The AAP does not recommend an MRI for global delay unless there are other issues on a neurological exam. Asking why your doctors recommend an invasive procedure, what change it will make in treatment, and whether watchful waiting would be acceptable, is totally OK and the basics of being an informed patient. |
Nor can OP’s and it worries her AND the teachers ANDS the doctors seeing him. |
https://pediatrics.aappublications.org/content/134/3/e903 |
Disagree with the ADOS suggestion. PPs, they are estimating his overall cognitive and developmental level at 9 months. An ADOS would be a waste because if he has trouble completing the activities there is no way to tell if it is because of autism, or because he has the skills of a 9 month old. A diagnosis of autism is only made in a child with delays if the social delays seem beyond the other delays. There are still a lot of social things a typical 9 month old is not doing yet. The ADOS just doesn't have that kind of specificity. No one is ruling out a diagnosis of autism forever, but an ADOS is unhelpful at this point. |
+1, we are not talking a 3-4 year old but a child under age one |
APP gives general recommendations. It is up to the specific doctor and there may be a reason for it. |
A young child not painting with a paint brush is not to be concerned. Not walking and babbling/starting to talk, yes, but painting is a bit absurd to worry about given the situation. |
PP here. The pediatric neurologist, in a highly-regarded childrens hospital, recommended the MRI after dd's EEG, based on results and exam. I'll go with the doctor's expertise on this, not Dr Random-on-internet, thanks
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OP I am not a parent of a kid with autism (mine has a physical disability) but I am familiar with autism due to my education and work. The motor delays, not imitating others' behavior, and repetitive behavior (spinning toys rather than playing with them in a typical way) do make me think of autism. I honestly have no idea whether the autism screening tests are validated for kids with global delays, but I would Google the M-CHAT and see how your child scores. It is validated for ages 16-30 months (but again, may not be appropriate for kids with global delays). If you get a concerning score talk to your doctor and/or therapists about it.
Does your child look at things when you point to them or act really interested in them, or look to you for reassurance if something unusual is occurring (e.g. a loud noise)? Does he bring or show you a toy or object just for the sake of sharing the experience with you? You might find this video from Kennedy Krieger helpful as it focuses on early signs of autism in 1 year olds. https://www.youtube.com/watch?v=YtvP5A5OHpU I personally don't think it would hurt to get a second opinion about an MRI. The fact is that anesthesia has long-term effects on a developing brain. Of course the benefit outweighs the cost if the MRI is deemed medically necessary. I myself am holding off on an MRI for my child until he's old enough to stay still, even though a doctor would probably sign off on one for him. It may or may not identify a cause for his disability, and in the meantime does not change how we treat it. The MRI will show anything that might be going on at the gross anatomical level but will not tell you anything about possible abnormalities in brain cell function or communication. Abnormalities at the molecular level can have a big impact on development, but our methods for assessing these types of abnormalities in people is very limited due to the invasiveness of the techniques. I hope you get some answers sooner or later, OP. It's so hard when they're young and you don't know what the future looks like. |
What is your deal? He’s 18 months and not doing any of the things you listed. Nobody on this thread has said he’s getting evaluated for not being able to paint. It is one more piece of the puzzle that OP mentioned as an example of the many ways he lacks gross motor function and doesn’t use other people’s actions as a model for his own , which is how young children learn. |
OP here. Yes, that’s exactly what the developmental pediatrician said as well. It is going to be hard to evaluate him because of his skills as a 9 month old. |
OP here. Thanks, this will be our approach when we meet the neurologist this Friday. |
I disagree. The toddler module for the ADOS can be administered as early as 12 months, and does not look at physical or language skills, but rather at joint attention primarily. Diagnosis of autism as early as 14 months is very stable: https://www.sciencedaily.com/releases/2019/04/190429111803.htm. If OP gets on the list for KKI or Childrens, her child will probably assessed right around 2 years old, which is good timing. https://www.sciencedaily.com/releases/2019/04/190429111803.htm |
that makes no sense to me. The ADOS is not a test of physical skill. It's a test of how the child relates to the examiner. I would get on the list at KKI. |
You misread. He is not 9 months. He is 18 months and developmentally at 9 months. |