Another Pointing Thread....cont'd from smallwhitecat WARNING LONG

[RoxanneMur]

Hi everyone....smallwhitecat's thread was getting long and I know that kt14 asked how my son was going so I thought I would do an update for those who were interested.

I had Ashton seen by a top neurologist here in Melbourne. I went armed with the following letter:

Things Ashton does that are typical:

? Follows simple instructions such as ?Go find your teddy and dummy?, ?Go and put your bottle in the sink?, ?Put the dirty nappy in the bin?, ?Climb up on your chair for breakfast?;
? Always wants to be in the room that you are in and will follow you around the house to where you are;
? Points at things that he wants. Albeit, he didn?t start pointing until 16 ½ months but once he did it has been fairly consistent. Holly pointed at 14 ½ months;
? Has always followed a point. Even at 12 months, I would point to items and he would always look directly at the item;
? Points to things of interest. For example, pointed to the picture on the wall of him and Holly and said ?Baby?; points to dogs while out for a walk in his pram; will also point to cars driving by;
? Comes to us several times during the day wanting to be picked up;
? Uses household objects for their intended purpose. He has always known that a phone was for talking, a toothbrush for brushing teeth, a hair brush for brushing hair, etc;
? Has great imitation skills. Needs to only be shown how to do something once and he will copy and perform the task;
? Loves playing peek-a-boo and Round and Round the Garden;
? Loves going to playgroup and being around all of the other kids;
? Has a varied diet ? all meat/fish; corn, potatoes, pasta, bread, rice, vegetable soup, yogurt, cheese, bananas, grapes, weetbix, cruskits, etc. Uses spoon and fork;
? Has always met all physical milestones such as crawling, walking, etc. on time
? Seems to know when I am telling him off and if I walk towards him to take something off him he knows he shouldn?t have, he will turn and run away from me;
? Does seem to have a level of fear built in to him. If he climbs on the kitchen table, he will scream out to be rescued as there is no way he is jumping down;
? Is happy to sit with you on your lap and have a cuddle; when he is tired, he brings his teddy and dummy and climbs onto our lap;
? Does not line things up or have an obsession with anything in particular, except closing doors as stated below;
? Smiles and laughs appropriately while playing;
? Babbles constantly as if he is saying a sentence, using inflection;
? Has the following words in his vocabulary:
o Mum mum mum mum
o Dad dad dad dad
o Shut
o What?s this? (sounds like ?This?)
o Baby
o Uh-oh
o Car
o Bot Bot (we have always said this for bottle)
o Makes a dog sound like ?Woof Woof?

Things that make me go hmmm:

? Eye contact up at close range is still inconsistent (ie if you are holding him). However, eye contact from a comfortable distance seems to be okay. For example, sitting across a dinner table or playing on the floor. Or when you call his name, he will look directly at you.
? Ashton has to shut the doors in our house if they are open. When he does this he will look at us and say, ?Shut?.
? Toe walking about 40% of the time, especially on the cold tiles. However, I have noticed Holly doing the same and have no concerns about her at this stage. I also took Cameron to a podiatrist when he was about 4 for the same thing and it resolved itself. Ashton has only recently started doing this;
? When watching television seems to get thoroughly engrossed for short periods. During these periods, he does not respond to his name even if we say it over and over. If Ashton is not watching TV, he will almost always respond to his name. He does not sit there for super lengthy times and always moves on to playing but does seem to zone out with it for a minute or two.
? Still tends to wake one to two times during the night crying. Once you go in and give him his dummy he will settle and go back to sleep straight away.
? Will sometimes cover his ears but not enough to really say he does so regularly and not at any particular time. Does this once every two weeks or so;
? Ashton will sometimes hit his own head with his hand but it is not prolonged or repetitive for lengthy periods.

PHEW!!!!

While we were there he observed him quite carefully and his gut feel is that he is fine. Here is what his letter said:

Roxanne continues to be concerned regarding the question of autistic spectrum disorder and came along with the list which has really more positives on it than concerning features.
I described that most 18-20 month old boys do have soem concerning features but it is really a question of the overall trend here, he is having good engaging play. He refers to his parents. He settles down well and interacts well.
I think it is sensible we are pro-active in addressing these concerns and he will come back to see me if needed for a formal autism assessment. However I am delaying it for three months in the expectation that his improvement over the last 4-6 weeks will continue and that Roxanne will be delighted to cancel it.

So hopefully his gut feel is correct and all is well although he just doesn't seem as switched on as his twin sister but is getting there.

JIMJAMS - if you happen across this post (and if anyone has read this far) - I know you say pointing is very important and I agree. You have also mentioned that it can be a bit of a red herring in that there can be pointing and autism still present. In those cases, do they do all three types of pointing? Ashton does point for needs, interests and does follow a point. Or because he was a bit late with it, we are still under a red flag?

