). I agree with the professional. Nothing in your description of your child seems awfully evident of an autism disorder, bar some language development, and provided she is using even limited speech to communicate, then she ain't got it.
By all means have further evaluation, it never hurts, and it may help with developent of her speech, but i would be really surprised if a diagnosis of autism was kicked up.
Autism is enjoying a new "fame" I think, and the numbers that are currently being diagnosed may point to wider criteria, and greater understanding by the professionals, but I have seen kids with a labe of autism, and I'm stuffed if I can work out how that got. Enjoy your daughter, and don't worry!!!!!
A special thank you to the doctor and to the others who commented. It has been a very upsetting 2 weeks for me since this all came up. When I did have her in for her well check this week, the doctor did check her ears and they were fine. They attempted to check her hearing, but she would not keep the ear phones on. Personally, I do not see anything that would cause for alarm with her hearing, but she does have selective hearing, as does any child! I think the school's concern was that she would not test, she would not answer their questions, and would not look at them. That is not unusual for her, if she does not know someone. They attempted to do testing in a room full of toys that she had not seen before (including a slide) and they wondered why she would not cut a piece of paper with scissors down the line they had drawn. Finally, I think she got fed up and walked over and tore the paper down the line. They all just sat there and looked at each other! She refused to ride the trike and only did what she felt she wanted to do. She is a very head strong child, but instead of seeing that, they think she is autistic. I do not see how they can make that judgement in a 45 minute screening, which is only a small window into her whole world! Again, thanks so much to every one!
Your reply reminds me so much of my nephew - the selective hearing, not looking at strangers, not using a slide or tricycle, non-use of scissors, and being headstrong. In addition, my nephew did not speak until three years of age, echo-talked until he was five and then began to use speech but still in a more question/answer format than conversational. He spoke in a monotone and was unable to understand social cues as body language, inferences and jokes. Everything was either black or white - he was unable to perceive the "gray" areas in life. He could memorize anything, loved to be "on stage", and was/is fascinated with a certain few objects and activities.
Today, he has graduated from college, holds a good job, and is married with a young child. By the way, he was diagnosed with Asperger's which is on the autism spectrum (but at the high-functioning end). I hope your child is not AS (and I certainly am not in the medical field); however, I think it might be too soon to rule out this possibility. I wish you the best in your search for answers.
My child has aspergers very close to autism, and she has speech problems. Except for speech your child sounds like a three year old! I would put her in speech therapy, because if you wait until they are older it could cause problems with reading later. I would also ask your ped. what they think about your child and autism.
My daughter just turned three on March 4th. She has been in early intervention and is now in the school, preschool with an IEP. She goes to preschool twice a week and during that time is taken out for a half our each day for speech therapy.
I'm writing to tell you that she seems to be at the same level as your child with speech, but is behind when it comes to drawing, shapes and numbers.
She did have a hearing test done yesterday, at the request of the school. ( I had no reason to think twice about it) As it turns out there is something blocking the absorbtion of the sound in her left ear. Could just be an infection so we are retesting in three weeks.
If with just a 45 minute interview with your child and they are saying possible autism... I would question it big time!! Like someone else said, try to keep your child mainstreamed because they could fall further behind if not.
Let us know how everything goes.
Thanks again to those who shared their thoughts with me. Audrey is continuing to progress, but slowly. She is finally answering questions like, "What's your name?" and "How old are you?" correctly. (Although she does like to tease us and say "2" instead of "3"...she thinks that's hilarious!) We have significantly cut down on the television, especially Blue's Clues and Dora. The spontaneous "rambling" has slowed...Thank Goodness! She continues to be very active, especially outdoors (learning to pump her legs on the swing now!), playing any form of ball, and learning how to drive her older sister's Barbie jeep. Still an extremely loving and affectionate little girl, with very good peer relations. We have started attending a play group two times a week now. Verbal skills are definitely improving, using new words and phrases! She still refuses to talk to strangers, but I don't think that's such a bad thing! I have been working with the school system dilligently, and we are in the process of setting up a speech/language evaluation. (Hopefully soon!) Subsequent therapies will depend on the therapist. (This is a bad time of the year, with school coming to and end in about a month.) It is a possibility that we may get to continue through the summer if the therapist is willing. We are pushing this very hard! Thanks again to everyone..this site has been a very positive experience for me in a very stressful time!
