Monday, October 27, 2008

Andre's brush with autism

I realise that there are some parents who worry about whether their children have developmental disorders, so I wanted to share my experiences with Andre.
As a toddler, Andre was always happy and bubbly, though rather timid. In terms of physical development, he was right on schedule - walked at 12 months, ran at 14 months. However, in terms of speech, he was worryingly slow. By age 2½, he could only say a sprinkling of words like "car", "ball" and "no" (which is more typical of a 1½-year-old). He only called me "Mummy" for the first time close to his 3rd birthday.

We brought him to a speech therapist but the evaluation was inconclusive as he was too young. Interestingly, as his vocabulary slowly grew, at first it almost entirely evolved around vehicles - something he's crazy about. "Red truck", "big bus", "train", "crane" and his favourite "dig dig sand" (this was his name for the digger). In fact, every time we drove by a construction site, he would get all excited and exclaim, "Many many dig dig sand!" This was past his third birthday. (For a long time, his ambition was to be a truck driver, by the way).

Then we grew more concerned when we read up on autism and we realised that he had many of the symptoms, such as delay in speech, inability to relate to what is "realistic" and what is not, and constant repetitive behaviour. Eg. he would zip around on his tricyle or little car round and round exactly the same spot in the living room for long periods at a time.

Another symptom of autism that Andre manifested was an unusual focus on parts of toys rather than the whole toy. I had come across a pamphlet on autism which said that one thing austistic kids like to do is to spin the wheels of a bike and stare at it. Reading this gave me a big jolt as that was EXACTLY what Andre would do. He would turn his sister's bike upside down, spin the front wheel and watch it. Over and over and over again.

Andre loves cars. But instead of making the cars move or park or do other car-like motions in make believe play, he would just line them up in rows, sometimes straight, sometimes in circles (like in right pic). Once he had used up all his cars, he would remove the first car and start another row. He never actually "played" with them. And when he was lining up his cars, nobody could touch them or mess up the rows, that would trigger a screaming fit of anger and frustration.

When we eventually brought him to a child therapist for an assessment, she explained that this was apparently some sort of social deficiency in play. Since play is a way for children to re-create their social construct of the world, how they play is very revealing. In the therapist's room were a variety of toys, which she encouraged Andre to play with. He was drawn to a large dollhouse with many pieces of furniture. But instead of playing with the furniture, he took them all out and started lining them up in rows, like what he did with cars at home. The order was random, ie he didn't care whether it was a bed or a table or a lamp, he was only interested in forming patterns with them.

We only went back to the therapist for a couple of sessions. Like the earlier speech therapist, she couldn't confirm any diagnosis. But I guess since that was her rice bowl, she tried to make it sound like Andre needed to go for regular therapy to iron out his kinks. We just didn't buy it, I mean there must be 1001 different ways in which children develop, right? By then, Andre was making progress in his speech (albeit slowly), so we decided to take a step back, monitor his situation on our own and not be so quick to label him.

We know now that was the right decision. Andre is now a cheeky, well-adjusted 8-year-old who CAN'T STOP TALKING. He still enjoys arranging his toys (this pic on the left was taken when he was 4 years old) but he has also naturally learnt how to play in a social manner, without any therapy or rigid enforcement by his parents (imagine being told, "you have to play like this!")

Of course hindsight is 20/20. I'm not suggesting that all children be left to develop on their own. If your child does have autism, ADHD or other developmental disorders, early intervention is preferable. I know a child who was clearly autistic but whose parents were in denial and refused to admit he had a disorder. He was brought for an assessment only years later and confirmed to be autistic, wasting precious time that could have been constructively spent managing the condition. If you suspect something is wrong, I don't see any harm in getting a professional assessment, although if your child is too young, the tests are often inconclusive.

All I'm saying is that more often than not, what we think might be symptoms of a disorder are just the quirks in our children developing in their own way. So keep an open mind but don't be too quick to jump to conclusions. Child psychologists agree that the spectrum of child development is so vast and varied that it's impossible to mention every possible scenario. Such is the uniqueness of human beings.


breve1970 said...

My goodness, this is good information for me! Thanks a ton, Monica. Will let you know once Hayley gets assessed next month. The therapist is meeting up with me first before assessing Hayley in December!

Anonymous said...

My youngest boy plays cars exactly the same way as Andre - lining them up in rows. And when he played on the long sofa, nobody else can sit on it, otherwise he would burst into fits of anger and tears. But of course, now that he is older (4 years), he responds to my threat.

He also has a fascination with trucks. When he was just a toddler, his pronunciation wasn't very good. He would trip his "t" and often coming out as a "f". So imagine the reactions of passers-by whenever he saw a truck zooming past, and he would shout out loud the F-word. Haha... I would always try to cover his mouth, but in vain.


Alcovelet said...

