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Is my two year old autistic?

Hi I have a 25 month old happy boy. I am meeting with pediatrician and speech therapist shortly, but in the meanwhile I am worrying a great deal about him.

My boy has always been a picky eater (unlike his older two brothers who are not ASD). Up to 18 months he hit all of his milestones. But he began to slowly cut items that he would eat (I homemade healthy foods for him), until yogurt and peanut butter and jam sandwiches, and breastmilk were left. He goes on food strikes if I don't give him what he wants. Because he is now measuring at the 15th percentile for weight and 50th for height, I have added pediasure to his diet. He is very difficult to feed and refuses all other food, sometimes only taking yogurt with hidden fruits.

My second major concern is my boy does not speak. He used to say a word or two, but I am not sure he ever understood the meaning of these words. I cannot specifically say it is a regression, more of a non-progression. He is an avid babbler and seems he is on the verge of speaking...but still, no words. His brothers were late bloomers and began talking around 22 months, (admittedly only a few words) but NOW these older two are racing ahead in all social and academic areas. But this little guy, he doesn't say one coherent word yet.

The thing that throws me off with autism, asd, and potentially sensory processing disorder, are the following facts:

My boy is extremely happy, makes perfect eye contact, and is affectionate. He initiates play. He brings us balls and toys and shows us what they do. He is a hugely interactive, he has adorable laugh attacks and loves back and forth play in anything: rolling balls, throwing balls, etc. I think he plays pretend? He sweeps the floor and puts on glasses on his head, and brushes his teeth. He knows how to play with toys correctly. I have yet to see any lining up of toys, repititive behavior, or any concern for routine. He loves his three hour nap (time of putting him down doesn't matter). He has never been a fussy baby. Zero temper tantrums (unless you cajole him to try a food he hates, which is anything that isn't sweet. Then he cries and pushes you away, but mildly. He basically won't open his mouth and squeeze his eyes shut willing you away). Zero self-soothing behaviors, mild flapping of arms when he is excited (which both his brothers do when they are excited). No rocking, stimming, etc. He sometimes covers his ears in anticipation of a loud explosion on his favourite television show, or when I put on a blow drier, but he is most always grinning when he does this.

He is the happiest and most go-lucky of all my boys. This kids laughs for days. He even gave the last doctor I saw a highfive on prompt. If I seem upset I feel like he understands. He comes, gazes into my eyes and softly caresses my face. But he doesn't understand language or commands. He will come if you call him, and run to Dad or Mom when they come home, and run to hug his brothers when they come home. He plays at playgrounds, climbs things (not recklessly) and I think he knows how to play with other kids. In any case he likes to be around other kids. If his brothers are watching minecraft, he is with them. If they are playing Lego, he sits on the center of the table and pretends to do as they are.

But he can't understand a simple command like "go get me the ball". Unless you are holding the ball right in front of him. And yes, he has had his hearing checked. He knows who Mom and Dad are, and will check to make sure we are near and miss us when we are gone.

I know we are getting specialists to look at him. But sometimes I wonder if we are barking up the wrong tree with asd? I don't know enough about it, and I know it is a spectrum. It seems play and social he is doing very well. I can't nail down a single obsessive behavior. However, his only method of communicationating his needs is he pushes us towards the thing. Or he will open his arms to ask for "uppies". Or if I do "Wheels on the Bus" he makes me do the actions by manipulating my hands with a huge smile on his face.

Does any one have any idea at all what could be wrong with my little guy?

2 Responses
973741 tn?1342342773
Hi there.  First let me say that you sound like a terrific mom.  I love how in tune you are with your kids and how hard you are working for their sake as a mother!  My older son has sensory processing disorder.  Autism does seem unlikely with the social skills that you mention.  But 'something' is possibly going on.  I'm less concerned about his lack of speech than I am about his lack of understanding.  That does sound a bit like processing to me.  Sensory integration disorder can look very differently from child to child.  

