2 year old hand flagging & jumping on tiptoes

[Anonymous]

Anonymous wrote:

Anonymous wrote:It can be normal in all kids and a phase or it can be a symptom of autism. Some kids just do it when they are excited but can stop if you tell them to stop. If its a speech delay, you will get some similarities to autism but generally the kids will outgrow them at some point as the language gets better. Get speech therapy.

My daughter did some things like this at that age and my ped told me that if I ask her to sop and she stops, it's not a sign of autism. Also, she didn't talk till 23/24 months, but it was clear she understood everything that was going on, was engaged, curious, etc.

That's not actually true. Not all kids with autism can stop stemming if they're asked to but many can.

[Anonymous]

Anonymous wrote:OP here. My LO did not do ADOS, but the developmental psychologist from dc children hospital told me that my LO does not have consistent eye contact. I need to work on her on that part, like playing with her & interacting with her more & cut down screen time. I will sit and observe & hope she will outgrow the hand flapping & jumping part on tiptoes.

She will have an another follow up appointment 6 months after. Hope by that time, things would get a bit better.

Are you getting speech therapy from early intervention services? If not, see if you can. Ask if you can do the Hanen program "it takes two to talk." If there not offering it, you can see if your local library has the book or order it off amazon.

This child has autism but the strategies used would be similar with many developmental delays in becoming more integrated into the child's play:
https://m.youtube.com/watch?v=V-c50HNnPg0

[Anonymous]

OP, I'm unclear why the developmental pediatrician did not do ADOS with a child who has a speech delay, poor eye contact, is hand flapping and walking on toes. One or two of those symptoms possibly ok. But all four is a giant red flag. I think you should insist on the ADOS. And many kids with autism, especially those on the milder end, can certainly stop stimming if told to do so. Also, be aware, that most Drs are on the lookout for boys with autism. Girls often are diagnosed later, because they can present in slightly different ways.

[Anonymous]

Anonymous wrote:OP, I'm unclear why the developmental pediatrician did not do ADOS with a child who has a speech delay, poor eye contact, is hand flapping and walking on toes. One or two of those symptoms possibly ok. But all four is a giant red flag. I think you should insist on the ADOS. And many kids with autism, especially those on the milder end, can certainly stop stimming if told to do so. Also, be aware, that most Drs are on the lookout for boys with autism. Girls often are diagnosed later, because they can present in slightly different ways.

Yes, I'm surprised that they didn't do the ADOS or some additional screening for ASD. There is another screening tool for ASD called the M-CHAT which your pediatrician can do (perhaps the Drs at Children's did this one?) Your child could simply have a speech delay, but I would trust your gut on this and try to get additional screening or a second opinion. If the child has ASD, you might want to add ABA or other therapies now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I'm unclear why the developmental pediatrician did not do ADOS with a child who has a speech delay, poor eye contact, is hand flapping and walking on toes. One or two of those symptoms possibly ok. But all four is a giant red flag. I think you should insist on the ADOS. And many kids with autism, especially those on the milder end, can certainly stop stimming if told to do so. Also, be aware, that most Drs are on the lookout for boys with autism. Girls often are diagnosed later, because they can present in slightly different ways.

Yes, I'm surprised that they didn't do the ADOS or some additional screening for ASD. There is another screening tool for ASD called the M-CHAT which your pediatrician can do (perhaps the Drs at Children's did this one?) Your child could simply have a speech delay, but I would trust your gut on this and try to get additional screening or a second opinion. If the child has ASD, you might want to add ABA or other therapies now.

OP here. The reason we went to see developmental pediatrician at children's hospital because my DD failed M-CHAT at 18 months checkup. Her pediatrician told me that she did not think my DD has autism based on her experience & observation, but since my DD failed M-CHAT, it is just better for preventive screening to schedule one at children's hospital. It was a long waiting time for us to get an appointment & finally meet developmental pediatrician at children's. The developmental pediatrician was aware of our concerns for possibly autism & adhd for our LO.

