My friends son has lack of eye contact and his speech therapist says he does not make choices........

[mum2twins]

My friend has asked me to post this (she has just had new baby so long typing out of the window) and is looking for some reassurance or advice on some problems with her 2.8yr old DS.

Her DS was identified as having glue ear at approx 2yrs, he was not speaking and clearly could not hear at all. Following the op 8 months ago he has started to say a few single words or two word phrases. He was given some speech therapy which was play based, but his speech therapist commented that he did not make choices. We have been offering choices but still he seems unable to grasp the concept. He very rarely gives eye contact and when you speak to him he only repeats what you say. He does not seem to do any independent speech or link any words together. My friend has taken to focusing his face on her face when she talks but he is quick to look away. He babbles away as if he is trying to talk. Obviously this is frustrating for my friend especially as she now has ds2 who is only a few weeks old. Has anyone got experience of this and the choice / eye contact thing.

and again

Great thanks - just read it and will conduct my own covert test tomorrow. Will let you know outcome. Thx Jimjams

Mum2twins - I have a just gone 4yr old ds who was diagnosed with severe chronic glue ear at the age of 2 - he had very little hearing but he could lip read (I had no idea that he couldn't hear, but did realise that with only 6 'words' at age 2 he was at the bottom range of speech). He had grommits just before his 3rd birthday and 1 SALT session - waste of time as he wouldn't interact with the SALT.
This probably won't be much help to your friend, but I just wanted to say that I've had 3 people (one is a special needs teacher) tell me that they thought he was AS of some type.. and he has very different behaviours to those of his friends..but personally I believe that he is NT and that the effect of the deafness for the first 3 years of his life and the frustrations that that has caused have formed his character along certain lines.
His op. was 1 year ago and his speech is still not clear a lot of the time - whole phrases will be fine and then it will return to gobbledigook - and there is a lot of repeating of phrases rather than making up sentances for himself.
He def. went through a stage where he would not make eye contact - which, since he lip-reads was frustrating, but I chose to interpret it as his way of 'not listening'. He has a lot of anger and is 'challenging' (especially now I have a hearing dd to compare him to) but I've put this down to the frustration of not being able to communicate properly. He is still not bothered by wanting friends - will play games with other children from his nursery but until recently would not go into the playground if there are strange children there, and would not go in if it was empty - this has got better in the last few months.
Maybe I"m deluding myself and there is something more to it than the deafness, but just wanted to let your friend know that other deaf children have problems.
I would still recommend the developmental paed (now I know they exist
Hope she gets some reassurance/help soon.

Blimey - whilst I was writing all that I missed the definition of stimming with the eyes - ds did that too - but haven't noticed it recently (used to get comments from the nursery about him doing it during meal times).

bluebear - one of my friend's little boys had severe glue ear and therefore deafness for a long time. At 2 and a half they appeared on a casual glance as being pretty similar- both non-verbal, quite a bit of independent play etc, both a bit dodgy at sitting down in music class. My friend and I both used to talk about how we were waiting to be able to have a conversaton with our children. Looking back there were definite diifferences though - pointing (or lack of in ds1's case) was an obvious one, as was ds1's inability to copy (so his deaf friend would be doing all the actions in music class whereas ds1 would just be watching, or making a very vague attempt). Hsi friend was much more tantrumy than him (then not now!) as well- although both had tantrums through frsutration.

Oh God, I'm so confused now after reading these posts. DS has appt with the dev. paed. in August and I was expecting him just to say 'gdd', but DS sounds exactly like the little boy who mum2twins has described.

Are there any behaviours that would mean that a child could not possibly have an ASD, eg. being very friendly to strangers, really liking other chidren or not being bothered about having routine changed.

I'm so sorry to hijack this and hope this thread continues, but please can someone answer this question for me.

jenkins for gdd your son would be delayed in all areas (so late reaching physical milestones as well). In autism there abilities are often described as peaks and troughs- so for example althouggh at 6 ds1 can't talk he's know his alphabt since 2.

I don't think that there are behaviours that rule out ASD, more a collection of behaviours ruling it in. Again wrt ds1- severely autistic but often over friendly with strangers- will climb on their lap for example.

also the picture changes with age- at 2 ds1 wasn't remotely bothered by routines- 4 years later he is- the clinical psych said in her experience that is common.

