Autism or am I being paranoid?

[Rockape1992]

My LO turned 16 months yesterday. He is mostly a very happy sociable little chap. Very smiley, laughs a lot. Has been a wee bit slow reaching his milestones but he is meeting them. He can clap on request and along to songs, waves (in context), gives high fives and responds to requests for kisses by pressing his mouth against mine. He has demonstrated an understanding of language and will (mostly) follow simple requests such as ‘where is so and so’, ‘can you press the button on so and so’, ‘please give the so and so to daddy/mummy/the dog’ as examples. He babbles constantly mamama, dadada, hiya and yeah yeah but no real words yet. He brings me books and toys to show me or if he wants me to read to him or play with him. He seems to be socially referencing with us as he does seem to look at us if he’s done something he’s proud of or if he’s unsure. He doesn’t seem to have any issues with routine or any sensory issues around food, noise, colour, or social situations. He took a little while to settle in at nursery but seems quite happy there now. He is mostly happy at toddler groups and seems to enjoy them. I don’t have any concerns with his eye contact either with us or with strangers and he responds to his name 99% of the time.

sooooo... what am I worried about? He isn’t pointing. He will occasionally jab a finger at something in a book but never in response to my request ‘can you show me the so and so’, it’s always just a random thing and often uses his whole hand to touch it on the page. He never points at anything in ‘the real world’, the closest we’ve come is a casual sweep of his whole arm in the general direction of what we’re pointing out to him but I’m not sure if he thinks he can touch it by doing that. He does follow a point consistently though.

Everything I’ve read said not pointing screams red flag for autism. My husband has no concerns and neither do our parents etc. Their attitude is ‘he’ll do it when he’s good and ready and it will come’ but I find this frustrating. I can’t believe I am the only one worried about this. We’ve had some checks done in the past with the paediatrician for other issues but the doctors said at 13 months when I mentioned my concerns that they had no concerns in that regard about him at that stage.

So in your opinions and experiences mummies and daddies, am I right to be worried or do I just need to chill the hell out and enjoy him and wait for it to happen naturally?

I am anxious and a worrier by nature.

Thanks in anticipation everyone

It's always tricky to say from just a bit of a pen portrait like this and no one thing rules autism in or out but tbh he sounds right on track and nothing you're saying screams autism to me. My 21MO wasn't saying much either at 16MO, maybe half a dozen words at the very most then all of a sudden her language is exploding. In literally the space of a few weeks she's gone from maybe about 30 words to now around 80+ words and saying a couple of simple phrases and most of this tbh has come on in the last couple of weeks. Even a few days can be huge in their world. The fact that he seems to understand so well is very encouraging as well. Pointing is a very important skill and I'll be honest I think my LO was doing it at around 10 months but only quite badly. Probably she was around 14-16MO before she pointed with a single finger. The reason it's so important though is that it's allowing them to share their world with you and allows them both to express what they want and also what they'd like to know about which is highly beneficial for their language development so it doesn't really matter how 'good' they are at it so long as they're getting their point across (pun very much intended ) I think if he's at least attempting to point then that's totally fine for his age. I was a little concerned initially about my LO's expressive language as she seemed a little slow to take off. However I told myself I would wait until she was 2 to seek professional help as that seemed to be the 'magic age' and I'm glad I did as I believe she's now pretty much already at the level of a 24MO. If prior to this age your child is generally meeting their other milestones and has a reasonable degree of receptive language and is making some sort of effort to share their experiences with you and communicate their needs then I think most clinicians would deem this within acceptable limits tbh. I've been there and I know it's worrying but based on what you're saying I'd give him til age 2 at least and then re-evaluate. In the meantime I'd recommend listening ti some podcasts by a speech therapist called www.teachmetotalk.com. They'll make you think much more differently about speech and will give you some simple practical ideas for how to engage your child in speech rather than falling into the trap of getting frustrated at your kid and just constantly trying to goad them into talking which really doesn't work Don't forget to enjoy him too OP. They grow so quick at this age it's enough to make you weep as I'm sure you already know so just enjoy this stage. Good luck x

Thanks for your reply @Jannt86 I appreciate you taking the time. The problem is, I don’t think he is really trying to point. Even when we are out for walks, he never seems to look at things and certainly never points stuff out to me. I just can’t shake the feeling that something isn’t right but everyone is telling me he’s fine!!