During the 2 hours appointment, he plays with her with a lot of different types of toys, and also some role-play stuffs. We answer a lot of questions & also tell the doctor about our concerns & things. He says that my DD loves to interact/social with people, has eye contact, but just not consistent, so we need to work on that. My DD is not ADHD based on his observation, and he is certain about it. My DD only did hand flapping & jumping on tip toe for a couple seconds during the 2 hour appointment, and it was because she was so excited with the toy the doctor was holding. The doctor saw that behavior & said that as long as any repetitive behaviors is not excessive, it is not a check mark for autism for her age. He was not concerned at all. The doctor told me that a lot of time, speech delays and autism have a lot of similarities, and he think that my DD situation is more like speech delay situation.

My DD perform really well during the whole appointment. As a result, my DD's pediatrician & developmental pediatrician are not concerned for autism & adhd on my DD at this moment. I don't know what ADOS is, the doctor didn't mention about it during the appointment. Sorry, so I assume he did not do it then, but we will have another appointment 6 months later for follow up to check on mainly her speech & eye contact.

[jjconcern]

You have received many informative replies to your post so I won't go over the same information. She sounds like a lively child who loves movement and dancing. As a school psychologist I would think that she would need to show more neurological signs before an ADOS is considered for a 2 year old. She is a little young to be looking at ADHD and speech delays. Our grandson did not talk till 3 years old but once he did his vocabulary was advanced and we realized as he grew up that he was an observer rather than a talker and a very gifted engineer. There is so much fear now regarding developmental delays and disorders it is easy to get caught up with making premature diagnoses on isolated symptoms. Time will tell. If there is a true developmental disorder you will know in time. Meanwhile, enjoy your daughter and don't let others comments or stares affect you or your daughter. Hugs to you.

[Anonymous]

Anonymous wrote:NP. My child is 7 now and sometimes (at times occasionally and at times frequently) hand flaps and toe walks, sometimes together and sometime separately. He's had some behavior problems and we've considered screening but haven't been convinced it's been serious enough to warrant that. Should the stimming plus some behavior problems (mostly at school) point to a screening?

Yes.

[Anonymous]

Anonymous wrote:
OP here. The reason we went to see developmental pediatrician at children's hospital because my DD failed M-CHAT at 18 months checkup. Her pediatrician told me that she did not think my DD has autism based on her experience & observation, but since my DD failed M-CHAT, it is just better for preventive screening to schedule one at children's hospital. It was a long waiting time for us to get an appointment & finally meet developmental pediatrician at children's. The developmental pediatrician was aware of our concerns for possibly autism & adhd for our LO.

During the 2 hours appointment, he plays with her with a lot of different types of toys, and also some role-play stuffs. We answer a lot of questions & also tell the doctor about our concerns & things. He says that my DD loves to interact/social with people, has eye contact, but just not consistent, so we need to work on that. My DD is not ADHD based on his observation, and he is certain about it. My DD only did hand flapping & jumping on tip toe for a couple seconds during the 2 hour appointment, and it was because she was so excited with the toy the doctor was holding. The doctor saw that behavior & said that as long as any repetitive behaviors is not excessive, it is not a check mark for autism for her age. He was not concerned at all. The doctor told me that a lot of time, speech delays and autism have a lot of similarities, and he think that my DD situation is more like speech delay situation.

My DD perform really well during the whole appointment. As a result, my DD's pediatrician & developmental pediatrician are not concerned for autism & adhd on my DD at this moment. I don't know what ADOS is, the doctor didn't mention about it during the appointment. Sorry, so I assume he did not do it then, but we will have another appointment 6 months later for follow up to check on mainly her speech & eye contact.

The bolded part is very true -- I can say this from personal experience and I have heard many others say it. Given what you said here, I'd wait six months and if you are still concerned in 6 months, as the dr. to do the ADOS (it's another screening/test for ASD) at your next appointment.

[Anonymous]

My two year old does hand flapping when she's excited; it's much less frequent now, and usually happens at mealtimes.

She also went to Children's because of a global delay at 1 year (she's now caught up in all areas except gross motor). Two psychologists there both agreed that the hand flapping wasn't anything to worry about.