What's wrong with my baby (2.3 years) - speech delayed ..is he autistic?

[Mom2mysonny]

My son turns 2 years and 3 months this end of July (2011). He achieved all his other milestones at about the right time, but his speech is delayed. So much so that he hasn't spoken an intelligible word to this date. He has been waving bye bye for more than a year now, (though he stopped doing it after a few months of learning and now does it sparingly) and he did say bye bye twice over the past 6 months. That's it. When he wants something, he pulls us physically sometimes one body part at a time and makes us stand up (my hubby and I) and then tries to take our hand to that thing .. the usual pointing gesture is missing if you know what I mean. He has average eye contact and though I am pretty sure he hears very well, he doesn't respond when I call his name. Usually he doesn't follow instruction unless it is something about that he wants to do (like some food he loves - then if you say go to daddy he may very well obey .. else he'll just act as if he didn't hear anything). We are having his hearing evaluated soon. He does, however usually dance to his favorite songs ( smiles at the least). If I ask him to clap he wont clap but when he sees the audience clap in the teleshopping programs (those are his favorites and I feel he has them by heart now), he starts clapping.

Now, he is a very friendly boy and loves playing alongside kids (does not play with THEM but plays alongside) and is not afraid of strangers usually. He is also very playful and rather active though I would shy of calling him hyperactive - yet the thought crosses my mind sometimes when he stretches all limits of my patience. He plays with toys in an unusual way in that he usually tries to break everything that gets into his hands and that he sees has some seam or opening that can be pulled apart. He is however not so abusive of his stuffed toys and even presses two of them to his shoulder often and walks around as if he is giving a baby a stroll. Also he tries to arrange some blocks (toy bricks) and does manage to mount two-three of them vertically. He scribbles aggressively .. on paper, bedsheets, pillows, walls, body ... anything.

He runs most of the time and spins around in circles on bed. He sometimes bangs his head on the wall or against our bodies .. usually when he is upset and sometime between play he just lays flat on the ground face up and stares into the space for a minute or so and then gets up and gets to his play. He is very curious and tries every trick in the trade to get to things that have been placed out of his reach. He is a selective eater, though he was eating way-way better when he was around 1 and half year old. Now, he eats lesser than he did then and eats rather selectively too.

Sometimes he tries to dress himself up and is easily able to pull off lose pants. I have not been successful in potty training him yet - though that may be due to my own laziness I believe). Does he sound autistic or does it sound like a severe speech delay? I am in India and we dont have any good evaluation programs where we live. I would love it, if other mother or people with experience share their views. I am trying to get to some good doctors and development evaluators in the meanwhile. I am really worried about when my child will speak and if he will have a normal childhood. I just put him in play school that he attends for 3 hours , 5 days a week.

[FarmerBeth]

I think in your situation I'd have him evaluated all round (pediatrician, SLP and psychologist).  There do seem to be a lot of red flags that could be autism (especially the not responding to name and the way of playing with toys) especially if his hearing turns out to be OK.  There's no way to know for sure until you have him evaluated as best you can with the resources available.  Best of luck!

[PikkuMyy]

I am a behavioral therapist for children with Autism and I do see quite a few red flags in your post. I am going to bold what stands out in your post for me. I think you should look for a developmental pediatrician as soon as possible. The earlier you start any type of therapy, the more it will help your son and your family.

"My son turns 2 years and 3 months this end of July (2011). He achieved all his other milestones at about the right time, but his speech is delayed. So much so that he hasn't spoken an intelligible word to this date. He has been waving bye bye for more than a year now, (though he stopped doing it after a few months of learning and now does it sparingly) and he did say bye bye twice over the past 6 months. That's it. When he wants something, he pulls us physically sometimes one body part at a time and makes us stand up (my hubby and I) and then tries to take our hand to that thing .. the usual pointing gesture is missing if you know what I mean. He has average eye contact and though I am pretty sure he hears very well, he doesn't respond when I call his name. Usually he doesn't follow instruction unless it is something about that he wants to do (like some food he loves - then if you say go to daddy he may very well obey .. else he'll just act as if he didn't hear anything). We are having his hearing evaluated soon. He does, however usually dance to his favorite songs ( smiles at the least). If I ask him to clap he wont clap but when he sees the audience clap in the teleshopping programs (those are his favorites and I feel he has them by heart now), he starts clapping.

