Q: My 3 years and 9 months old daughter hasn't started speaking yet. We are very confused with speech therapists and doctors with autism. She has been tested by an audio therapist about her hearing problems. They found that she can hear properly but she is not very attentive. Sometimes she hears a small noise and runs after it and sometimes she doesn't recognise sounds of vehicle horns outside the house. She sometimes responds to her name but sometimes she doesn't. I think she doesn't even know her name yet. When I come back from office and if she is watching TV, she doesn't even notice me. But after sometime, when she sees me, she comes running towards me. She likes to play outside but prefers playing inside if someone is there to play with her. She plays with anyone of her age group. She loves playing with pets, but once she approaches them, she starts yelling. She speaks a few words, like baba, mummy, water, TV, etc. Sometimes she calls me mummy and sometimes with an unknown word. We are Bengalis and live in Nasik, where most of our neighbours are Maharashtrians. They speak in Marathi or Hindi. She recites the first line of Johnny Johnny Yes Papa…. She can write from A-J, but haphazardly. She can draw faces etc. She can draw the sketch of a cat. I have given her a drawing book and colour pencils. She maintains direct eye contact with every one and doesn't feel shy when new people visit us. She comes straight to them and tries to talk in her own language. She goes to school and mixes well with other children. She had taken part in the school annual function as well. Apart from her speaking problem, she is absolutely normal compared to other children. We have taught her to speak her name. If we ask her name, she says it correctly after trying for 2-3 times. She prefers bright colours and new clothes. While sleeping also she prefers new clothes. She doesn't like to eat anything except wafers and chocolates. She doesn't like the usual daal bhat and roti. She cries when we force her to eat. She weighs 13 kg and her height is 3’.5”. Someone advised us that she may be autistic. We are unable to find a good child psychologist in Nasik. Is she an autistic child? If not, what should we do next? If she has delayed speech, then what is the solution? Will it be good for her to shift to Kolkata for some time where the doctor is also a Bengali? Kindly advise.

A:I am impressed with the detailed observation you have made of your daughter. From your report, I would say that your child is not autistic. However, there is a problem in her attention, I think and in her eating habits. She should be eating more nutritious food and should improve her weight. Instead of offering her what is cooked for everyone, you should make the food specially for her, at least until she is more healthy. Wafers and chocolates by themselves are highly inadequate. You could make a milk shake with her favourite fruit. Cheese could be added to a piece of bread. Eggs could be made in different ways. Find out what she likes and get her to increase her input gradually. If you can, please include some fruit and vegetables in her diet. Make the food attractive to look at. I know of mothers who would make the roti (or dosa) in different shapes that the child liked and could recognize, to get the child to eat. Let her have snacks between meals, but protein-rich snacks. Spend a lot of time with the child and make it fun for all of you. If it is possible for you to shift to Calcutta, it could be a good idea: the language heard at home and outside would be the same and she may pick up the words more easily. Some children get confused when they are exposed to two languages at the same time. As you say, there may not be an expert that you can reach in Nasik. But you can still find out whether she listens to music, playing children's songs on tape may enthuse her to join in the singing. It does not seem that your child has a major problem but you are right to be concerned. All the best.