Possible PDD-NOS or other spectrum (28 months)

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I am the father of a 28 year old boy. He has been somewhat developmentally slow his whole life (late walker, talker). He is now 28 months and has very few 2 word statments (come on, all gone, bye daddy). He has about 75 single words. He was referred for speech services last month. The therapist has worked with him 4 times. She is currently saying she is "not sure" regarding if he has a simple language delay or something more. She mentioned that his eye contact was "ok, but not great". We have an evaluation set up for next month, but would really like to hear some opinions in the meantime.

Here are the positives (As far as I can tell from researching)
Smiles and laughs all the time
Points to show us things
Sleeps great
Does have detachment issues
Brings us objects all the time (he is contantly handing me things saying "here ya go daddy" (although here ya go sounds more like "heargo"
Responds great to name
No stimming
No self destruction
No lining, stacking or repetetive

Here are the concerns:

Language (he literally says less than 5 total words during a 30 minute sessions with Speech Therapist. He knows about 75 but is far less verbal than any other kids in his class)
Babbles alot in what appears to be his own language
Behind on some of his fine motor

Here are the things I am unsure about:
At the park and in play settings, he is hot and cold about playing with other children. Sometimes he is interested, other times he wants to do his own thing.
Eye contact is great with us. His therapist said it was a little bit of a concern
He does have tantrams when leaving something he is enjoying. (the park, etc. not sure if this is a symptom or a typical 2.5 year old reaction)
I dont think incredibly picky eater, but doesnt eat everything. Probably 20-25 different foods.
I dont notice many sensory issues, but he doesnt like his hands to be dirty.
He will pretend imaginary play, but usually at our prompting. (We will say "feed your horse, and he will pretend to do it".

As I mentioned we do have an evaluation planned for next month ($600 wow...) but I would be interested to hear your input and can answer anymore questions.

It is good that you are looking into testing. The wait and see approach is generally not best. I have a three year old that was borderline that we had checked and they said that it isn't a problem now so we should just work with him.

If he is on the spectrum it doesn't sound like it is causing problems outside of language so that is good. My older son (classic autism) had about 15 words at his second birthday, but now at five has an average vocabulary for his age. He stuggles with language still but it is better than I imagined possible. Without using ABA you can accomplish a lot.

Good luck!

I wish the best for you and your son.

I definitely think it is good to get him evaluated just in case, but it doesn't seem to be ASD to me. When I was a baby (I have HFA, though), I did not speak at all until 2 1/2, then lost speech again after that. I didn't play with other kids. They might have played near me, but I didn't play with them. Sometimes, even if they were near me and I was aware enough, I would move away because I don't like background noise and never did. I did have trouble with imaginary play. I spent most of my time organizing, categorizing, lining up, and stacking my toys, Sometimes I would spin them a lot too. I spent hours out in the yard sitting next to my bike just spinning the tires over and over again. I also remember sitting behind the door just bouncing the springy door stopper over and over again. I did a lot of repetitive play that other kids would not have found interesting. Sometimes I would jump on the bed over and over again for hours. I was not allowed to do that, btw, but I did. The huge scar I have through my right eye brow after falling and splitting my head open did not stop me from jumping up and down on the bed either. When I was older--I had a lot of cousins my age, and at least one friend every school year (only one at a time)--they tried to get me to pretend, but I couldn't. I never really did what other kids thought was fun, which is probably why I had a new friend every school year instead of one best friend that lasted for years like other kids had.

I was not smiley, I had constant meltdowns, I did not make eye contact, and I often just sat there lining up my toys and rocking back and forth--doing repetitive things as early as I physically was able to. I had the same sleep habits as a newborn in the hospital as I do today (I won't sleep until the wee hours of the morning). I barely babbled, and did not speak to others at all. I did not acknowledge other people that much because of being in my own little world, and I think I probably largely just perceived other people as moving objects (I say that because I still often do the same today--when walking down a crowded sidewalk, all I see are moving objects I have to walk around. I do drive, and I don't see the other cars as people behind the wheel, I see them only as objects free from humanity).