Wow Monica, you guys must have been worried stiff. Coupled with having a super smart elder girl, the natural comparisons must have been difficult. I'm glad Andre grew out of the issues. So it is true that most kids even out by 8 or 9!

What was it that made you think he wasn't autistic and therefore confident enough not to go for OT? Was it because you could see rapid changes, and that he could relate to people around him? Mummy's ALWAYS know, despite our penchant for over worrying.

monlim said...

MD: LOL!!! I can imagine the passersby thinking what on earth you are teaching your kids!!

Ad: I think mostly because by then, he had started to talk, which was the part that we were most concerned about. With the speech development, his understanding also improved, so we thought even if he was autistic, it would be a very mild form and we could wait a bit. Lesley-Anne also spoke very late (after age 2), but once she started, she spoke in whole sentences :P

But yes, it was worrying though we did keep in mind that all parents at some point worry whether their kids are normal!

monlim said...

Ann: Good luck! Do keep me posted, hope everything turns out well.

eunice said...

MD: I can imagine what passers-by were thinking!

When Sean was young I was afraid he had ADHD, he couldn't keep still, couldn't focus, he couldn't even sit still to watch TV etc. It was quite worrying esp when a few people pointed how how hyper he was compared to other babies his age. I didn't get him tested cos I wanted to wait and see.

Physically he developed quickly. He walked and talked pretty early (10 months to walk, 12 months he started running).

He's normal (as normal as an 8 year old can be) now and can focus on work. It helped that when he was in Reception (4yrs old) there were only 8 kids in his class (1 teacher and 1 teacher's assistant). The teacher did say that his attention wandered frequently but because there were so few children she was able to pull his focus back. That year really helped.

I realise that many parents and people are quick to label children if there don't conform. I know of many of my friends whose children are labeled cos they don't fit the norm. In some cases, the children really have special needs. In others, I feel that all the kid needs is a little bit of discipline and boundaries.

What I'm trying to say is that sometimes children just need a little more time to develop.

Anonymous said...

For a while we wondered if our older kids--23 & 18yrs old--have borderline autism (aka Asperger's Syndr). They are very intelligent & gifted, but are socially immature--they hardly make eye-contact, don't initiate conversation in adult company & take a very very long time to answer when asked a question, sometimes the other person just thinks they're not going to answer. With that one or two of their best friends though, they behave as 'normal'. A couple friend of ours--a GP & a nurse--also wondered if they're borderline autistic.

But recently I read this book "The Highly Sensitive Child" and I realized they're just highly-sensitive--a trait that encompasses up to 10-20% of children. The characteristics of this trait describe many of their behaviorisms--which also extend to excessive fussiness with food, clothing, textures, odors, certain aspects of cleanliness, etc.

One can never change them from being highly-sensitive, but one can help them to cope better with the world, while channeling their high-sensitivity into constructive ways.


monlim said...

YY: Thanks for sharing. I still haven't found the book since you mentioned it, but will keep looking. Sounds like Lesley-Anne definitely falls within that category!

Anonymous said...

The book is supposed to be there at kinokuniya...


Lilian said...

I think I wrote in my blog somewhere that when Brian was young, he'd line his cars up facing a particular leg of our coffee table; and at a particular tilt, and the cars were in the exact same positions.

He also liked to walk up and down the tv console staring at the console with the side of his eye (for more than an hour); he did this also in my mum's place in Malacca, and I also have a video of him doing this outside the Louvre in Paris. I was sitting on this and he ran up and down staring at the entire length of the seat. Really weird.

Spinning wheels, that too. Also very quiet especially with strangers. My mum didn't help by wondering out loud if he was autistic.

And what YY said, "they hardly make eye-contact, don't initiate conversation in adult company & take a very very long time to answer when asked a question, sometimes the other person just thinks they're not going to answer. With that one or two of their best friends though, they behave as 'normal'." describes Brian too.

He's opened up a lot the past year or so, much less shy than before, in fact, he seems to be overcompensating by being overly sharp in his retorts these days. Is Lesley-Anne the same? He's pretty comfortable talking to my friends now, while in the past, it's like there's gold in his mouth. Perhaps what Eunice said about needing time to develop is true.

monlim said...

Hey Lilian! How's Tokyo? hope you're enjoying yourself! Lesley-Anne was extremely shy when she was younger, but became markedly more confident after she was in GEP for about 6 months, that's why I attributed part of it to the programme's emphasis on presentation skills. Like Brian, she never used to speak to my friends, now she happily chatters away, sometimes even on topics that are not related to what the adults are talking about! (I guess that's a different issue :P)

monlim said...

Lilian: if only we had compared notes on Brian and Andre when they were younger, probably would've saved us a lot of worry. It's comforting to know that so many kids do "unusual" things - really, is there even such a thing as "normal" anymore??

Anonymous said...


Wha, maybe Brian was admiring the mathematical beauty of the Louvre pyramid & running through all the formulae in his head... haha..


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