The other night, we went to a barbeque with D’s coworkers.  One of his colleagues has two kids, and they were there, too.  One is roughly 13 months and the other is roughly 3.  (I didn’t ask for specific ages but the mom was talking about potty training, and how they would be probably trained at the same time, at 4 and 2…so it isn’t a bad guess for the ages.)

I will say that I *used to* evaluate kids ALL. THE. TIME.  Because for my job, I was evaluating kids ALL. THE. TIME., and giving these kids diagnoses that they would potentially carry with them for the rest of their lives, and *my* role in the evaluation was to ask their parents a bunch of questions and observe the kids in their home environments.  But?  The kids were all pretty much scoped out for me.  This was for a research project, and the kids were referred by their EI (early intervention) providers for some concerning symptoms, and we had done the M-CHAT (Modified Checklist for Autism in Toddlers) on the phone with the mom, and *sometimes* we had even done the ADOS (Autism Diagnostic Observation Schedule) with the child in our lab, so I had a good sense of what the kid was doing EVEN BEFORE I was in the family’s home.

So I spent a lot of my time with “typical” toddlers (or those who did not carry a diagnosis of an ASD) observing them, too.  Because I can describe what “initiating joint attention” is – in layperson’s terms – with the best of them, but to see it?  Is something entirely different.

And I am slightly embarrassed to say that I would sometimes diagnose our friend’s child with an ASD, and those children appear (now, a few years later) to be completely normal.

OK, that happened once.  Just once.  And there were many more kids that we met that I decided were normal and, lo! – they were.

(For the record, I *NEVER* shared my opinions with other parents unless I was specifically and directly asked.)

So ANYhow, I stopped this practice probably 2 years ago, mostly because I got a decent sense of typical toddler behavior all on my own, PLUS I started evaluating teenagers and adults, and the bulk of my clinical experience to that point had been with teenagers…so it became less necessary.

I say all of that because it kind of explains my new post series, called, “My toddler…”

This weekend, we met these two kids, and the three-year old (a boy) was just kind of hanging out by himself, being cute, whatever.  I honestly didn’t pay much attention to him at first.  D and I got some food, put it on plates, and walked out to the balcony where other people were hanging out.  Little Guy came out, plopped himself next to me, and, without LOOKING up at me or saying a word, reached over to my plate, dragged it over in front of himself, and proceeded to eat my grilled corn on the cob.

Which was, frankly, hilarious.  I just got up and got another piece of corn.

Then there was a cordless phone in the middle of the table.  He reached out to the phone and started messing with the buttons.  I decided that was probably not the best idea (his parents were inside, and the rest of the table was totally not paying attention to him), and redirected him by asking him if *I* could see the phone.  I reached out my hands.  Again without making any eye contact, he handed the phone over, and then proceeded to take his (my?) corn, go over to the grill on the balcony, and try to stick his corn in the grill by saying, “Hot.”  “Hot.”

Which we interpreted to mean, “I would like this corn hot”.

(The grill was off by that point, for those of you wondering about child abuse and neglect here…)

So one thing, that I am not going to ask about because I *KNOW* without asking, is that this child’s expressive language is delayed.  VERY delayed.  Two-word phrases, all prompted (some less prompted than others, but the unprompted, spontaneous language was all comprised of single words), and very few of the phrases included a subject, like, “Corn hot”, or “I go in”, etc.  So let’s leave the language alone, because it is clearly an issue.

However, here are the things that I would normally pick up as a concern:

1)  The taking food without looking up at me and making eye contact.  Yes, it was funny.  But do three-year-olds typically make eye contact when taking something?  The food was certainly far enough from him that he PROBABLY did not think it was his, but the way he grabbed it…well, he probably did know it wasn’t his.  In fact, later in the evening, he proceeded to grab food off my plate again (I really don’t care about that), and his mom was sitting next to him, scolded him, and he looked up at me again, as if to ask if he could take the raspberry…which says to me that he knows how to ask permission.

(Nonverbal kids can still “ask permission” to take things, by using joint attention and eye contact.)

So…does your kid make eye contact when grabbing something from someone else?  A stranger?  A familiar face?  A parent?

2)  Eye contact, round two:  if someone asks your child to hand them something, does s/he make eye contact with the individual asking for the object?

3)  Tantrums:  if your child likes an object, and is playing with the object, and a stranger asks him to hand it over (in a happy, fun voice), how would he respond?

4)  Playing with the grill:  this is a two-part question:

a)  Does your three-year old know that something is “hot”, and should not be touched?

b)  Does your three-year old try to mimic you, by putting things in the grill (or on the stove)?

5)  When saying goodbye, does your three-year old:

a)  wave upon mom/dad saying, “Say bye-bye”, or in response to others waving to him/her

b)  Wave on his own, because he knows he’s leaving, and that’s what you do when you’re leaving

c) not wave.

I will post the description of what *I* might be looking for in an evaluation of a toddler (either typical or with suspected ASD) in my next post.  I’m really curious to know whether I am too harsh in my interviews (maybe?  Although I follow the algorithm of the interview VERY tightly) and whether my image of a “typical” toddler is, in fact, “typical”.

So…what does your (2-4 year old) kid do?  (**Don’t worry, these questions comprise only a *TINY* proportion of what I ask about, so even if your answers are, “never looks at anyone, doesn’t wave, and plays with fire”, I will not think any differently of your child.)

Thanks for your responses!

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