You can tell the difference between a tantrum and a meltdown, btw. A typical two year old (or any age) tantrum can be stopped by giving the child something he wants (and when they are old enough to understand, by threatening to take away something important to them). Sometimes, depending on the child and their age, you can talk a child out of a tantrum. An autistic meltdown (that resembles a full blown-out tantrum only more) is very intense for not just the person having it, but those witnessing it. It cannot be stopped regardless of what you say or do, what you try to give or try to take away. It only stops when the autistic person (child or adult) exhausts themself from it and it goes away on its own. The autistic person has no control over it all. If you say, "stop and I will take you for ice cream" and the person stops, then it is not an autistic meltdown (even if the person in question is really autistic--if the child stops, it is a tantrum and not a meltdown--autistic children like all other children can also have tantrums).

Sensory issues are very common in some form or another for people with autism. As a child, I could not stand loud noises, bright lights, and a lot of textures as well. I could not wear lace without melting down, I did not like soft things to touch, and I always had to cut the tags out of my shirts and pants. Sensory issues often led to meltdowns. Now I have issues with dirt, but I think that comes more from my teenage years as I was raised by a mother with OCD who has a thing against germs. As a child, I did not pay any attention to dirt and germs (I would play in the mud just like other kids, I would just do it alone).


Anyway, I know I rambled a lot, but that was so you can see some of the signs of autism in a child. My official diagnosis was AS that I got in adulthood, but I am in the process of being reevaluated now. I have classic autism, am severe, but still on the high-functioning end. Much of what I went through is similar to how other children on the spectrum behave as well. Some AS children will be similar as well, minus the language delay/regression. Even mild children will show many of these things, though perhaps not all, just in a milder form. PDDNOS does not necessarily mean mild, and those people have most but not all of the classic autism diagnostic criteria. They can be mild to severe, but still clearly on the spectrum.

From all the information you gave, I would say that your child probably does not have ASD; however, that is just my opinion and is not for certain obviously since I am not a doctor. Well, he definitely wouldn't qualify for classic autism, and there isn't really a speech delay. He combines two words and already says about 75 words (and probably understands more than that even if he doesn't say them yet). He is not even 2 1/2, so that is quite typical of an average language skills, even if he is at the later end of things. It might be a very slight delay, and it might not be, but according to autism and speech development websites, doctors only look for the combination of two words at the age of 2.

There are many disorders out there that are similar to ASDs as well, or maybe there is nothing really wrong with him. I know the evaluation can be very pricey (here, they cost almost 2000$!) but it will be worth to find out one way or another. If he is found to have mild ASD or something else entirely, it will be better for him to find out early on so he can receive any help he might need. I wish I had known when I was 2. Good luck through this process!

Well, I am not a doctor, and I can't diagnose over the internet, but my son was diagnosed at 2.5 yrs of age with PDD-NOS. Here is a description of my son:

Late walker-21 mos.
Had words on time (10 mos) but we realized that he was not really using them to communicate with us. He would memorize lines from his children's books or tv shows
Did not really point or show us things.
Did not, and has not ever really played with children (he is almost 6 now)
Just did not seem to really "get things" as naturally as other kids.
Delays in fine motor

However, he always smiled, is lovable, loved to be hugged and has great eye contact.

He has been in speech therapy for almost 4 yrs now, and he speaks in full sentences.

Every case of autism is different. If your gut tells you something may be wrong, go ahead and have the evaluation. It can't hurt, and it could put your mind at ease.

Good luck, and please feel free to ask any questions that you might have!

Also, about my son----He has never been a picky eater, and has never really had severe sensory issues. However, he did start flapping his hands at 1 yr of age, and shaking his head back and forth as if he was saying "no" He was a terrible sleeper up until about 3 yrs of age, and now he sleeps pretty good most nights. He never really had bad meltdowns or tantrums. But when he turned 5, he became a little more agressive, but that has calmed down a bit. He never lined up toys, he never spun himself, and never rocked.

