Hello! My Son Is 20 Months Old. He’s A Healthy
My son is 20 months old. He’s a healthy boy, he walks and eats normal but he’s a little bit slow on his skills development such as talking and understanding commands. He has been evaluated by a specialist and they said he needs some therapy in order to help him develop his skills. I have been worried a little bit about if he has autism so I wanna describe to you his situation and see what you think about him. I know it’s not the same as seeing him in person to evaluate him but any advice would help. I wanna start with the stuff he's not good at and the stuff that worries me the most and then tell you the stuff he's good at.
So he is 20 months old. He doesn’t say any words yet, he doesn’t respond when we call his name and he doesn’t point with his finger when he needs something and he doesn’t understand yet when we tell to pick up something or bring us something. He copies what we do sometimes but not all the times, he used to clap back when we clap but he doesn't do it very often. And he doesn't waive with his hand when we waive at him. When I point at something with my hand and tell him to look at it, sometimes he looks at what I'm pointing at and sometimes he doesn't.
But on the other hand he likes playing with other kids. He loves playing with me and his mom. He smiles back when we smile at him or do something funny for him. He loves going to the park and play on the swing and the slide. He's not sensitive to noises or smells or lights. And he's not sensitive to food. He makes eye contacts most of the times when we are playing with him, sometimes he doesn’t do it as we want him to but overall I think his eye contact is acceptable, and he notices when some stranger comes to the house. He follows me and his mom when we go to the room or the kitchen. He gets so excited when we take him outside. He doesn't spin around himself or walk on his toes but sometimes he makes some movement with his hands similar to flapping only when he's running, or excited or when he's upset but he doesn't do it constantly. He doesn't cry a lot or and he doesn't try to harm himself or hurt other kids. He's a very sweet boy with other kids and with me and his mom. So pretty much he's good at everything except the talking part, responding to his name, pointing with his finger and understanding commands and waving with his hand and the similar to flapping hands movement sometimes. From what I described above how do you evaluate my son and do you think from what I described that it could be a sign of autism?
Thank you
My son is 20 months old. He’s a healthy boy, he walks and eats normal but he’s a little bit slow on his skills development such as talking and understanding commands. He has been evaluated by a specialist and they said he needs some therapy in order to help him develop his skills. I have been worried a little bit about if he has autism so I wanna describe to you his situation and see what you think about him. I know it’s not the same as seeing him in person to evaluate him but any advice would help. I wanna start with the stuff he's not good at and the stuff that worries me the most and then tell you the stuff he's good at.
So he is 20 months old. He doesn’t say any words yet, he doesn’t respond when we call his name and he doesn’t point with his finger when he needs something and he doesn’t understand yet when we tell to pick up something or bring us something. He copies what we do sometimes but not all the times, he used to clap back when we clap but he doesn't do it very often. And he doesn't waive with his hand when we waive at him. When I point at something with my hand and tell him to look at it, sometimes he looks at what I'm pointing at and sometimes he doesn't.
But on the other hand he likes playing with other kids. He loves playing with me and his mom. He smiles back when we smile at him or do something funny for him. He loves going to the park and play on the swing and the slide. He's not sensitive to noises or smells or lights. And he's not sensitive to food. He makes eye contacts most of the times when we are playing with him, sometimes he doesn’t do it as we want him to but overall I think his eye contact is acceptable, and he notices when some stranger comes to the house. He follows me and his mom when we go to the room or the kitchen. He gets so excited when we take him outside. He doesn't spin around himself or walk on his toes but sometimes he makes some movement with his hands similar to flapping only when he's running, or excited or when he's upset but he doesn't do it constantly. He doesn't cry a lot or and he doesn't try to harm himself or hurt other kids. He's a very sweet boy with other kids and with me and his mom. So pretty much he's good at everything except the talking part, responding to his name, pointing with his finger and understanding commands and waving with his hand and the similar to flapping hands movement sometimes. From what I described above how do you evaluate my son and do you think from what I described that it could be a sign of autism?
Thank you
Autism less likely
Detailed Answer:
Hi dear,
I have gone through your query in details, and understand your concern.
The most prominent feature of autism is a lack of reciprocal social interaction. This is a must for diagnosis. But since he is smiling back when smiled at, enjoys group playing and maintains good eye contact, this feature is not there and chance of autism is less.
The only symptoms of concern is a delay in language development , poor response to call/commands/pointing objects and some flapping movements of hands(sine this is present only during running, less likely to be significant)
So, for a more clear picture, few more points, I would like to know:
1. How was his delivery and new born period- gestational age and weight at the time of delivery, any issues like breathing difficulty, seizure or ICU admission etc
2. Report of thyroid and new born hearing screening
3. How was his motor developmental milestones(neck holding, roll over, sitting, standing, walking)- any delay? A normal child will stand without support support by 1 year, walk by 24-26 months and run by 18-20 months
4. How is interest in toys- enjoys different toys or interested too much in 1 or 2 only?
5. Any history of autism or any neurological diseases in family? What is the status of siblings if any?
6. Have you evaluated hearing and vision for this purpose?
7. It would be of very help if you can upload a short video of you interacting/playing with him. Try to include the flapping if possible.