Pointing to request and to share interests is not considered late until after 18M - pointing can come very rapidly, i.e. one day they don't point and the next they start pointing at everything. He still has two months to do this, which at this age, is a very long time from a development point of view, so for now, it is not at all concerning. Following a point is normally a precursor to pointing so as he does this already it does seem to suggest that him pointing is just around the corner :)

@AladdinMum thanks for your reply. I know he’s still in the realms of ‘normal’ and I have probably hit panic stations too early but the time just seems to go by so quickly and he just doesn’t seem to be getting it. For example I put a carton of his favourite smoothie on the kitchen counter this afternoon after briefly showing it to him. Instead of pointing at it, he came to me and put his arms out to be picked up, grizzling. I kept asking ‘show mummy what you want’ but nothing. As soon as I picked him up he wriggled to get free and started grizzling again. Is this normal? I know it’s not a competition or a race but he seems to be the only one out of his peer group not to be doing it. He was also last out of his peer group with meeting most of his milestones so he has a history of taking his time. I am encouraged by the fact that he does follow a point but he seems to have been doing this for a long time yet still no pointing. Is it possible that he won’t point to share or request but could still be NT?

Sorry OP, I misunderstood but I still think he sounds fine. Just do lots of pointing yourself as you are and he'll get it soon enough. It's frustrating I know when you see kids ahead of your own as everyone wants to give their kids the best chance but they really are all different and this is just a tiny (allbeit important) chunk of time. Look at the website I recommended. At the very least it'll make you feel empowered to feel like you're doing the best you can. And then enjoy your son and give him til age 2 at least. A lot can happen in that time. Trust me xx

@Rockape1992

• Is it possible that he won’t point to share or request but could still be NT?
• very unlikely, pointing by 18M to share and request is a critical milestone.

It does seem that at the moment he doesn't get it but once it happens it can happen very suddenly and all other indications seems to suggest that he is getting very close, just give him time, he has the time - once he gets it and understand the "power" that comes with it he will use it profoundly (once they start it is not unusual for a toddler to point in excess of 50+ times a day for the first few months).

Thanks @AladdinMum. Can I just check whether you meant he’s unlikely to be NT if he doesn’t point to request/share by 18 months or if he doesn’t point ever? Sorry, wasn’t sure which you meant! I’ve felt like it’s just round the corner but that corner keeps getting further away! 😢

Your DS sounds exactly like mine. At 16 months he had no markers for autism apart from not pointing and I was worried exactly like you are. I forced myself to wait until 18 months before I went to see the HV (he also wasn’t speaking at that time). So he turned 18months on the Friday and on the Monday I saw the hv so naturally on the Thursday he pointed for the first time... and hasn’t stopped! Pointing to request and share and now his speech has come on loads too. The pointing literally came out of nowhere, there was no sign or warnings that it was about to happen.

He turns 2 on Sunday and I’m quite sure he is NT. He’s bright, happy and developing normally.

I hope that this story helps you, though I know that until your son points you will continue to worry. I just hope this helps to reduce the worry to a dull back of your mind one. I know it is incredibly frustrating but it genuinely is too early to panic. They can catch up literally overnight!

@kle209 thanks for sharing your experience with me, and while you’re right that of course I will still worry, it does give me some reassurance that the same outcome might happen for my son. They really have the power to make us worry don’t they? I can’t believe your cheeky monkey waited until you’d seen the hv, it’s as if he knew! 😆 Where was your son in regards to his other milestones? Was he early, on time, or late? My son has been a wee bit late with all of his, apart from crawling, and is still not walking independently.

In terms of getting on the move he’s always been on the earlier side of normal coz he just wants to be on the move all the time. He is super active even now.

But was late to talk (and we did do a round of private speech therapy) so we waited until 22 months for him to call us mama and dada! He is now on track in terms of learning vices and joining words together to make 2 word sentences. His pronunciation is quite bad but he also has glue ear so that doesn’t help matters. But even with these things he is getting on really well at nursery, we have a great bond and understand each other and overall he’s a happy little boy.

I think just coz they were on time for some things doesn’t mean they will be for everything and indeed just coz they are late doesn’t mean they won’t have a spurt and suddenly over take other children. But I’m sure they can’t do more than one thing at a time, so my son was working on walking and running before he decided that actually communicating by pointing would be a good thing to do!

Apart from the pointing, your son sounds waaaaaay more advanced than my 15 month old! My son isn't doing half the things you've described yet!!

Granted, he is pointing. Not when I request him to, but he does point at things when out and about, and to request things. He wasn't doing so at a year, and I asked a HV about it and she said it's totally normal not to be pointing at this stage, and to just model pointing a lot (e.g. point to pictures in books when we're reading them etc). He started pointing so suddenly - one day he had never pointed, and the next he wouldn't stop! From what you've said your son sounds delightful. Be patient with him on the pointing and I'd be surprised if he doesn't start in the next couple of months. Pretty much everyone I know has wondered if their baby was autistic at some point... 'I certainly did. If you're still worried at 18 months then you could ask for a referral.

sorry for the confusion, yes I meant that "he’s unlikely to be NT if he doesn’t point to request/share by 18 months", but he still has lots of time left till then - two months is long time at that age.

