Please Help - 2 yo, Poss AS, to be Evaluated Next Week

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I am the NT mother of a 4 yo NT son and a 2 yo son who may be presenting behaviors from the AS. As such, I thank you so much for sharing your lives and experiences in this forum. You have already helped me so much! Having said that, I really could use your help and thoughts on my younger DS.

About four mos ago, I took my younger DS to Early Intervention (EI) due to speech delay concerns. By way of background, I went back to work when DS was 4 months old and got buried with it. I now feel like I neglected him because there are so many things I didn't get to do with him that I did with his brother. I later found that his baby sitter wasn't doing what I asked to teach him. Also, we had his baby sitter speaking to him in Spanish only. We later found that she spoke to him in English sometimes and sometimes in Spanish (language confusion?). Don't know if this had an impact, but I'm writing this to indicate that we thought his speech delay was due to environmental factors (i.e., mommy messed up - royally).

I left in complete shock after the evaluators identified delays across a number of areas including language/speech, cognitive and social areas. Basically they said that my then 20 month old was behaving like a 9 month old with scatters to 18 mos.

Here is what I have noticed.

Language: DS has a lot of words in his vocabulary. I was looking for the 50 word benchmark which he hit. However, his 50 words included the numbers 1-15 (doesn't actually count, but says the words often - if you say six he'll begin counting from there) and some letters. When I cut the numbers and letters out, I wasn't sure he had 50 words (counted about 20) so I took him to EI. DS rarely used/uses his words pragmatically to get what he wants. He usually begins whining or gesturing (doesn't point - more a whole handed gesture) in the direction of what he wants. For example, DS knows the word banana and often says it when he sees one. However, if he wants a banana, he whines and gestures. However, he does say "hello" and "hi, how are you" at least 50-60% percent of the time and answers correctly (okay maybe not grammatically) with good . He says things like "Mommy, are you happy?" which he has heard his brother say, but he also alters the phrase to "Mommy, are you come?" when I come in the door from work and sometimes says "I want" (not remotely consistently). He babbles real words and songs that we have only begun to understand. He answers to his name selectively.

Eye Contact: He makes good eye contact much of the time. When we watch a favorite TV show like Baby Signing Time, he looks at me or his brother and smiles in seemingly shared enjoyment of the moment. When he is upset or happy, he stares right into your eyes to fully communicate his feelings. I have watched this closely to see if he's really looking at my mouth. However, there are time when he just won't look in my eyes. Since, I'm overwhelmed by the potential diagnosis, I find myself trying to get him to look into my eyes. Last night, when he woke up for milk/water (yep, he still does that - we're working on it) I could not get him to look in my eyes. When we catch him doing something he shouldn't and say "no", he covers his eyes. Always assumed he was hiding. Could this be something else?

Stimming: We don't see any obvious stimming. The only thing that I can think of is that he is a hair twirler. We keep his hair short so that he doesn't pull it out. Instead he strokes and likes to hold onto my hair and his baby sitters hair. Occasionally, he will run in a circle, but this is very rare and he seems to be imitating his brother. One laughing fall to the ground and he's done. I don't think this is stimming - yet.

Physical Contact: He is very affectionate with me, his babysitter, and grandmother (all of whom live in the same house). He is not particularly affectionate with his dad (who lives with us too). I have always thought this was because his dad "treats him like a boy" with slight rough housing and DS prefers a gentler touch. He "speaks" to his brother, plays near him, and they sometimes rough house together. He will not let his brother hug him (may think there is an alterior motive like taking his toy - to be fair, usually there is)

Sensory: He is a toe walker. He can walk flat footed, but lately prefers toe walking almost exclusively. His brother was big on toe walking too (still does so at home) so we've never worried about it until now. He is a drooler, but his brother drooled until he was at least 2.5 years old. Lately he has been bothered by how some clothes fit around the arms and ankles. We've noticed some allergic reactions on arms and legs (itchiness and bumps) so we're not sure of whether this is heightened senses or reaction to itchiness

Obsessions: He doesn't seem to have any obsessions - I think. He loves letters and walks around saying the A says aah. B says buh etc. We have tons of leap frog products including the videos, refrigerator toys and computer games that he plays so it could be that he does what's been greatly reinforced? He plays with toys regularly (makes vroom sounds and drives cars, says choo-choo and plays with trains, etc.)

Playing with Others: We have a bi-weekly play date with a same age friend. DS is excited when friend arrives, but doesn't play with him. Still normal parallel play? If the friend plays with something of interest, he will try to take it. He watches his big brother play with older friends and joins in for car races, but not preschooler bowling. He showed interest in a fishing game his brother and friend were playing and stayed fully engaged to play it with my help (4 yo toy so he needed help - without me there, he would have played the game inappropriately based on his age, but probably still would have tried to play until chased away.). At the park, he walks up to the play house and says hi, how are you. He stays for about a minute, runs off to do something else, and comes back.