Now, he is a very friendly boy and loves playing alongside kids (does not play with THEM but plays alongside) and is not afraid of strangers usually. He is also very playful and rather active though I would shy of calling him hyperactive - yet the thought crosses my mind sometimes when he stretches all limits of my patience. He plays with toys in an unusual way in that he usually tries to break everything that gets into his hands and that he sees has some seam or opening that can be pulled apart. He is however not so abusive of his stuffed toys and even presses two of them to his shoulder often and walks around as if he is giving a baby a stroll. Also he tries to arrange some blocks (toy bricks) and does manage to mount two-three of them vertically. He scribbles aggressively .. on paper, bedsheets, pillows, walls, body ... anything.

He runs most of the time and spins around in circles on bed. He sometimes bangs his head on the wall or against our bodies .. usually when he is upset and sometime between play he just lays flat on the ground face up and stares into the space for a minute or so and then gets up and gets to his play. He is very curious and tries every trick in the trade to get to things that have been placed out of his reach. He is a selective eater, though he was eating way-way better when he was around 1 and half year old. Now, he eats lesser than he did then and eats rather selectively too.

Sometimes he tries to dress himself up and is easily able to pull off lose pants. I have not been successful in potty training him yet - though that may be due to my own laziness I believe"

[Emmeline II]

I think all that could have applied to my ds except the speech delay and though he may be on the spectrum (high functioning Asperger's), he isn't Autistic (ADHD/SPD and related issues). My ds is in a regular school and is at or above grade level in all subjects.

I think seeing an audiologist would be a good place to start. If a developmental-behavioral pediatrician is an option I would do that as well.

[Mom2mysonny]

Glad to know that your son is doing well. I hope my son will also "grow out of it"... I am not actually burying my head in the sand there... I just hope that he gets over some of his interactive-aloofness soon. It's really tiring ... he's not learned any trait typical of a 2 year old in the past one year - I mean his walk is steadier than it was a year back.. his eye contact is better.. he is way more settled and even pauses a while to listen to stuff that I say but he gives no indication of whether he's understood anything or not, nor does he imitate anything much (except for a few dance steps I showed him that he did copy after my repeated tries but again he seems to have given up on them). Other than that, the things I have mentioned above like spinning and breaking toys are much less... in fact he rarely lies on the ground nowadays. He's been to his pre-school for 9 days now and the teacher said that she finally managed to get a response from him (it's such a heart breaker when I see all children interacting and talking and everything). Also, the teacher said that he's trying to engage in play with other children. I am not at all worried about his behavior regarding breaking toys because it is easy to distract him from it by giving him something constructive to do. Even, he can watch television for hours (mostly commercials and teleshopping programs and a few of his favorite songs - mostly no cartoons) .. and he even tries to imitate some activities from the tv ( like clapping, jumping) and laughs of cue. I am getting so depressed with him being autistic (his behavior never struck me as odd earlier unless I saw other children at his school ... I guess I forgot what 2 year olds are like) and I can't get my thoughts straight. Around this time last year my mom was diagnosed with terminal brain tumor (glioma) and we are struggling with her everyday. Now, this added tension is driving me nuts. Is there anything that I can do at home that can make him more interactive with us? Toys, songs .. anything?

PS: I am taking him for a checkout tomorrow to rule out anything pathological (hearing etc).

Thanks all of you for your support :)

Originally Posted by Emmeline II 

I think all that could have applied to my ds except the speech delay and though he may be on the spectrum (high functioning Asperger's), he isn't Autistic (ADHD/SPD and related issues). My ds is in a regular school and is at or above grade level in all subjects.

