I Think My 2 1/2 Year Old Nephew May Have An ASD. Please Help!

[AmandaUchiha]

I am concerned that my 2 1/2 year old nephew may have an autism spectrum  disorder or another developmental disorder. This will probably be very long, but please hang on until the end! To start, I myself have Asperger’s Syndrome, and I’ve noticed some autistic traits in my nephew from the time he was 1 year old. When he is seated, whether in his high chair or in a stroller, he will rock back and forth. He tends to flap his hands a lot and puts his hands up to his face and shakes them very quickly, as if they’re trembling or vibrating, when he gets excited. I think that this may be stemming. He used to hit himself in the face when he would throw a tantrum, but I haven’t seen him do that in months. Speaking of tantrums, he throws them all of the time, even more than the average 2 year old, trust me. From the time he was 5 months old he never liked being held by me, but he did his mother. When I was left to babysit him, he would scream and cry for hours on end no matter what I did to comfort him, but he apparently did not do this with his mother. The most concerning thing I’ve noticed is his speech. I’ve read that the average amount of words that a 2 year old speaks is 200-300, but I have not personally heard my nephew speak more than 20 different words. I am over at my sister’s house constantly, so I see him very often. I have never heard him put 2 words together. A couple months ago his pediatrician had a speech therapist come to evaluate him, and I was absolutely floored to hear that he passed. Apparently he knew about 1/3 of the flash cards that the speech therapist showed him. This makes me believe that he actually knows more words than we think, but he just won’t say them. Regardless of how hard me or his mother try, we cannot get him to say any other words! I’m not doubting the speech therapist, but I’m still quite concerned about his speech. He doesn’t even seem to know his own name. He had also had a hearing test around the same time that the speech therapist evaluated him, and he passed it. His receptive language is pretty good. He understands simple commands like “throw that in the trash, “get me your cup”, “pick that up for me”, “plug in the vacuum cleaner”. However he doesn’t seem to grasp the concept of cause and effect. He will throw his ball down the street, scream and cry because he thinks he’s lost it, me or his mother will go find it for him and give it back to him, and then he will immediately throw his ball back down the street and continue the cycle. No matter how many times we tell him “don’t throw your ball down the street or it will roll away”, he just doesn’t seem to get it. It’s like this with a lot of his things. He seems to really value them but will randomly throw them down the street or off the deck, cry about it, and then when he gets his item back he will go and do it again. Some of the things I have noticed to seem to point to him not being autistic is that he likes to socialize with other children, he makes eye contact, he plays with his toy cars the correct way (doesn’t roll the wheels), and he smiles and laughs. As someone who is autistic, I realize that every case of autism is different, and that others may not share the exact same symptoms I have. I am really leaning towards the side that my nephew does have an ASD, and I’ve talked about it with my sister but she seemed to dismiss it. Should I have another more serious talk about it with her and recommend a place I found that screens young children for autism to her? My Asperger’s was initially recognized when I was 14, and I know early intervention can make a huge difference. If it does turn out that he has autism, I just want him to get along in life better than I am.

[specialmom]

So, this is my take on it.  I think parents really have to gage things and go from there.  You've brought your concerns to her and she has followed up.  AT this time, she is not concerned.  I think you need to let it go.  As an aunt, it's so wonderful to be caring but you've already brought it to their attention.  If he does have aspergers or autism at some level on the spectrum or even sensory processing disorder like my son, it becomes very apparent as he does things like begin preschool.  Once he has a teacher and he is in an environment in which observation can really be made, these things come to a head.  My son was evaluated at 3 and it was inconclusive.  I believed at that point he did not have any type of developmental delay.  Thins escalated when he was 4.  I had him re evaluated and spent time observing him myself in his preschool classroom and on the play ground . . . it was more apparent.  If anyone had hit me up during that time frame of his first evaluation and his second with their thoughts on it, truthfully, I'd not have been terribly appreciative. Just being honest.  I assume your sister has her child's best interest as her own and will follow this situation herself to best be able to help her child.  I had the opposite too when my child was diagnosed . . . a well meaning sister telling me that it was bogus and he did not have a delay.  I did not appreciate that either as I was digesting things and beginning to work on things.  I did not want to argue about it and have the extra stress of family involved as I was working on things myself.

Remember, your sister will be scared and concerned.  This is her child that she loves dearly!  So, let her handle things.

During the preschool years it is a bit tricky to figure it all out.  I hope it all works out and really admire how much you care for your family and want to help.  

To add, I'm sorry it took so long for your diagnosis.  You don't hear of that as much these days as teachers and those working with kids are much more versed in looking for things.  I would count on that if your nephew has a developmental issue, it will be picked up.  If you continue to notice things for another year or so, then ask about it.  

My son was not diagnosed until 4 and that is when he began occupational therapy.  Your nephew has time for intervention as he would be very high functioning if he is on the spectrum at all from your description.  And he could just be a quirky kid too and not be on the spectrum.  

[Arp1234]

Sorry I read myself... I meant stimming not stunning.  I apologize for other mistakes, I am French.... :) hopefully you can still understand what I wrote.

[Arp1234]

Hello.
First of all, if you have asperger, your nephew has more risk than average to have the same thing.  But not always the case.
When he flap his hand and then become rigid , this is stimming. But stunning doesn't always mean autism. It's not rare to stim for toddlers with speech delay as they express themself that way.
Head banging too, if he stoped hit his head, no worries.  The biggest thing in autism is social delay. Does he seem ok with other kids his age ? How does his eye contact is ? Etc...
Also, because we talk about asperger, is he very advanced for his age at something? I mean can he already make difficult puzzles or count or something else?  My brother has asperger and since his very young age, school was too easy, he was advanced in math, sciences, etc... so that could be a sign. You should convince his mom to see early intervention,  they can help with speech delay at least.

[specialmom]

Actually the hallmark of autism is communication problems.  Speech delays, difficulty forming words, difficulty with non verbal communication, difficulty with expression and receptive language. All of those affect communication.  There is, as you say in another post, a variance for when someone will start speaking but speech delays are more than just that typically.  It's understanding and following directions, etc.  Someone who does not speak often will follow directions given to them or express what they want by pointing.  In autism, they often do not.  Speech pathologists usually begin addressing speech issues at the age of three, which was when my son was evaluated.  He does not have autism but something called sensory integration disorder which has similar features.  

Stimming is something children with neurological developmental delays (which is what autism and sensory processing disorder and even adhd are) and stimming is movement that self soothes/calms them.  It's done on impulse.  Head banging is often a symptom of disorders in which the nervous system desires input.  It's also an impulse.  OR it is an issue of limited communication skills and a child can not adequately express frustration, anger or whatever emotion is driving the action.  I would not take it too seriously until a child is more verbal.  My child banged his head on the floor.  My child has a neurological developmental delay.  But other kids WILL occasionally do this when very young and not able to express feelings with their words yet.  Giving a child the words to use or role modeling appropriate ways to express themselves usually solves the problem in a typical child.