One additional comment, my son loves other children and loves to go to preschool. Again, this is another myth which must be busted. I suggest that you search for some blogs written by parrents with autistic children. One high functioning child which I would direct you to is: http://momnos.blogspot.com/
Again, don't be scared. If your child is autistic, it's not the end of the world. Most of history's most brilliant people were on the spectrum.
There is quite a lot of misinformation both in your comments as well as those who gave you advise. First off, much of what you listed is not necessarily typical nor atypical development. Because your child has speech, doesn't mean she isn't autistic, although I doubt she is. My son, who is autistic and just turned three, can do everything your child can and on top of that he can read books. Probably one of the biggest myths is that autistic children are not affectionate! ********. Every autistic child I have met (dozens) is affectionate with their parents and close family members. Another myth, pediatricians know autism when they see it. Peds simply are the least qualified to spot this disorder and are likely to delay early intervention. Eye contact- my son has great eye contact, another myth.
Now, this is why I don't believe your daughter has autism (more likely she has a learning disability), girls on the autism spectrum tend to be the most severe. No one knows why, it's just a fact. Your school system is not qualified to diagnose this disorder not are most psychologists. It requires a specialist with a lot, and I mean a lot, of experience working with spectrum kids. Enjoy your daughter and take this opportunity to educate yourself about the disorder so you can perhaps drop some of your stereotypes.
My son turned 3 yrs old last month on the 11 of March . I have concerns also about his speech . His Dr. said the same thing about giving him a few more months. Then we would go from there. But since December he has started talking alot more. I can get him to count to 5 he don't know his colors or shapes yet I have not tried those. I was wondering is there anything that i might be able to do to help him along better . He is a little boy through and through, wants to play with his cars and was blues clues on tv . He shocked me this morning watching it and when they were asking question he was answering them before the kids on tv could. We don't have the money to put him in preschool, so i was wondering what else can i do to help him more! Please help!!!
Autism is a spectrum disorder from mild to severe. Common traits run throughout the spectrum. In my son's case, he has problems with the pragmatics of language, conversation and some verbal stimming. While he is social, he struggles to connect to other children in very subtle ways. When he is anxious, you can really see the autism come out by his constant stimming and unusual body postures. Some of his speech is scripting, albeit appropriate to the situation. He likes to look at certain shapes out of the corner of his eyes (although not that often). Sometimes he likes to sit and spin objects, although not as much as when he was an infant. He has sensory issues with food and when he feels we can't understand him, starts to tantrum. He doesn't ask questions!!!! That is a big one.
To a casual observer, he may seem active but a little odd in some respects. When most people unfamiliar with autism think of the disorder, they have the most severe of its form in their minds, not higher functioning autistics. My son is only 3 years old now so we don't really know how his ASD will manifest itself as he gets older, it could worsen or it could get better. There is more, but I hope this helps.
One additional item. My sister, an RN, was the first to suggest autism when my son was 18mos old. Her son has Asperger's Syndrome (high functioning autism) and he attends college now. My son's diagnosis came from our local Children's Developmental Agency and was confirmed by Duke University and the University of NC at Chapel Hill. Autism comes in many different "flavors". Fortunately, his is on the milder side, but even the milder high functioning kids struggle a lot with learning. By the way, someone mentioned "splinter" skills earlier. That is a very ugly term used to objectify these children. Instead of seeing the ability with these skills, they see the disability in the other areas. Autism can be as much an ability as it is a disability. The key is to focus your child into his/her area of strengths while helping with their weaknesses. But never forget your child is special and has a uniqueness to them that will help you become a better parent and person. I believe that autism parents are uber parents and can be a very good source of information on childhood development because we spend every waking hour thinking and researching it.