I think seeing an audiologist would be a good place to start. If a developmental-behavioral pediatrician is an option I would do that as well.

[melissa17s]

My child is not on the spectrum, but had many things in common with your ds. Although my ds has other dx, it does not mean your ds does have any of the same issues.   For instance, ds did not talk until 2.5 and when he did, it was often incoherent.   We had him evaluated by a speech pathologist, who felt he was with in the range of normal.  I wish I had been more persistant with my concerns with our pediatrician.  

To me, all of this is normal "Now, he is a very friendly boy and loves playing alongside kids (does not play with THEM but plays alongside) and is not afraid of strangers usually. He is also very playful and rather active though I would shy of calling him hyperactive - yet the thought crosses my mind sometimes when he stretches all limits of my patience."  I can not say that I have really seen 2.5 yrs olds play together; it is always along side unless coordinated by an adult. 

 "He plays with toys in an unusual way in that he usually tries to break everything that gets into his hands and that he sees has some seam or opening that can be pulled apart. He is however not so abusive of his stuffed toys and even presses two of them to his shoulder often and walks around as if he is giving a baby a stroll. Also he tries to arrange some blocks (toy bricks) and does manage to mount two-three of them vertically. He scribbles aggressively .. on paper, bedsheets, pillows, walls, body ... anything."  Kids dexterity at that age is poor, but they are curious and more prone to break things or in the least play with them in multiple unconventional ways.  It is an innate human desire to make marks especially when we are young.  In fact, no matter what culture or language children speak, they make a similar progression of marks that eventually lead to the ability to draw and write. http://www.learningdesign.com/Portfolio/DrawDev/kiddrawing.html  Kids will mark on everything until you give them boundaries. 

OP, after the hearing evaluation, I would recommend talking to your ped.  They can tell you whether or not your concerns are issues or age appropriate.  They can also send you to specialists for the things that are issues and need to be evaluated.  

[Linda on the move]

He's barely 2, and the most concerning things listed could all be caused by a minor hearing problem, such as chronic fluid in the ears.

Nothing in the post screams "autism" to me. Lots of kids spin. It's normal. Lots of kids take things apart. Many small children are picky eaters.

Not everything is autism.

My advice would be hearing check with someone good with small children, and speech therapy.

I would also try to include lots of active play for him -- swimming, swinging, etc. All little kids need to move, some more than others!

[Mom2mysonny]

Originally Posted by Linda on the move 

He's barely 2, and the most concerning things listed could all be caused by a minor hearing problem, such as chronic fluid in the ears.

Nothing in the post screams "autism" to me. Lots of kids spin. It's normal. Lots of kids take things apart. Many small children are picky eaters.

Not everything is autism.

My advice would be hearing check with someone good with small children, and speech therapy.

I would also try to include lots of active play for him -- swimming, swinging, etc. All little kids need to move, some more than others!

I did go to an ENT specialist today, but he advised me that if I have any feeling about his hearing not being good enough I could get an auditory test done .. I have absolutely no doubt he hears well .. reason - he is drawn to the smallest (faintest) sounds .. sometimes even in his sleep but his unresponsiveness is related only to our calling his name and then he'll not look back or at us ... meaning that if he's up to some mischief and I call out his name sternly he will laugh and run off but he's just standing there at the same distance and we call his name, he will seem like deaf.. most of the time there is absolutely no response .. but sometimes when I say "Baby, come here" he'll come running (he used to respond better to that too when he was a bit younger). He responds to the faintest sounds of his favorite songs and commercials. So, in a nutshell, I feel pretty sure it is more of a behavorial issue... so I did not get the auditory tests done... I guess it's fairly easy to evaluate at home when the child doesn't respond to faint sounds and/or distant sounds. I have not seen my son having any such issue, except that he usually does not respond when called.. even if I call out very loudly.