I just wanted to say that I am sorry if I offended jim jams or other mothers with autistic kids with my 'autism is overdiagnosed' contribution. I am indeed finding out from this thread that my knowledge of autism is less than comprehensive. At the same time, it is true that young kids (I'm talking two-three) who don't talk can have autistic symptoms without being autistic in the long run. EG toe walking is common in speech delayed children, whether they are autistic or not.
What value is there in maternal gut instinct when it comes a disorder like autism? Did the mothers of autistic kids on this thread always suspect that there was something different about their autistic child? I suspected my child had autism for a while because of her speech delay and toe walking and restlessness. She is now 2.5 and completely normal if not 'advanced'. I hate to use such a fascist term, but she does talk in a rather amazing way for her age - asks complex questions, makes up stories, says things like 'actually I will...' or 'definitely not' - and this seems interesting when you consider that she only started speaking quite recently.
I suppose I am trying to give hope to mums of late talking toddlers more than anything else. And make the point that you ought to (if you can) spare yourself as much worry and misery as you can and just enjoy the child, since you really can't say for sure what will happen in the the long term. I know that I got really depressed about my own daughter's late talking, and, as it turns out, unecessarily so. But of course delayed kids (especially over two) should get therapy. The parent can maintain an open attitude and get the child intervention at the same time!
And by the way, I shocked and saddened to learn that one of the London bombers had ASD. That terrorists would take advantage of a disabled boy in this way has upset me more, in a way, than anything else about the whole affair.

Just wanted to add (in response to poster who said I had not mentioned any stories of late-talking kids) that I have encountered a lot of anecdotal evidence about late talking. That is, I personally know a couple of people who told me they were severely speech delayed as kids. One of them is a professor and the other a lawyer. And Einstein did not talk until he was five!
Of course speech is not the only issue with ASD. But I do think that the 'milestones' as to normal development in this area can be misleading as cause parents a lot needles anxiety. There is just so much variation.

I hadn't heard that about the bombers- do you mean on this thread- I meant a passenger- not a bomber!

Of course not all late talkers are autistic. DS2 isn't and I never thought he was. Thomas Sowell's books show that as well but- and its a big but- would your child have passed the CHAT test? Thats a much more reliable indicator of children at risk of autism than age of speech development. And it doesn't take speech into account at all.

the normal milestones for pointing btw are remarkably fixed!

I think Jimjams meant that the boy with AS was one of the passengers/pedestrians caught up in the bombings rather than one of the actual bombers.

With ds1 I think I suspected that there was something different about him from the very early days. It wasn't 'normal' IMHO for a newborn to sleep only 6 hours a day. The 'odd' bits were more to do with his behaviour than his speech (or lack of speech). He was so cut off from us as a young toddler that my first thought was that he was deaf.

With ds2 I was convinced that he was NT as he was so different from his brother. He had traits but the overall picture was pretty good. It was only as he got to about 9 or 10 months that I really suspected he might be on the spectrum. His lack of communication just confirmed it. His language development is very disordered. He will often come out with quite long and complex sentences but cannot understand a simple instruction like "put the spoon in the cup" or answer the question "What is your name?" His general development is also disordered, which fits with ASD. At 2yrs the Child Psychologist assessed him as having the mental ability of a 3.5-4yr old child. His fine motor skills are also freakishly good. Physically he is way beyond children 6 months older than him. All that is pretty useless to him though if he can't understand anything going on around him. I'm hoping that his development will start to even out as he gets older.

Sorry jim jams - misread your contribution about London bombings - thought you meant one of the actual suicide bombers was autistic. What ARE the 'pointing' milestones, by the way? And what is CHAT? I can't remember when my dd started pointing, except that by 15 months she was pointing like crazy (every photo of her from that phase she is pointing at something). I did not know the pointing thing was a big deal until I started reading up on speech delay. When I said there is a lot of variation, I meant with speech development, not all areas.

Jimjams - thank you for replying. I was obviously hoping that an ASD could be ruled out by a particular behaviour, but I understand what you mean about a dx being determined on present behavours rather than absent ones.

My gut feeling is that he isn't autistic, as I just think I would know. I'll just have to wait and see what the dev. paed says.

Cathterese if your dd wass pointing like crazy by 15 months then she was never showing 'at risk' flags for autism. A link to the CHAT test is below- in a message from last night. You are right that there is a lot of variation with speech development- which is why it isn't used to signal concers about autism.

In the case of this little boy it is the combination of behaviours he is showing that are worrying- the echolalia, the using the adult hand as a tool, the inability to play very well, the slightly ropey eye contact, the stimming, the inability to understaand choice, the possible lack of pointing. None of those on its own would dx autism, but taken together they paint a picture that a proper assessment is needed to see what is happening.

good luck jenkins- when't the appointment?