Do color of the week. example 1st week the color is blue have toys, flashcards, playdough whatever, all of them blue. Show them to him while he is eating breakfast or lunch and say "blue ball" or some flash cards have shapes "blue triangle", then in the bathtub do the same thing with bath toys, "blue boat". Do this Mon thru Friday.Dont have any other colors around. Write down somewhere what colors you are covering then cross them off as you go, so then the next week could be green, etc. You can find alot of stuff for this at Goodwill, dollar stores etc. You can even teach him the signs for the colors and that will help him as well. Go on AmericanSign language.com to learn any sign. It works, I taught my son this way and he knew his colors by 26 mos. You can do the same with shapes as well. Just so you know though not knowing all of his colors by age 3 is not a milestone, so dont panick.
You said that your pediatrician said your daughters ears were OK. Have you gone to an ENT and had her tonsils and adenoids checked?
My daughter is speech delayed, and falls into the Autistic ranges in all of her testing at this time, but it was recently discovered that her adenoids were EXTREMELY large for her size. We had them removed, and have seen great results.
She also refused to participate in the hearing tests, but we finally agreed to let them to the tests after putting her under, and we discovered that she fails the test miserably in one of her ears. I am making it a point to talk on her right side as much as possible now.
Just a thought...but I agree with everyone here, the description you gave does NOT match Autism in anything that I have ever seen or heard.
I have a friend who has 4 children. All are normal but one. I am really worried as she has never mentioned anything wrong with him and thinks he is fine. He is 3, has cronic nose bleads, drools, doesnt speak clearly (he grunts), only knows the color blue, doesnt know any numbers, letters, colors. He can match up go fish cards and stack all the same animals on top of each other. As a teacher, I think he has some sort of autism, or ear/nose throat problem. obviously if he cant hear well, his speech, etc isnt working out. He also has random fits of crying when nothing is wrong and of course cant tell us what is wrong because he cant speak clearly. She has figured out his grunting "language" and can respond to him, but no one else can. What do you think is the problem? Her doctor has never told her of any problems, but she has never mentioned these things to him. I am just afraid she will be shocked when he goes to Kindergarten and they are like, something is seriously wrong. What do you think this could be>? ANy feedback would be great.
Chronic nose bleeds and drooling is a bit concerning (not a sign of autism). Not being able to effectively communicate his needs is probably why he is crying, not necessarily autism. If she is interpreting grunts for him, she's actually going to make it more difficult for him to learn to speak. Lack of knowledge of some items listed above is not necessarily autism either (colors, numbers, letters etc.). Many autistic kids frequently learn those things before their neurotypical peers. When my son was going through his diagnosis, the examiner actually noted that he knew his complete alphabet and several numbers and many many colors as evidence of uneven skills which is a hallmark of autism.
I think your right to be concerned but knowing how to approach the subject with this friend can be tricky because often times, parents don't want to know if something is wrong and go for a long time into denial. I know, I've been there. My sister was the first to suggest my son was autistic at 18 months. I was angry with her at the time but now I wish I had listened because we could have started his therapy a good 8 months before we did and he would be even further along. Your friend's pediatrician should have given her a developmental checklist to fill out at the 2 year well checkup.
If the child is autistic, they should be displaying certain behaviors such as the following: Unusual body movements (you know it when you see it but it can include hand flappying, staring at fingers or complex whole body movements); difficulty with simple transitions (more than usual for this age); insisting on following the same route when driving somewhere in the car (my son use to tantrum whenever we backed the car up); no representational play (such as using a brush like a telephone etc.), sometimes a lack of prolonged eye contact; self stimulatory behavior like spinning objects or wheels, looking out of the corner of their eyes at objects, facination with movie credits, verbal stimming such as making babbling noises when anxious; ANXIETY ANXIETY ANXIETY ( I'm not talking about the normal 3 year old anxiety, again you know it when you see it; no appropriate toy play (lining up objects is not necessarily what I'm talking about because normal kids do that as well); unusual interests (road signs, planets etc. in my son's case); not using gestures such as pointing; and finally unusual fears such as the vacuum cleaner or other object in the house which they routinely see.