The eating issue.  My son has motor planning difficulty and therefore, choked on things like cut up meat or anything he had to really chew.  This left an impression early on and he avoided meat for a very long time.  He had 'gag memory' which means that things he previously had choking/gagging with caused him to immediately gag when put in his mouth when he tried to eat it.  He also has texture and temperature sensitivity and whew, smells.  He won't eat ANYTHING mixed like a casserole which cramps my mom cooking style.  :>)  He's gotten better.  We worked with our occupational therapy and an eating specialist on it.  A good book for this is called "Food Chaining".  It goes through a process of introducing foods.  My son is a better eater now.  Still won't mix his food.  I made chicken in red sauce over pasta last night.  But I sautéed the chicken breast for him in soy sauce and gave him noodles with parm. cheese on the side.  So, he doesn't always eat what the rest of the family eats but he's getting closer.  Try the book and keep at it.  

Now, I'm glad you are having your son evaluated.  My son, to be honest, was pretty happy at home, no major meltdowns, etc. until he started preschool at almost three for 1 half day a week.  That stressed him. He was out of his comfort zone.  And that is when the traditional regulation problems and behavioral issues you read about when discussing sensory processing disorder surfaced.  Does your son do any type of thing like that outside the home yet?  I'd highly recommend it as preschool is a good place to learn important things about your child's coping skills.  I'm not into preschool for all the academic stuff people get hyped up on---  but the social aspect and acclimating to new environments is very valuable for development.  

When you say your child has good play skills with others---  can you describe that?

I'd keep working on simple commands with him.  Keep reading to him, speaking slowly to him and make eye contact when you do it.  There is a cd that I really liked that helps called Speechercize.  I got it on ebay.  It's very fun and basically is exercise for the oral motor function.  Moving the tongue around, face, etc.  and making sounds.  

What kind of specialist is evaluating your child?  we saw an occupational therapist and the first time, they weren't sure.  Second time we had him evaluated, there was no doubt.  On any of our parts.  :>)  He then did occupational therapy for SIX years.  But oh my gosh, so worth it.

Just to update, my son is 12 and a straight A student now, plays trumpet in band, plays sports on competitive sports teams, has a circle of friends, etc.  He functions really well after working through the difficult preschool and early elementary years.  He definitely is a sensory kid still but has learned how to handle it.  

I'm here to help any way I can.  good luck
Hi SpecialMom,

First of all, I can't thank you enough for reaching out to me. I just can't find anyone else who has similar issues to my son, and I have been desperately searching for answers. I will inbox you so we can keep in touch. I'll post publically on here should any other mom have the same issues as we do.

Second of all, I am ECSTATIC to hear how well your son is doing. How wonderful to hear. How lucky for him to have such a loving and supportive mother!!! Such hope your email gives me.

My son's sensory issues are only, so far, centered around food. He will gag or rub his tongue off any other food that I offer - apart from the ones he likes. Even the ones he likes, he has to be cajoled into eating.

His older brothers: 4 and 7, are huge fans of food. Any food! I homecook most meals, and my other two eat anything from curry to sushi. Sometimes baby holds a french fry to copy them, but he won't eat it.

I am hoping their good eating habits will rub off on junior.

He is too young for preschool, but a few months back, when he was 21 months (not 25 as he is now) we went to Calgary. He was very clingly and wanted to nurse 24-7. He food striked even his favourites. He only nursed for three days!!! He was ok once in the water park, though. He loves to play. Once he got home, everything was back to normal (normal being the rotation of the then 5 or 6 foods he at that time accepted).

So perhaps, you are onto something with SPD. He isn't fussy with ANYTHING else, although, I have paid attention to him covering his ears. He does this whenever he doesn't like sound or is interested in tuning something out. (ex: hair dryers, water running, etc). He isn't too disturbed beyond that.

Playing: He loves music, tries to copy brothers on piano. He makes me "pretend" to drink from empty cups and drinks himself, etc. He plays with all his toys: mows his lawn with the toy mower, stacks things, etc. He is especially fond of back and forth playing ball. That is hands down his go to game. He is reciprical in all modes of play.

He has good concentration with movies, so it almost? seems like he comprehends things. He can sit through "Curious George" movies or "Toy Story", etc. He laughs at the funny parts.

He doesn't understand any language besides extremely direct comments, that are made RIGHT in front of him (give me THE BALL). He has to see the ball.