From what you said, chance of autism is less for me, but for sure, we can screen him if you are so concerned. Kindly get back with details, so that I can guide you better
Regards, Dr Aslam
Autism less likely
Detailed Answer:
Hi dear,
I have gone through your query in details, and understand your concern.
The most prominent feature of autism is a lack of reciprocal social interaction. This is a must for diagnosis. But since he is smiling back when smiled at, enjoys group playing and maintains good eye contact, this feature is not there and chance of autism is less.
The only symptoms of concern is a delay in language development , poor response to call/commands/pointing objects and some flapping movements of hands(sine this is present only during running, less likely to be significant)
So, for a more clear picture, few more points, I would like to know:
1. How was his delivery and new born period- gestational age and weight at the time of delivery, any issues like breathing difficulty, seizure or ICU admission etc
2. Report of thyroid and new born hearing screening
3. How was his motor developmental milestones(neck holding, roll over, sitting, standing, walking)- any delay? A normal child will stand without support support by 1 year, walk by 24-26 months and run by 18-20 months
4. How is interest in toys- enjoys different toys or interested too much in 1 or 2 only?
5. Any history of autism or any neurological diseases in family? What is the status of siblings if any?
6. Have you evaluated hearing and vision for this purpose?
7. It would be of very help if you can upload a short video of you interacting/playing with him. Try to include the flapping if possible.
From what you said, chance of autism is less for me, but for sure, we can screen him if you are so concerned. Kindly get back with details, so that I can guide you better
Regards, Dr Aslam
1) everything was normal when he was born, his weight, his height and size. There wasn’t any complications with his birth
2)His hearing screening came out normal
3) His development milestone was normal as well. No delays at all
4) He loves building blocks but he also like playing with other toys such as cars and balls
5) He doesn’t have any siblings. He’s our first child and we don’t have anyone in the family with Autism history
6) We have not evaluated his hearing or vision for this purpose but I believe his hearing and vision are normal.
7) I tried to upload some videos of him playing and interacting with others and a video of the hands movement but it did not let me upload them. It kept giving me an error message. Is there any way I can send those video to you so you can have a better idea of him? How can I upload those videos?
At the end I like to mention a couple of things:
1) We have a history in delay of speaking in the family especially the nephews and nieces
2) We live in the USA but all of our family live in our original country. So my son doesn’t have no family or cousins here to play with and interact with. Plus we do speak Arabic ( our original language ) at the house but when he’s around kids or watches cartoon it’s all in English. So he’s dealing with 2 languages at the same time and with almost no family to be around except me and his mom and some friends every now and then.
3) I have to admit that me and his mom we did not have a very good experience with teaching him. So we were not interacting with him as we should have been and we used to let him watch cartoons more than he should. Now all of that has changed and we realized our mistake.
Thank you again and I will wait for your respond
1) everything was normal when he was born, his weight, his height and size. There wasn’t any complications with his birth
2)His hearing screening came out normal
3) His development milestone was normal as well. No delays at all
4) He loves building blocks but he also like playing with other toys such as cars and balls
5) He doesn’t have any siblings. He’s our first child and we don’t have anyone in the family with Autism history
6) We have not evaluated his hearing or vision for this purpose but I believe his hearing and vision are normal.
7) I tried to upload some videos of him playing and interacting with others and a video of the hands movement but it did not let me upload them. It kept giving me an error message. Is there any way I can send those video to you so you can have a better idea of him? How can I upload those videos?
At the end I like to mention a couple of things:
1) We have a history in delay of speaking in the family especially the nephews and nieces
2) We live in the USA but all of our family live in our original country. So my son doesn’t have no family or cousins here to play with and interact with. Plus we do speak Arabic ( our original language ) at the house but when he’s around kids or watches cartoon it’s all in English. So he’s dealing with 2 languages at the same time and with almost no family to be around except me and his mom and some friends every now and then.
3) I have to admit that me and his mom we did not have a very good experience with teaching him. So we were not interacting with him as we should have been and we used to let him watch cartoons more than he should. Now all of that has changed and we realized our mistake.
Thank you again and I will wait for your respond
Autism less likely, but let us screen
Detailed Answer:
Hi dear,
Thank you for the elaboration. All my questions answered well. I guess thyroid screening also was normal. If having trouble, you can mail the video at: YYYY@YYYY , wit subject as "ATTN Dr. Muhammed Aslam TK". But, if still having difficulty, not a big issue. I already got a clear picture of him.
Now I will summarise my observations in the case:
1. With good reciprocal communication, eye contact, group play, enjoying time outs, and absence of stereotypical movements, chance of autism is low. Family history of language delay also points supports that.
2. Still, since there are few areas of concern(no words yet, no response to call by name, no joint attention), I would recommend an autism screening for him. As per standard recommendations, parental concern is an important indication for screening. Screening is a simple outpatient test, based on a questionnaire, and can be done by a developmental pediatrician, pediatric neurologist or a child psychologist.