Jimjams - thanks for your reply further down the thread. There was a little wobble in my firm belief than ds is NT when I read about the eye stimming. Ds pointed (at his water beaker) at 7 months (his motor skills were and are really ahead of the norm) but he doesn't copy actions well (dd is 2 yr 3month younger and amazes us with her fab actions to songs etc) - it comes across more as a 'I can't be bothered to copy' than a 'I can't copy' if you see what I mean.
I'm kicking myself as I promised I wouldn't do a 'Is he normal? post' Oh well, he starts in reception in 6 weeks so we'll see how he gets on...he's blooming gorgeous whatever.

Sorry for the hijack Mum2twins.

bluebear- the stimming can be a sign of sensory type things going on- which are present in lots of children. For example ds2 is quite noise sensitive. Copying again can be a motor thing- its more the combination. If you can remember back to 18 months then the CHAT is a good indicator of whether coommunication and play was developing normally (never mind langauge). So my friend's son with glue ear and tantrums etc would have passed with flying colours.

Don't worry about individual things- always look at the bigger picture. For example ds2 is the only person in this house who has ever lined things up- but he's not autistic.

Caththerese, I didn't say that you hadn't given examples or talked about personal experience of late talkers who are OK, but you haven't said if you personally know any, or several, people dx autism who then turn out not to be. I think you've got the wrong end of the stick about the claims made about Einstein. Its not that he was a late talker (I've always heard he was 3) but, hey it was OK, he was Einstein in the end! Its that he is NOW claimed to have been autistic, although how or whether anyone really knows this, I'm not sure. Its one of those old chestnuts that people trot out when you say your child is autistic, "oh but Einstein was autstic" or "what is his special skill, music, maths or art?"
I have never heard that children age 2-3 who are not talking display autistic behaviours. My DD could be classifed as a late talker and she DOES have glue ear, but her communication is all there, she copies, she plays etc. Of course people should relax and enjoy their children (we've certainly seem some threads here before where someone seems totally paranoid for no good reason) but there's no point in avoiding facing up to problems if they are there, that doesn't do anyone any good.

Jimjams - ds def. has sensory 'things' going on - noises are often too loud (he often puts his hands over his ears - and his hearing isn't up to much yet), he is extremely temperature sensitive, food must be room temperature or it is declared too hot, he can't stand sunny streets (too bright) - he also mouthed toys for ages (over age 3). I guess the eye stimming is just part of this then. Thanks for the info.

Thanks DIno - I'm hanging on to my belief that ds is just a strange but NT child.
He has a bigger thing about holding vibrating things to his ears - has had nasty nicks to his eye pinna from holding electric trains right up to them.

I have an Aspergers son and also a glue ear son, their problems do not mirror each other at all! Glue ear son (DS2) does have limited eye contact though, and his speech impairment is greater than DS1 with Aspergers. Aspergers son though ahs difficulty not so much with language than concepts- day and night, sharing, humour- that sort of thing.

Can I recommend you look at a site? www.bibic.org.uk will do a free consultation over the phone and deem whether they can help not from any particular diagnosis, but the problems a child is experiencing. Both sensory and AS problems come into their spectrum, we are trying to raise funds for our eldest to go there at the moment, but if he has private heathcare anyway it might be right up their street!

Had quite a good day with my friend today. Her ds seemed better in his own environment. He ran around with my twins like crazy things, laughing at chasing and being chased. My two started setting up his tea-set and they were all sat down with a place setting at their laps, although it was difficult to see how much of this he actually did, I think he just sat and enjoyed being given the items. He played for a long time with a remote controlled toy and sat nicely and ate his dinner. He washed his hands with me when I asked him to and did point to where his cup lives when I asked if he wanted a drink. I asked him where his potty/car/bed was and each time he glanced at me and just carried on what he was doing. His eye contact was better and would hold contact with me for approx. 5 seconds at a time. He was unable to answer any basic questions. We made a star chart as she is going to try potty training and he watched my dd go to the toilet, he then got some tissue and actioned at drying himself so I told his mummy how clever and she gave him a sticker - he was visably delighted with this and ran round with the chart putting it up to the faces of my DD and DS. It is really hard, as I feel he is much better than before and was using more words like 'wee wee' and 'potty' and the eye contact does not seem too bad.
This is how I would rank the CHAT test.

1. Yes
2. Yes
3. Yes
4. Yes 5*) Jury still out
5. Yes (once over 6 hour period) 7*) Yes (as above)
6. Yes
7. No

i) Yes
ii*) Not sure may look but would look away quickly
iii*) No
iv*) No - but if this is to establish pointing he would glance up and just look away.
v) Not tested