Newly diagnosis some questions

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Hi, I've been browsing through the forum for a couple of weeks. But still have some questions that I believe the experienced parents can help me with.

My son is 3 year 4 months, diagnosed by a developmental pediatrician in mid April, one week after my daughter was born...

Now looking back, he reached physical milestones on time: sitting, crawling, first words at 8 months, walking by 12-14 months. However, his speech & language didn't develop much until last summer when he was 30 months. Before that, he usually pointed to everything and looked at us and made the sound "en?", but he rarely repeated after us.
We thought that life might be too boring for him and he felt longing, so we started taking him to the early year center and attended as many programs as possible since last summer. He started saying A-Z, 1-10, colors, shapes, etc. We saw a private SLT for 9 sessions since last fall and he started coping our words and simple mandings for food, drink, certain activities, etc. On 2 April this year we finally saw the public SLT for assessment, she mentioned some red flags of ASD at the end of session and my head exploded. We soon made the appointment with that developmental pediatrician and she diagnosed him onsite 2 weeks later.

We thought he was only delayed in speech & language because: 1)bilingual (Mandarin at home, English only for videos he likes and at the early year center), 2) he is a quiet/shy boy (like his father) 3) he always appeared to understand everything we said (now we know he doesn't except for 1-2 steps instructions...) 4) no family members up to 3-4 generations had any related problems so we were really not alerted. 5) Sleep soundly alone in an adult twin bed since 2 year old (both afternoon nap and evening). 6) Not many sensory issues or much of obsession to routines (So far).

Autism traits he displayed before diagnosis:
1) he threw wood chips at playground when he was 1.5 year old, saw a girl did that, then he started doing that (now stopped).
2) he likes open-closing doors and sometimes self-stimming (we didn't know it's self-stimming...).
3) self-stemming: he stretches his arms (downward) and stomps when he is reading some interesting books or playing some toys he likes.

We sent him to a regular daycare full-day and 5 days from May 1st as doctor suggested. And he has been coping well. Didn't cry from day 1, started full-day and afternoon nap from the second week. Following teacher's instructions, plays at the playground, ride tricycle, started going to washroom with other kids and peed (not pooped yet). Eating by himself (not very skillful with spoon/fork but he is learning).

Autism traits he displayed after diagnosis:
1) a new hand gesture when running and self-stimming.
2) a little toe-walking (1-2 seconds).
3) doesn't speak in daycare.
4) likes touching other kid's face or arm to show his affection.
5) cries (without sound) when other kids try to play his toys or take his stuff (e.g. bag).
6) doesn't appear to have working-memory (never answered the question like "what's for lunch?"), has no concept of yesterday-today-tomorrow (I bought a magnetic calender to help)
7) again severely delayed in expressive language: only says no+echo our question in Mandarin (e.g. No eating, no pee, not going to bed, etc.)
Coordination problem: weak arms and hands (he doesn't rub his hands like us when washing hands, can't zip-up/down clothes, pull-up/pull down pants properly)
9) Doesn't blow bubbles (doesn't know how to blow)

I enrolled program on Autism & behavior science in a college, hoping to help him as much as I could.

Last week, we received the call from Surrey Place (we are in Toronto) saying he is not eligible for the government-funded IBI. But suggested me to keep him in the regular daycare among NT kids as much as possible. But as a mom I know my son needs help, spending 8 hours in that daycare is not helping him enough, he might slip further away when he goes to Kindergarten next year.

I have some questions for the experienced parents and other members here:

How many hours of IBI might he need? (we are self-funded, and I don't work. I was planning to pursue a job as data analyst after the birth of my daughter, but now I'm fully occupied by the ABS program)
Do we incorporate OT & SLT into IBI program or do them separately?
Do we have to switch to English at home? (Our English is okay but definitely not as good as native)
Is he going to develop more sensory issues as he grows up?
Does my son have the sign of developmental delay (mental retardation)?--lack of working memory and understanding of abstract concepts, can't tell a story when reading the book, instead, he labels the objects in the book.

It breaks my heart thinking he might be mentally challenged. He has beautiful eyes and smart face and I always thought what have I done to deserve such a boy. I can see him as a quiet, friendly, and kind boy with/without autism.

J

It sounds like your son has some language, minimal social challenges, and motor challenges. This does not mean he is mentally challenged. ASD is a medical issue (sensory and immune issues) who's symptoms are called a mental illness by those that do not understand. ASD is due to a combination of multiple immune genes that present a immune sensitivity, brain architecture genes that shape how that sensitivity will be shown, and exposure to environmental stresses. These genes are normal genes in that they exist in a large portion of the population for 100,000's of years. They provide benefit in some environments and challenges in others. If your environment is different than your family has had for generations, then the genes could exist but sensitivity not show. Say heavy metal toxicity. If metals were low where your ancestors lived, but are high were you live now, the sensitivity show for the 1st time.

It sounds like he might be mostly sensory under-responsive (with a combination of insensitive and seeking).

Bilingual is fine, as long as both languages are spoken or practiced at home.

Has he had allergies, GI problems (including diarrhea and constipation), multiple ear and eye infections?

I would push your doctor to better understand his upper-body motor issues, and get . Does he run and jump and dance? How is his stamina?

Because he has an diagnosis, I would push your doctor to get a formal assessment of his language, motor, sensory, social and executive function needs. Seek Parent Implemented Intervention training. It has been proven to be the most effective for kids, birth to 9. Then have your doctor arrange professionals to help define an at home program aligned to his needs. Then periodic professional "evals" to see if the program needs to be changed.

Hi, many thanks for reply. My post is really long...

1. He has no GI issues. (just having hard time doing it on the toilet)
2. No eye/ear infections.
3. He might have some mild allergies to something (my husband is allergic to shellfish/shrimp, I'm sometimes allergic to shrimp), we haven't figured out yet. He sometimes has rashes (itchy) around his neck, on hands, and on the back or on the legs. I guess he might be allergic to dairy--there're several times he got rashes after he poured milk on his clothes in the daycare. He doesn't like it anyway, not even the ice cream. From the beginning we didn't provide snacks/sweets/ice cream/yogurt/juice at home, since our grandparents have diabetes.
4. He can focus on one thing for 5-10 minutes. Can play mega block with me for 30-45 minutes.Stay in the swimming pool for 40 minutes.
5. Jumping (both feet), climbing, running are okay. Recently practicing bicycle, seems doesn't know how to use the strength of his legs on pedelling.
6. He likes certain songs but cannot sing. He can fill in the blank/rush through the entire lyrics, but without rhythm. Basically just "say" the lyrics. My husband has poor sense of rhythm, ironically I'm very good at it.
7. We'll see the dx doctor on thursday, will ask for more detailed and regular assessments down the road.

J