My questions for you:

1. What age did your son speak?
2. Did he go to school on time? (I can hold my son back he is a November baby and I am a teacher by trade, not practising).
3. When did he start eating better? (I would die of happiness if my son ate a "veggie" chicken breast....he eats nothing. (we are vegetarian, but I started giving him fish oil to help with speech as I am worried).
4. What age did he seem like he was one of the other kids? Example: when did he blend in? My two year old is very behind.
5. Does my child have a chance to catch up? He doesn't speak at 2 or comprehend much.
6. What are the longterm effects if it is SPD?
7. Is it only food you have to worry about with your son? Does the SPD transfer or start to transfer to other areas (I know each case is different but it seems our guys are somewhat alike).
8. Did your guy as a baby only eat a few things? Mine only eats sweet NO SAVOURY.  

Our current steps:

1. We are meeting with a peditrician on January 16. He works for Children's Hospital, so we are very lucky. They want to rule out any medical reasons before we look at anything else. Of course I plan to look at speech therapy and OT once we meet with him. I think they will automatically get the ball rolling on this.

2. We are researching as much as possible to aid our guy.

Thank you and sorry to bombard you with a thousand questions.

973741 tn?1342342773
Hey there, glad you came back.  So, with speech---  there are three parts that all need to work for communication.  Receptive (taking in the words someone speaks to you, organizing them in the brain, making sense of them, understanding), Expressive (taking your own thoughts and organizing them in the brain, making them into something that makes sense, knowing WHAT you want to say) and Articulation (actually making the sounds to say the words).  All three are equally important and if something is wrong with one area, speech is impacted.  Sounds to me that perhaps your son has issues with one, two or all three of these areas.  This is really important to address with a speech therapist. We went to Children's Hospital in our city and met with a PHD speech therapist to evaluate our son when he was 3.  

My son did talk and understand simple commands.  He left the middle part out of words though and it could be garbled.  Overall, the therapist rated him 'close' to within normal and thought it would improve on its own and it did.  I worked with him myself with the speechercize cd's that I got on ebay and having him watch my moth when I talked, etc.  He never had speech and this came together for him.  But with the communication issues you describe----  I do believe this is something you should address sooner rather than later with a therapist.  Kids sometimes don't speak until a little older but they are pointing and 'expressing' and understanding in other ways than words.  

If you put juice, milk and water on the table and tell him to pick what he likes to drink---  would he understand that?  I'd start trying things like that more and more.  Push a little to help him start communicating.  

We did preschool when he was 2.9 months old for one half day a week (well, two and a half hours).  Then the next two years we did 2 half days a week until it was time for kindergarten. We were at a preschool that worked with us and his developmental delay and he did private occupational therapy.  When it was time to go to kindergarten at 5, he did go on time and without an aid or !EP plan.  He did eventually get a 504 plan.  If you don't know what these are, I can tell you.  

Your older kids eat better than I do.  LOL  You've done a great job with their eating habits.  Do try the 'food chaining' book I mentioned.  It's a great way to introduce food.  My son has been slow going with food. But he currently will eat a balanced diet.  He refuses to this day to eat many things based on texture or if it's 'mixed'.  He most likely will always be a picky eater.  But he is not alone.  so, I'd strive to have your son eat a healthy diet.  Some kids with autism will eat very few items.  It's an ongoing challenge.  My son with his sensory issues is more willing to grow what he eats than that.  We can go to a restaurant and always find something he likes.  
Hi Special Mom,

He definitely has language delays in all areas. Cognitive delays are apparent as well because he can't follow easy puzzles and shape sorters. He doesn't respond to his name, point or gesture. He has, I see this now, regressed in speech. He did lose his words. He only eats two things or a few. He tested for low iron.

I am not sure he will get ASD label because he lacks any drumming, repetitive behavior. His fine and gross motor skills are shockingly high. He does share in joint interaction. He has eye contact.

All of his areas of struggle seem centered on communication. Maybe he has speech and language impairment.

I don't know if he can get ASD label without behavioral issues as he doesn't engage in temper tantrums or fussiness. I leave him in childminding occasionally to run, he fares fine. He likes other kids.

On February 27 I am beginning to deal with a private clinic. They can formally diagnose him. He will be a tough case to crack. I have heard mild autism maybe from both pediatrician and doctor. Both also said he may also grow out of this since he doesn't have classic autistic signs.

I am more on the path of early intervention, so I will get him the help now. It seems now that he isn't as much like your son as I'd originally hoped.

Thanks and please share your thoughts.
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