Okay so here are my questions:
1) Does this sound like an ASD to you? We have doctors (his ped and family friends) telling us that "we'd know" if it was autism. My husband is very skeptical that our son could be different. I feel alone and emotionally exhausted.
2) How do I handle the doctor evaluation? Since so much of the evaluation is based on mommy reporting, I'm worried that I will incorrectly bias the evaluation and get an incorrect eval.
3) I've already got an IEP for 5 days a week, 3 hours a day for the next school year. I'm worried that I'm losing time until the school years starts. The Infants and Toddlers "Special Educator" who teaches the family how to teach DS is nice, but we need real help with the teaching task. I feel like his window for significant improvement is closing (teaching most effective to 3 yo?). How can I find a teacher or class that we can attend now and over the summer.
4) Why won't/can't my baby talk? He has the capacity to say words. We have heard him. He even understands what he is saying (he says excuse me when he belches, has said open when he wanted a door opened). He sings grace at dinner though his articulation is not clear (maybe the prolonged bottle-like sippy cup use). This is the toughest thing for me to understand.

Okay, I'm sorry for the tome. I'm just overwhelmed and researching/asking/acting is better than crying. Right?

Thank you in advance for your help

I'm going to jump straight to the questions.

1) I think it's bunk that you would "know" with a 20 month toddler if it was autism, unless you were talking lower functioning. My son is high functioning Aspergers and NO ONE would have picked it out at 20 months. Yes, there were signs, when one looked backwards, but it was far from obvious. Those signs could have meant any number of things, and I'm rather glad to have experienced that 10 years ago, before autism panic set in among young parents. We were blessed with people who told us to enjoy him and to take the time to get to know him as he was. Which was clearly "different," but in what way no one knew; most kept telling us we had a genius on our hands. He was (and is) affectionate, he met all his language milestones, he loved being around other babies (parallel play, really - or him pushing himself on them and them ignoring him), he was highly social, and he enjoyed staring into our eyes. But he also entered intense stranger anxiety much earlier than most kids, and much more intensely, scared off about a dozen potential caregivers, and stopped napping by 18 months.

2) Just be as honest as possible in the evaluation. You aren't looking for one answer in any direction; you want to know as accurately as possible - which isn't that accurate to start with. When you get the right evaluation for you, it will make sense; the pieces will add up. That is how most of us felt when we finally got to Aspergers; it seemed to fit in ways nothing else before really had.

3) What your child needs most at this point in his life is one on one interaction. It doesn't need to be with a professional. In fact, someone who loves him and enjoys his company will probably help him feel most at ease, and simply being at ease will help him progress. You need to make sure someone is talking and engaging with him on a regular basis. Nothing more, nothing less. Most therapies being used were developed first by parents doing what comes naturally with their toddlers: engaging with them in play and conversation.

4) It is hard to know why. But we do know that worrying over it, or pressuring him, probably won't change a thing. In days gone by, and not that long ago at that, it was considered perfectly within the range of normal for a child not to speak until age 3 or 4. People understood that some kids simply were like that. Very, very few of those turned out to have severe autism that kept them from ever communicating, and it is of the course the fear that it is that rare case of severe, non-verbal, autism that has young parents worrying. But keep it in perspective: the numbers that turned out to be life long non-verbal were so small that the common person wasn't aware of the possibility at all. We all just knew of kids who were like that. What people looked for then, and should now, IMHO, are signs that the child is engaged in his world. It doesn't matter if he communicates in his own unique way; you can tell if he is engaged, v. totally separated. Theories as to why a child capable of speaking might not include:
- The perfectionist. This was a dear friend's child. He didn't want to verbalize until he had it all perfectly correct. He went from never speaking (but pointing and motioning quite effectively) at age 3 to full, perfectly articulated sentences right around his 4th birthday.
- Having trouble separating inner and outer life. One autistic child once told his mom, about his non-verbal years, that he thought he was talking, and couldn't figure out why no one ever heard him.
- Sensory issues. Some adult AS who are mostly non-verbal have posted that speaking bothers them. The whole sensory aspect of it. How it feels, how they hear it.

No one here can tell you if your child is AS or ASD, but if he is, he is still your little boy and he still has gifts and joy to bring. Spend time with him, care for him, love him, get to understand what makes him tick. That s what any toddler needs the most.

On more of a side note, I'm not that concerned about the baby sitter situation. My son's nanny spoke a total mix of Spanish and English to him, and he learned some words first in Spanish, and others first in English. We would clarify it for him by, for example, when he asked for "pan," asking back, "you would like some bread?" We didn't make a big deal of it, and stayed consistent in which language we used. Sometimes we might also say something like, "your Spanish is very good! Yes, zappatos is the word for shoes in Spanish." Since he only had the nanny until he was 2, he eventually forgot all his Spanish, but the sound connections are all there, which was the whole point, anyway. When he took a Spanish class in 4th grade, his teacher said to us that she was amazed by his pronunciation.

We have many, many kids around here growing up hearing a total mix. While having language identified to one person certainly keeps things much clearer, and aids the multi-lingual development, kids seem to be pretty good little sponges at those ages, and while having the people around them mix languages might slow things down, from what I've seen the children do figure it out.

I wouldn't beat yourself up over it. You've given your child the gift of the sound connections, and if he has speech problems, I doubt the language confusion is the reason.

Thank you so much for the insightful comments. You have been a life saver (or at least a sanity saver)!