My nephew is not currently diagnosed (parents in denial!), but I am certain he has some form of ASD. He had a language delay--we thought he was deaf for awhile because he wouldn't respond to his name or look over no matter how hard you called. If you stamped your foot hard enough on the floor to make it vibrate, he would turn and look and then go back to what he was doing. He was given a hearing test, and passed.

I thought he has autism, but he probably has PDDNOS because he had a language delay, but other than that, he is far more like AS than autism ever since he spoke his first words. He now has an extensive vocabulary, and speaks like he is 50 sometimes. Very much the stereotypical "little professor". He never liked being touched and always cried when picked up by anyone but his mother and father as a baby. Now he is 8 and is very huggy, cuddly, and touchy feely--more than me, and sometimes I have to gently push him off. He is also very blunt and to the point, can seem a bit "rude" sometimes (and very sweet most of the other times!)

I will mention a bit about him--on a severity PDD test I took which was very indepth; I scored severe, and he scored mild. So, here is how ASD of some sort manifested mildly in one child. He is super smart--don't know his IQ, but he is definitely above average or gifted/genius level. He is only in grade 2 and is an straight A student. He is probably a math genius in the making, and is a terrific reader. He has already surpassed his 11 and 13 year old cousins in both of those subjects....and probably every other subject too. He has a few intense narrow focuses. Right now, he is obsessed with rocks and crystals and video games. He rarely tantrums, but he does meltdown sometimes when taken away from his video games. He loves playing with other children, but has trouble with social interactions. He interacts, but is clearly awkward and doesn't really get social protocol. When he plays, the other children must play as he wants them to, say and do exactly what he has in his mind. If not, he will stop the game and tell them, "no, say this: _______". He does get into a lot of arguements. When he was a toddler, he did have some odd playing habits, but he could pretend. His favourite thing to do was to come here and get me to play with his toy farm with him. Because I don't know how to pretend, this was very difficult for me......but then he would tell me every single thing I had to say anyway, so that made it easier.

He is a very picky eater, does not like sauces or condiments, or many textures of foods. He hates loud noises, and has trouble keeping his eyes open outside (though he rarely complains about it--he is definitely sensitive to bright lights though). He doesn't stim that much, but was a toe walker for years. He used to curl his toes over and walk on the tops of them. Always. Without pain. He did that until he got so big, he would break them if he did it. He also has no sense of danger, and makes a lot of risks on the playground, etc as a result. Anyway, he has a mild ASD--I am 99% certain of it. It runs in my family, and I know if he went and got evaluated, he would be given the label.

I once heard somewhere, if you met one person with autism, then you've met one person with autism. They are all different.

I will give you the link to the severity level test I found. Why don't you go try it out for your son and see what you get. It is not a diagnosis either way, but it might still give you some ideas and clarification. It is far more in depth than just a few sentences given here on WP. My suggestion is, however, when/if you take the test, you use the "how to rate" link FOR EVERY QUESTION. If gives details and examples of how to rate for every single question and they tell you what they mean by mild, moderate, or severe. Trust me, it is often DIFFERENT than what YOU might consider to be mild, moderate, or severe. When I took it, had I not read the how to rate link, I would have been WAAAAAY off because sometimes I thought I was severe when, according to them, I was moderate or mild, and sometimes vice versa. To get an accurate score, you need to follow that.

http://www.childbrain.com/pddassess.html

Thank you all for taking so much time to answer my questions. I took the childbrain test and he scored at 43. This score falls in the No-PDD range, but I do understand that it is not a "true" diagnosis.