3. In such cases, I used to do a formal hearing and cognitive assessment(IQ testing). Even if we feels these to be normal, an objective documentation is good for further proceedings.
4. It is not too late, he is only 20 months, and this is the time we can plan developmental & speech therapies with best results.
5. Speaking two languages will not affect language development badly; but it will be easy for him if you can keep one for the time being
6. Cartoons and screen time must be restricted, as this has many adverse effects on development. Ideally, children below 2 years should not be allowed for TV, and after 2 years, restricted to maximum 2 hours/day
7. No need to regret; we have enough time to bring him up. Engage in plays, promote him to speak and listen, do not hesitate, tell stories and promote group play with peers whenever possible.
Hope I have answered your query
If you need further clarification, I will be happy to help; otherwise you can close the discussion and kindly rate the answer.
Regards, Dr Aslam
Autism less likely, but let us screen
Detailed Answer:
Hi dear,
Thank you for the elaboration. All my questions answered well. I guess thyroid screening also was normal. If having trouble, you can mail the video at: YYYY@YYYY , wit subject as "ATTN Dr. Muhammed Aslam TK". But, if still having difficulty, not a big issue. I already got a clear picture of him.
Now I will summarise my observations in the case:
1. With good reciprocal communication, eye contact, group play, enjoying time outs, and absence of stereotypical movements, chance of autism is low. Family history of language delay also points supports that.
2. Still, since there are few areas of concern(no words yet, no response to call by name, no joint attention), I would recommend an autism screening for him. As per standard recommendations, parental concern is an important indication for screening. Screening is a simple outpatient test, based on a questionnaire, and can be done by a developmental pediatrician, pediatric neurologist or a child psychologist.
3. In such cases, I used to do a formal hearing and cognitive assessment(IQ testing). Even if we feels these to be normal, an objective documentation is good for further proceedings.
4. It is not too late, he is only 20 months, and this is the time we can plan developmental & speech therapies with best results.
5. Speaking two languages will not affect language development badly; but it will be easy for him if you can keep one for the time being
6. Cartoons and screen time must be restricted, as this has many adverse effects on development. Ideally, children below 2 years should not be allowed for TV, and after 2 years, restricted to maximum 2 hours/day
7. No need to regret; we have enough time to bring him up. Engage in plays, promote him to speak and listen, do not hesitate, tell stories and promote group play with peers whenever possible.
Hope I have answered your query
If you need further clarification, I will be happy to help; otherwise you can close the discussion and kindly rate the answer.
Regards, Dr Aslam
I’m following up with you on my son Autism case that wet discussed online earlier but I couldn’t send you the videos on the website. Here are some videos of my son interacting and playing with other children and in the last video it shows you the hands movement that I was telling you about.
Thank you again for your time
I’m following up with you on my son Autism case that wet discussed online earlier but I couldn’t send you the videos on the website. Here are some videos of my son interacting and playing with other children and in the last video it shows you the hands movement that I was telling you about.
Thank you again for your time
Everything you said was clear and helpful but before I close the discussion I wanted to mention that I emailed you some videos of my son. Hopefully you get a chance to look at them and give me your last opinion.
Thank you so much
Everything you said was clear and helpful but before I close the discussion I wanted to mention that I emailed you some videos of my son. Hopefully you get a chance to look at them and give me your last opinion.
Thank you so much
He is looking fine
Detailed Answer:
Hi dear, ,
Sorry for the delay, as I was on emergency duty.
Thank you for uploading; I have gone through all the 5 videos.
From videos, it can be seen that he is interacting pretty well with his friends, listening to calls, enjoying all sorts of toys and interested in group plays as well as in his entire surroundings. These are all against a diagnosis of autism.
The hand movements seen in last video is not a stereotype. Stereotypical movements will be there when resting also.
So, as I mentioned, chance is less; but just getting a screening done will ease your mind, as this will give you an objective evidence too.
I hope this answer will help
It was a nice experience to interact with you and watch him playing
I look forward to address your any future queries
Wishing you and family good health
Regards, Dr Aslam
He is looking fine
Detailed Answer:
Hi dear, ,
Sorry for the delay, as I was on emergency duty.
Thank you for uploading; I have gone through all the 5 videos.
From videos, it can be seen that he is interacting pretty well with his friends, listening to calls, enjoying all sorts of toys and interested in group plays as well as in his entire surroundings. These are all against a diagnosis of autism.
The hand movements seen in last video is not a stereotype. Stereotypical movements will be there when resting also.
So, as I mentioned, chance is less; but just getting a screening done will ease your mind, as this will give you an objective evidence too.
I hope this answer will help
It was a nice experience to interact with you and watch him playing
I look forward to address your any future queries
Wishing you and family good health
Regards, Dr Aslam
Thank you
Detailed Answer:
Hi,
Thank you for the nice words.
Such comments are well appreciated, and is an inspiration for us on the way ahead.
If you have no further queries, you can close the thread
Stay healthy
Thank you
Detailed Answer:
Hi,
Thank you for the nice words.
Such comments are well appreciated, and is an inspiration for us on the way ahead.
If you have no further queries, you can close the thread
Stay healthy