I also want to say thank you JimJams and the other well versed mums on here as I have poured through your info and you are all such a wealth of information - I know I am grateful for your constant input!

Will keep you all updated over the next few months. I know that is one of the frustrating things is sometimes never hearing the outcome - I will let you know either way.

Thanks for reading and listening,
Roxanne

[RoxanneMur]

Don't know why the list has all ? on it....they were bullet points on the preview...sorry.

[RoxanneMur]

Ashton has just turned 18 months old.

[cyberseraphim]

sounds very normal - I would go with what your neurologist says.

[coppertop]

I'm glad you've been able to get some reassurance from the neurologist. FWIW othing in your description has alarm bells ringing for me.

The different kinds of pointing sound very good to me. My two children with ASD are now 8yrs and 5yrs old and still find it difficult to follow a point. The 5yr-old still points at things using either his middle finger or little finger. The fact that your ds can do these things properly at 18mths is very positive IMO.

[lljkk]

Sounds like perfectly normal toddler in OP (IME) -- it is normal for them to have obsessions (to a degree) at that age.

[kt14]

Hi Roxanne, thanks for the update.
Wow, there are an awful lot of positives in there, and the "negatives" as you perceive them can mostly be explained away by normal toddler/boy behaviour IMO.
If I were you I really would relax a little, I would have been delighted if DS1 were like that at 18 months!
Hope it all continues to go well for your ds.

[meandmyjoe]

My ds is exactly like this Roxanne. He's 13 months and I have also had concerns over him as he was a very difficult baby who seemed unable to be cuddled or restrained in anyway. He has calmed down massively now and does have cuddles but only on his terms when he's tired. He usually responds to his name but not if he's too engrossed in a toy/ tv. Slaps his head occassionally but not repeatedly, it makes him laugh . He also is rather obsessed with opening and closing doors, over and over and over and over again. He points at things he wants and follows a point. He goes to get his 'blankie', 'shoes', 'cup', 'teddy' etc on command but he has no words which I am not too worried about yet.

He never sits still though and does seem to get very angry for no reason which I am a little concerned over. If he can't have something or reach something he screaches and roars. If he's had enough food, instead of just turning away or stopping eating, he cries. He cries when i dress/ change him. Cries when being put into any kind of chari/ pushchair. He just wants to be moving all the time, never stops walking, he even drinks from his cup whilst wandering around aimlessly.

His fine motor skills are very good. His gross motor skills are good.

He doesn't walk on his toes though but has only been walking for a month.

He met all his milestones early or on time and pointed at 10 months. I think from what others have said it all sounds fairly standard toddler behaviour. This has reassured me loads!

[RoxanneMur]

Thank you to all of you! I have decided to just enjoy him during the "wait and see" period as he really is an absolutely delightful little boy and nothing will change that. He is just so different from my other two but I suppose they are all different!

Meandmyjoe-if you could keep me updated with how you are going I would love to hear. They sound like they are very similar indeed! And for what it's worth, the door thing seems to be getting less and less every day and some days doesn't even touch them. I did find a developmental checklist that said they love to open and close doors and flush toilets at 18 months old. I relaxed a bit more after reading that. And my DS1 who is 6 now and NT was never cuddley or sat still and now he loves to cuddle with me and gets upset if the twins don't feel in the mood to cuddle him! Go figure!

I am sure our worrying will continue throughout their adult life

[meandmyjoe]

Will do Roxanne, your little boy sounds lovely. I hope we are worrying over nothing! I must admit in many ways my ds is so sociable and constantly does things, then looks up at me for praise!

The eye contact thing bothers me, he never stays still long enough to look at me for more than a few seconds but he does look in my eyes, just not for long! The always moving/ hating chairs is a pain in the bum and means I can never take him out to a restaraunt/ cafe. I do worry about him but he is so so young.

Hop everything works out fine for you x

[jimjamshaslefttheyurt]

It's not pointing at 18 months that is a red flag for autism. It doesn't matter at what age your child points before 18 months. And if they're not pointing at 18 months the usual thing would be to give them another month and review, then refer on for further assessment.

Eye contact is a total red herring. DS1 has very good eye contact.

Obviously if you're concerned then keep in contact with HCP's but I can't see anything in your list that would worry me.

[jimjamshaslefttheyurt]

Also a child who points later than 18 months can be perfectly OK because its not diagnostic. If your child isn't pointing at 18 months it's just a sign that their communicative development is a little delayed - one reason might be slower development- hence the reason for waiting another month or just keeping a bit of an eye for a while, another reason would be a communication disorder.

No link has been found between communication disorders and pointing earlier than 18 months.

When I say eye contact is a total red herring I should clarify a bit. It's not as important as people with limited experience of autism tend to believe (along with affection, cuddling etc)