If the child isn't doing any of the above on a routine basis throughout the day, its not autism. It could be mental retardation. I would suggest that you speak to her about your concerns, even if that means she will be angry with you at first. Suggest that she talk to the Ped about your concerns and see if he needs a referral to a specialist. Your right about not waiting until kindergarten, by that time the brain is not as "plastic" and capable of change.
The childs drooling may be dysarthria or he may have apraxia, which these are motor planning disorders along with weakness of the mouth muscles. These can be remedied with straw therapy and also blowing whistles or horns. If your freind takes hims to a speech therapist she should take him to someone who deals with feeding issues or oral motor problems. There is also a great book called The Late Talker which addresses all of this. My son drooled until he was 2 with the straws and horns along with using a nook we remedied this. Drooling at age 3 is not good at all. http://www.cdc.gov/ncbddd/autism/ActEarly/milestones_3years.html
Got to this website form the CDC these are child dev. milestones along with warning signs of a problem note at the bottom drooling is one of them
I viewed the CDC website. It's interesting because none of the Healthwatch items at the bottom occur in my son, with the possible exception of seperating from his mommy at bedtime (a recent behavior), which I'm not sure how extreme that has to be at this age to be concerning. Pediatricians need to be better educated about ASD's so they can educate parents because there are so many parents who see one or two "unusual" behaviors and all of a sudden they are worried about autism. Peds need to make sure they are giving the parents developmental checklists in the early years to fill out to make sure parents don't become overly concerned with what appears to be very normal behavior.
Your right. I do think most peds. use this as a checklist. And not every child falls under those criterias at the specific age. My son doesnt check off on any of those either. I do think drooling though at 3 is not good. I was concerned when my son was drooling past age 1. I dont think that of course has anything to do with autism, but it does seem like a definite motor planning or low muscle tone in mouth area.
One thing is does note if you look under symptoms to watch out for at age 1 is "Does not point to objects or pictures". Which is something I know you had mentioned before and that alot of the books you buy dont mention that.
I totally agree with you that the most important devlopmental checklist is those 1st couple years. I think there needs to be some major changes implemented with these doctors and one would be for sure a checklist to give parents and have them keep an eye and fill out on BEFORE the doctors visit, and have the doctors take continued education courses on Autism and other disorders, they waste precious time with their "wait and see attitude". It used to be thought that once a child turned age 3 their mind was pretty much developed and not as sponge like, thank God that has changed and now they are saying age 5. If age 3 was still the supposed cutoff age I think alot of kids may not have a chance to reverse some of the problems.
One of the best prescreening tests to do for a yount child from 18-24 months is called the M-Chat, which can be filled out quickly at the doctors office. I've tried to get our pediatrician to use it. Here is a link:
If you answer no to 2 or more questions, a further developmental evaluation is warranted. The test is designed to be super sensitive. Not all children who fail the test are found to have autism, but most are. In my son's case, at 18 months he was unable to do 6, 7 and 9. Many children regress after 18 months so in some instances, it might be good to retest at the 24 month period. By 24 months, it should be more obvious. In retrospect, I believe my son could have been diagnosed at 12 months by a trained examiner or another parent of an autistic child.
my son has many delays in his speech and also physically, your daughter to me does not sound like a child with autism, my sons occupational therapist has said that doctors are quick to diagnose children with autism if they see any charactaristics of autism, sounds like you're doing everything you need to be doing to help your daughter.
I am watching this child and he is nearing his 3rd birthday. He does not speak, he is in diapers, and uses a bottle still. When I ask him what he wants, he will suggest his hands as his voice, ie-curled up hand toward his mouth wanting food. His mother thinks this is normal. He will not ask to do something, and his parents assume his thoughts. When he pouts which he does with his hands folded within his chest... that is his sign of back off. I thought he may have a form of autism, or even some retardation. He never ever talks. He knows what he needs, but no matter how much you can w.hold an item he wants for his words, he will not give in. what are the thoughts?
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