When is autism not autism?

confused child

Does my child have autism, or is it something else?

Annie was a cute 4 year old that I was asked to work with. She had just been diagnosed with autism, had virtually no speech, ran around grabbing things and had tantrums throughout the day when activities were changed.

Flailing limbs, biting, kicking just to get her from an activity on the floor she was engrossed in, to the dinner table. Once there, she would calm down and eat. There were no trips to the stores because of grabbing items and screaming, no birthday parties due to the inability to play well with others and virtually no communication skills. I’ve been a speech therapist for twenty-five years, been involved with learning disabilities for the last 14 years, have seen thousands of kids, but I’ll never forget Annie.

Mainly because she wasn’t autistic.

Annie had great eye contact and would watch what a person’s hands were doing. She was quite social when engaged in an activity. She recognized people and knew who they were in relationship to her. But she really didn’t get what people were saying to her.

I quickly figured out she had a severe auditory processing problem.

Of course she would get upset when an activity changed. She’d be playing along, the usual murmuring of ‘blah, blah, blah” going on in the background, something she had learned to tune out since it didn’t make sense, and then, wham! She was being picked up and someone was forcing shoes on her feet or she was being led to the bathtub or made to do things without knowing what was going to happen next.

Along with working on listening skills, I taught the family to speak in only one- and two- word sentences. “ Eat now. Done play. Get bath.” Annie started processing those very short phrases and started imitating them. She stopped grabbing things and learned to say, “More cookie. Want bear.”

Within 6 months, Annie was using 3-4 word sentences and her behavior had improved immensely. She was allowed back in the shopping cart and could start a preschool program.

The point here is that sometimes we jump too fast to label a child with autism when in fact there may be other reasons for that classic identifier of a  “disconnect’ with the world.

  • Hearing impairment can cause a child to not understand speech and can go undiagnosed for years
  • Visual processing delays might cause a child to not have good eye contact and not focus on visual information put in front of them
  • Delayed speech may come about because of Apraxia, a delay in the motor regions of the brain that prevents words from being formed. Some children with apraxia, like children with autism, never learn to say more than a few words.
  • Poor word finding or low vocabulary can come about because of Dyslexia or an expressive language disorder.
  • Severe ear infections can cause a central auditory processing disorder, like in Annie’s case. Children do not attend to speech, won’t watch TV or movies and they often have limited speech in return.
  • Like with autism, a language-delayed child may not understand that someone is using humor. They may interpret the communication word for word and fail to catch the implied meaning.

Getting the right diagnosis is so important. If you are worried that your child is exhibiting symptoms of autism, visit the ear doctor, the eye doctor, or a speech therapist. If all of the processing areas check out, then a neuro-pediatrician or a behavioral specialist visit is warranted.

Remember, it may look like your child is exhibiting symptoms of autism, but other processing disorders can mimic many of that disorder’s signs and characteristics.



Photo credit: Canstock photo