He was no on almost all questions except:
Social Interaction Difficulties- Mild
Poor eye-contact- Mild
Temper tantrums- Mild
Ignores pain- Mild (He rarely cries when taking pretty tough falls)
Speech/language delay- Moderate
Frequent jibberish- Moderate
Repetative talk- Mild (Will say "bye bye" to dog over and over)
Cant Sustain Conversation- (wouldnt figure many 28 month olds can do this)
Uses language inappropriately- (Will also say "no mine", when it doesnt fit the situation)
Behavior difficulties- mild

Sounds like he may just have some language delays. Most 2-3 yr olds have tantrums to some degree. He is still a bit young, I think it will be more apparent as he approaches age 3. The main thing will probably be his interaction with peers. It was very apparent for my son at age 3, that he had very little interest in playing with his peers. Actually, my son has never been able to really even play on his own although he does enjoy tickling and acting silly with my husband and I. When I took my son to the playground at age 2-3, he NEVER approached other kids. He would just wonder around and run off and I would constantly be having to try and get him to do SOMETHING on the playground.

One thing that I forgot to ask, does your son have any obsessions with anything? Most kids in the 2 or 3 yrs old range can be hooked on characters, but what about anything that you think is unusual? My son was obsessed with car makes and models. At 2.5, he could tell you the make and model of a car just by looking at the logo or the shape of the car. He would talk about Volkswagons all of the time. He even started drawing the VW logo over and over!

I will watch for that interactive play with others. Like I said right now he is hit or miss. For instance, I took him to the park yesterday and there were 3 other kids there. For the most part he did his own thing, sliding down the slide, and running. But last week we went over to a friends house who has a daughter in his daycare class. They played together for a solid hour and a half.

As far as obsessions... he loves the Backyardagins cartoon. Usually when we are in the living room he will ask for that to be turned on. He also likes water, but not sure if its an obsession. We have been to places with play water exhibits (science fair type things) and he wants to continue playing in it rather than moving on. He has done the same thing at a public fountain. Would this be considered a type of obsession?

Sme kids are just shy too. My other niece and nephew live with me. I used to take them to the playground when they were younger. Neither of them have autism, yet neither of them were the first to approach other children at the playground. Sometimes when strangers (kids) would approach them and start playing, my niece and my nephew moved away. They are 100% not autistic, but they were both shy.

Most little kids are hooked on some type of show or character, I guess it is if it is just taken to an extreme. Like if that is all that he ever talks or thinks about it. As far as the water, I don't know. I think a lot of children are fascinated and enjoy water play. The fact that he played with another kid for an hour and a half is a good sign.

If you are worried about his language then maybe you could go ahead and start speech therapy, but it may just kick in. I also have a friend whose daughter just turned 3. Her language seems farther behind what my friend's first daughter's was, but the child does not seem autistic at all to me. She just seems language delayed to me. So I don't know. Just keep your eyes out and trust your instincts.

First of all, I do wish your family the best of luck in whichever situation arises.

Your son is still so young, just a baby! I was nursing my son until 29 months. Personalities start emerging closer to 3, and even more by 4. Boys (from what I have seen) seem to take longer to "get" playing with others, and tend to talk and potty train later as well.

To me, he sounds like a perfectly average little boy!

I wouldn't think so. Lots of kids prefer some exhibits over the others. At our science centres, the ones that have something fun to touch like water, sand, bubbles, etc are the most popular. Sounds normal to me that he doesn't want to leave. Does he have uncontrollable meltdowns when it is time to leave. Lots of children have trouble with transitions, even without meltdowns. Autistic obsessions are characterized by hyperfocus of that object. As your son gets older, and say he is interested in dinosaurs and he spends every spare moment studying about dinosaurs, can repeat lots of information not typical for a child of his age to know about dinosaurs, gets upset if he can't learn about them, etc, that is an obsession.

Also not even all language delays are considered autism. My brother didn't speak until he was 2 1/2 or 3, and he is not autistic. He does have learning disabilities, but there are some perfectly normal people with average or above average IQs that are just slightly behind in their speech.