My question is my 21 month old nephew dosen't eat -- he only ***** certain foods then spits them out. The only thing he really likes to suck and spit out is peanut butter and toast. They give him three bottles a day and some juice. He is still getting up in the middle of the night to have one of those bottles. His parents aren't concerned about it but the rest of the family is. Also he is not talking at all, the only noise he makes is car sounds, no mama, dada etc... He is coming to spend a week with us while his parents are on vaction and I was wondering if I should try to feed him some baby food, rice cereal etc. As a baby he didn't like to be cuddled and made very little eye contact.
About 80% of autistic kids have also Sensory Processing Disorder (see more on SPD Foundatino site).
"dosen't eat -- he only ***** certain foods then spits them out."
This is oversensitivity to taste - a Sensory Modulation Disorder. He could be oversensitive eitehr to certain tastes, or texture (I suppose he does not like gelly, fish, probaly peaches).
"The only thing he really likes to suck and spit out is peanut butter and toast."
So, due to this oversensitivity his diet is limited. Could be treated by gentlt progressive desensibilisation - propose periodically new food, try not to leave things he likes on the table - he'll be hungry and will be more happy to TRY.
"He is still getting up in the middle of the night to have one of those bottles."
Kids with autism and SPD could have several reasons for this:
1. He could not "stop" this behavior when he has SPD. In that case gradually decrease the dose in the bottle till he'll suck an empty in the end.
2. He could be checked for No Gluten No Casein diet (urinal peptides and intestinal permeability) - if tests are positive, the result would be quick (my son had same thing).
3. He could be also oversensitive to certain noises, tactile inputs, what would disturb his sleeping. If he has Intestinal problems, a diet would help as well.
"His parents aren't concerned about it but the rest of the family is."
A normal state for parents is it is their first child.
"Also he is not talking at all, the only noise he makes is car sounds, no mama, dada etc..."
A therapy called Applied behavior Analysis should be started immmediately - at that age it is VERY easy to make these signs dissapear.
"As a baby he didn't like to be cuddled"
Also Sensory Modulation Disorder, Tactile Over Sensitivity (responsivity) - he might be oversensitive alos only in certain body areas (like back, heard, ears), but OK with others - legs, arms.
"made very little eye contact."
Could be either visual over-sensitivity, but more likely Ocular-Postural Disorder (what in that particular case is Ocular Disorder) - they eyes muscles have low tonus, so he could not fix them or track any object move. Alos his Visual Discrimination capacity would be limited (this is called Sensory Discrimination Disorder) - so, he'll have difficulties with emotinos recognitinos, he might have difficulty with discrimination familiar faces from infamiliar - parents might feel he does not recognise them and could mix mother with any other women.
So, if the additinoal signs I mentioned here are presented, I'd check him for autism and do the these therapies. If you need any other info regarding "where, how and why" - do not hesitate to let me know.
Thank you guys -- I have been leaning towards autism -- I just don't know how to bring it up to my brother-in-law. They don't seem one bit concerned. I know when we saw tell tale signs of adhd in our first child, we wanted to look the other way and make up excuses for him but it finally got to the point where it was getting harder and harder for us to deal with him. As soon as he started his medication -- at the age of seven -- he came to me and I asked how he was feeling and he said I finally feel good -- it broke my heart that we had waited so long.
If anyone has any ideas on how to approach the subject with them please let me hear them. I know I'm not the only one concerned should we all sit down with them or would that be to overwhelming?
It does sound similar to some symptoms of Autism; I would want an evaulation just to "rule it out". I wouldn't worry much about the verbal bit, though. My son was a very late talker (about 30 months before he said *anything* but "mama", "dada", "no"). I worried about autism at the time, but there were no other concerns. Once he started talking, he caught right up and beyond!
But the s ucking, noises, etc can be characteristic of autism. On the other hand, maybe the child doesn't eat well because he is still accustomed to s ucking a bottle well past the APA's recommended age to wean. It's hard to say. Also, is he read to? Talked to? Does he have good, stimulating interaction with parents and other caregivers?
I do agree that the child's doctor should have noticed some of these developmental delays, unless the parents aren't being forth-coming about them.
As a family member, i can imagine it would be uncomfortable to broach your concerns with the parents, but I think it is worth a try. Keeping in mind that the child's best interests are your priority, and be willing to back off if the parents insist nothing is wrong. I would just try to encourage them to ask their doctor about the things you have noticed, to see if they are "normal", since they are first-time parents and may not be sure.
I agree with the other, he does sound like he has some of the symptoms of Autism. But I would advise caution on the advice "a child won't starve themselves" when infact a child with Autism or Sensory disorders may well do; I have a child that is testament to that. Even if this isn't Autism (there would be other indicators such as lack of social awareness, very little eye contact, repetitive behaviors with Autism) there are clearly concerns with his speech and feeding and it would be well worth an evaluation with early intervention. Best of luck addressing these concerns with his parents.
Unfortunately, Sensory Processing Disorder is not a Diagnostics yet, but you could already ask SPD Foundation to check for diagnostics and ask for help.
The bigest issue here is not what is this, but how to bring your brother-in-law to make a diagnostic, as i understand. A tip - it should not come from a family member, it should be an internal person, who sees many children, but not a doctor yet as soon as he does not want to accept it yet.
If the child goes to kindergarten, talk to people who work there. If they see any particular sign - like they call a child and he does not respond to his name sometimes, but some sounds hear from far, then it could be a sign. In our case 1 family member alarmed as, but we did not want ot accept, because a pediatrician said language delay is OK, because he is bi-lingue and we lost 2 years like this. Pediatrician sees a child for a limited time. You need a person to spend several hours with a child in a row AND to see other kids of the same age at the same time. If he approaches to other kids, but do not talk to them - it's OK. If he is indifferent to presence of other kids - this could be a sign. If he runs away and it looks like he does not hear you calling him or does not turn in direction of your voice - this is definitely autism (in fact, it is SPD, subtype auditive SDD, it is very frequent in autistic kids, and their communication-language problems go exactly from this disorder as well as SBMD).
So, talk to kindergarten, ask them what their feeling are and if they suppose a problem - convince them to talk to the parents. Otherwise you'd be rejected by them.
Diagnostics is better to be done by a qualified psychologist, rather than a doctor.
You could aslo do diagnostics yourself. They plan to have a new DSM5 in 2012, so now till 20-April the site dsm5.org is open for any public comments on diagnostics changes. You could go there and try what is the most suitable for the child.
But, honestly, for the moment they are not very good in these criteria - they have just changed Autism category in an orther that Asperger Syndrom would be in, but many autistic kids, who does not have fixed bexavior, would be out of diagnostics.
So, he should have: social problems or incapacity to create relations with peers due to his age, then communication problems (does he point? - it's also communication). When he says "mama", "dada" - does he relate it to his parents accordinly or just says that repetively? The he should have - stereotypes (play with rope, etc) or fixed behavior (line cars), or strong preferences, which are impossible to change (use same road, etc). Due to last DSM5, he should have 2 of 3 to be autistic plus social problems and communication. And it should be persisting and disruptive.
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