The doctor evaluated his condition and termed it as ADHD with a very very mild case (may not even be present) of autism. He said his verbal understanding is that of a 5-6 month old child and it may take a year or two for him to catch up. If the autism is missing, he may get there sooner. He did suggest some activities which I'll try to start soon as I get some necessary stuff for it. Meanwhile I can begin with getting him to categorize onions and potatoes. I doubt he'll sit long enough for that.. but if he does his attention skills will improve. I am sure once that happens he'll begin picking up things faster.

Yes, I agree that almost all of the above correspond to all other kids. I know. I have 4 nephews of different age groups and all have had some tendencies that correspond to autism or asperger's and they turned out to be perfectly normal - one had difficulty learning in first year or two but he "grew out" of it. Another was very uncommunicative but reached all his milestones on time and had few words at the age of two .. now he's friendly and really brilliant at school and comparitivity friendly and very talkative. I won't say they had any of the disorders because I think that all children have some "quirks" and as long as they are average and normal in all aspects these little things don't matter.

However with my ds, I am having a strong feeling that somewhere something is wrong and no, I am not overreacting ... in fact I am underreacting .. I waiting for 2.3 years before actually posting a question about it and it's  really distressing to see that he doesn't follow instructions as simple as "pick this up" and is unresponsive to everyday communication and talking ... is that normal? I wish somebody would say yes!! :(

He's supposed to begin his speech therapy on Monday and the therapy will mainly be directed at making him pay attention first. I hope it will help him gain something in terms of understanding of words and his surroundings.

I cannot begin to express how grateful I am of the help and support you guys are offering here. I cannot discuss these things too freely elsewhere and my hubby does not seem to be taking this too seriously (though I feel he is more concerned than me since he is really attached to the child) . I would appreciate any all advice or personal experiences that you guys can share.
 

[Mom2mysonny]

Originally Posted by melissa17s 

My child is not on the spectrum, but had many things in common with your ds. Although my ds has other dx, it does not mean your ds does have any of the same issues.   For instance, ds did not talk until 2.5 and when he did, it was often incoherent.   We had him evaluated by a speech pathologist, who felt he was with in the range of normal.  I wish I had been more persistant with my concerns with our pediatrician.  

Hey melissa17s, I would also like to believe that my son is normal. Like you said your ds did not talk until 2.5 .. is he okay now? I mean how old is he and does he talk well as per his age? How is he doing at school?

[melissa17s]

Originally Posted by Mom2mysonny 

Hey melissa17s, I would also like to believe that my son is normal. Like you said your ds did not talk until 2.5 .. is he okay now? I mean how old is he and does he talk well as per his age? How is he doing at school?

Yes, ds did eventually talk clearer and has developed a larger vocabulary than many of his peers.  Our ped. was not concerned when he was young, but after a year of preschool with they requested we seek the speech pathologist at age 3-4. Kindergarten teacher felt his confusion with words and lack of clarity in his speech was normal for kindergarten. He had difficulty with letters, sounds and reading in early elementary.  At the end of 3rd grade, his school had and intervention because reading and writing were not happening with ds.  When ds started summer school he had a clonic-tonic seizure (grand mal).  He has epilepsy.  Most of his seizures occur in his language center of his brain, and the are silent and he is no responsive for a series of seconds.  As a result of the epilepsy and the intervention, we took him to a psychologist, who did a neuropsych exam.  From this, she dx him as adhd and dyslexic.  He will go into 5th grade this year.

I think your ped needs to give you referrals to people that are specialized with brain processing and early intervention, if he feels your ds might be adhd or autistic- both of which are generally dx when kids are a bit older and by specialized practitioners.  Its very disheartening to find that they might also suspect an issue, but are not helping you pursue treatment.  My ds goes to psychologist to work on behavior and social issues related to adhd.  He works with special ed teacher at school for reading and writing.  He goes to occupational therapy for writing (she also helps with reading and has talked some to us about sensory issues).  He sees a neurologist, who gave us referrals to the psychologist (would have also considered a psychiatrist) and o.t.