Q: My three-year-old son has not started speaking as yet. All my son's milestones were a little late, for example, he held his head up when he was 70 days, started sitting at his seventh month, started standing with support at 11th month, and started to walk at his 15th month. He also has a squint problem. We took him to Sankara Nethralaya in Chennai when he was 26 months old. At that time, he did not cooperate at all, and the doctor told us that he does not have direct eye contact at all. He suggested that we take him to a Neurologist. We went to a Neurologist, who conducted an MRI scan and a chromosome test. The reports were normal. The Neurologist told us that he has no problem in nerve and brain, but suggested for occupational and speech therapy. At that time, my husband got an onsite project, so we moved to Hong Kong. As a result, we didn't take him for speech therapy. He understands everything and has a sharp observation. He speaks only a few words like 'amma', 'appa', 'grandma', 'aunt', 'uncle', 'food' and some other letters. If I teach a word, he only says the first part of the word, for example, when I say ball, he says only 'ba'. He responds to his name. He knows the alphabet, numbers (1-10), shapes and colours. Here, he went to a play group for two months where he listened to rhymes, but never participated. But at home, if I act out rhymes, he follows me and does all the actions. He never goes outside without me, not even with his father. He is afraid of loud sound and heights. He mingles with other kids of his age and likes to watch and listen to rhymes. He does not have any problem eating food. Is my son autistic? Is it necessary to start speech treatment immediately? Will it be good for him to return to India?

A:You will have to speak clearly and slowly to him and encourage him to reply in words. Let him ask for what he wants. When he is eating or being bathed, use the terms for everything around. Let him get familiar with the words for the things he uses. Do this playfully and as a game, not as a strict instruction. He may not have any neurological problem, just a developmental delay. Read story books to him and let him look at the pictures as you read. Get some CDs of children's music and let him learn the songs and sing along. At some point later, you can get his squint corrected. Let him develop confidence in doctors. Be patient, but also be systematic in getting the child to use speech for his communications.