Neurodevelopmental Conditions Require a Multidisciplinary Approach

Q: My 2 year old son has been to the neurologist and has had tests done on his brain. Doctor said tests seemed that of a normal kid, and that his symptoms weren’t all compatible with autism. He said that even then there could be something else wrong. He recommend PT, OT, and speech therapy a year ago. But his symptoms that he has had since birth continued.
His symptoms are:
  1. He is a picky eater.
  2. He shakes with hand and arm movements; raises hands above his head.
  3. He is hyperactive.
  4. He has developmental delay in both speech and OT and PT since he was a baby.
  5. He walks on tiptoes still.
  6. His tantrums are bad. He throws himself on the floor; sometimes he hits his head when he throws himself to the floor. He slams his butt to the floor. He likes to throw and kick things when he’s mad or throwing a tantrum. 
  7. He has tolerance for pain. 
  8. He sometimes spins while picking up his legs and rocks. 
  9. He gets along with adults no matter if they are strangers.
  10. He gets sort of OK with kids but he really doesn’t pay much attention to them; he rather plays by himself.
  11. He’s the only and first child
  12. He loves water pools, baths and toilets. 
  13. He’s loving and affectionate when he’s happy which is most of the time. 
  14. He plays by himself with toys. He likes balls and cars. He does things that spin but I don’t think it’s to an extreme. 
  15. He has short attention span.
  16. Recently he likes to jump.
  17. He seems to be a fast learner especially hands on, even though he’s bit behind other kids of his age, according to his therapists.
  18. Lately he’s been sometimes holding an object to his face closely and shaking and squinting his eyes. 
  19. He doesn’t like loud sudden noises.
  20. He avoids being in big crowds of people.
  21. He likes hugs. 
  22. He loves music and dance.
  23. He has awkward silly moves.
  24. He likes to count.
  25. He says words but doesn’t really know how to use them.
    This is just a list of things I notice different than other kids of his age. What could it be?
    -By Karen
Reply:
Screening for autism is quite difficult. Autism specific screening tool such as the M-CHA needs to be used.

From what you have presented here, the kid does seem to have some developmental, cognitive as well as behavioral problems. He needs further evaluation.

It is quite challenging to make a diagnosis is such cases. Your doctor would require to observe the child for some time before anything evident comes out.

Evaluating him would require a multidisciplinary approach. There are special hospitals where such cases are dealt. He needs a pediatrician, a psychiatrist, a neurologist, all at the same time.

There are some other conditions besides autism, which show such a presentation. These are usually genetic and are associated with some chromosomal anomaly. A careful examination is required to reach any conclusion.

Take Care,

Buddy M.D.