Wow @AladdinMum that’s pretty scary. While I know it’s so important, I didn’t realize that 18 months was the absolute latest a NT child would do it. I thought there might be some grey areas where some babies might be a little later but still NT. I know we still have time but that is honestly pretty terrifying

@surreygirl1987 thanks for your message of support. I’ve never thought of him as being particularly advanced for his age but it’s nice to hear that someone does! 😀 The pointing thing has just got completely under my skin, I know it’s too early to panic but I genuinely am panicking. I totally take on board how quickly it can come, but I just have a gut feeling he isn’t going to be doing it anytime soon. I think with that aside, if anyone asked me if I thought he was NT or not, I’d say yes, but the pointing thing is so worrying.

I get that but honestly with my son there wasn't even a build up - one day he just randomly started doing it! Same with clapping... one day he was in the bath and just started clapping! You never know what these little ones will do tomorrow.. . And I don't know if that 18 month 'cut off' mentioned by a previous poster is concrete or not, but even if it is, 2 months is ages! I'm still waiting for my son to walk, but his dad didn't walk til he was 18 months and in baby world that's forever away! Please don't worry! But do point at things in books etc. I bet he will get it. Will you please post back here when he does? :)

Yeah I guess that’s true. Our little one was the same with clapping and waving so maybe there is hope on the pointing front. He did gesture towards his food with his arm and do an opening and closing gesture with his hand when we were giving him breakfast yesterday and we asked him what he wanted. Perhaps just a coincidence or me making it into something I wanted it to be but I suppose it’s a good sign all the same. I will definitely post back at 18 months, please everyone keep your fingers crossed that my little man gets this ASAP!! Thanks for all your messages and support xxx

@Rockape1992, nothing around autism or pervasive development disorders will ever be black and white and there will always be (many) grey areas. It is widely accepted that pointing after 18M is considered 'late' but there has been cases (including in these boards) of toddlers pointing to show interests at 19/20M and turn out to be completely NT. The idea is that after 18M it gets increasingly unlikely of a toddler being NT, but not impossible. Also note that if autism is present it will not only be the pointing that is impaired, there will be other social communication deficits by 18M. (pointing gets a lot of attention because it's easy to measure, i.e. they either point or not)

@AladdinMum thanks for your response and for giving me a bit of background. It is evidently quite complicated and as you say, there is much more to an autism diagnosis than simply not pointing at 16 months. As I said in one of my previous posts, the pointing issue aside, I do feel he is NT although I admit is is all too easy to find behaviours to fit the diagnosis (or at least the one I’ve given him in my head) which I know is dangerous and pointless. I do feel to some extent that my worries, however justified or not, are impacting on my relationship with my son as I can feel my worries drifting into frustration with him which is really not somewhere I want to go and makes me feel so sad. As @Jannt86 said, the time goes by far too quickly and I hate the thought of looking back in a few years and realizing I wasted these precious months by devoting my energies into worrying instead of enjoying him. It’s so hard to switch that off though

@AladdinMum I’m so sorry to be a pain and to keep asking you loads of questions but what do you mean by other social communication deficits? Are you able to give me some examples of what those deficits are likely to be? Many thanks

@Rockape1992 Sure, autism is a social communication disorder so deficits will be prevalent in that area. So examples of social communication include pointing to share interests (like a plane in the sky), looking at you from a distance when he is cautious or unsure (social referencing), looking at you when he does something that he is proud of? (praise seeking), showing/giving you interesting things that he finds? (like an interesting rock or leaf from the ground), etc.

He doesn't have to do everything listed above all the time, but generally, and by using the examples I listed, you will get a feeling of whether or not he is 'sharing his world' with you which is what autism really tends to impair. Social communication is nothing to do with words or 'being social', but with having that connection with his carers to share his enjoyment though the use of communicative eye contact and gestures, not because he wants anything in return (or is meeting his needs) but just for the sole purpose of sharing.

hi @AladdinMum so if my son comes up to me and puts a toy cup to my mouth to pretend to drink is this sharing or play or is it both?

I would say both, that would be an example of imaginary play, and on this imaginary play he is sharing his imaginary drink with you - a clear example of joint attention (you are both focused on a shared object).

@AladdinMum thanks.