Curtis was 2 years 8 months old when he was first diagnosed with autism disorder in September 2006. Laura recently came across the paperwork from this visit to the Development-Behavioral Pediatric Clinic and we looked it over, remembering the visit very well. Curtis spent 2 hours with an assessment team before his autism spectrum diagnosis was determined. Here are some of the highlights from the report. I will split it into two posts due to length.

Review of Records: Curtis was referred for speech and language evaluation by his parents and pediatrician. The primary concern was his reduced response to spoken directions and reduced use of spoken words. Using the Rossetti Infant Language Toddler Scale, Curtis' receptive and expressive skills scattered at the 12- to 15-month range with some skills scattered up to age 18 months (he was 2 years 3 months old at the time of assessment. Using the Battelle Developmental Inventory-Second Edition, his adaptive skills, communication skills, and cognitive skills were all at less than the first percentile and significantly delayed. He showed a mild delay at the 4th percentile in personal social skills, and his motor skills were felt to be at the 32nd percentile in the low-average range. The Childhood Autism Rating Scale (CARS) was carried out by an interview with Curtis's parents, and he scored 39, in the range suggestive of autism.

Past Medical History: As a young infant, he was difficult to care for, wanted to be in constant motion and to be held most of the time, so his mother carried him in a sling for most of his first 3 months to soothe him. He had blood work done, including a lead test that was unremarkable, at two years of age.

Speech and Language Skills: Curtis was initially referred to CDS for concerns about speech and language delay. He did not speak his first words until 20 months of age and is now using approximately 100 words, but he is not combining any words into phrases. He does not point to indicate what he wants but will go and stand by what he wants. Receptively, Curtis' parents are not sure if he understands "no",

Adaptive and Social Skills: He has a very limited diet and is not interested in trying new foods. He is not able to drink from a straw. He chews only with an up-and-down rather than rotary movement. He has temper tantrums for seemingly random reasons and many are associated with change in routine. Curtis likes to carry an object around with him in each hand and will sometimes try to find similarly sized objects. He puts all his toy animals neatly in rows and will pull all of his letter magnets facing up and then flip them over, one at a time. On the playground, he has some ritualistic behavior, including stopping and touching every tree or every rock, and will run back and touch one if he realizes he missed it. Curtis is very interested in the parts of certain toys, such as the wheels of cars. He will flip his toy cars over and spin the wheels and examine them closely. He generally will not bring objects or toys to show his parents and instead prefers independent play. His favorite play activities include running, which he does energetically for long periods of time on playgrounds, paths and sidewalks.

Post 1 of 2 on this topic

Greg, Dad
Dr. H, MD, MPH, PhD