Q: My 2 years old son has not started speaking yet. Although he speaks a lot of gibberish but there has not even started saying ‘mama’ and ‘papa’ yet. Whenever he wants to communicate his needs, he will hold our finger and take us to the object. He says ‘huh huh’ for yes and ‘kha kha; when he wants food. He watches a lot of TV but even if he doesn't get to watch it, he is more than happy to play with his toys or to play with kitchen utensils. The problem is at times he totally ignores us. It seems that may be he isn't listening to us although we keep on calling his name. At times, it seems that he sees through us. But at other times he immediately responds. Ignoring usually happens whenever the TV is on. He is very fond of spinning the tyres of his cars but also equally fond of pens, spoons and straws. He is also fond of building up towers with his toy rings and then equally happy to break them too. He easily manages to eat with his hands and even eats with his spoon without spilling most of the time. Whenever he goes to the park, he is happy playing on different slides and rollers. He usually doesn't come in contact with other kids his age. Is this a problem? He is very happy to roam around in the car and very fond of sitting in the shopping cart while we go to shop. Our paediatrician says there is nothing to worry even if the child speaks in monosyllables till he is 2 and a half years old. Is he correct? I am worried. Is my son autistic?

A:Reading your narrative, I would think that there is some cause for worry. Your child has not developed any meaningful language in spite of normal hearing. He uses a lot of jargon speech, hears but does not listen; can play by himself; has poor peer interaction, prefers some toys; ignores parents at times. These features lead me to suspect a group of disorders called Pervasive Developmental Disorders (PDD) of which Autism is the prototype. There is no test like blood test, MRI etc that can diagnose PDD. The diagnosis is clinical, i.e. observing the child’s development and behaviour. Generally, the symptoms consist of:

1. Qualitative impairment in social interaction -Impaired eye gaze -Lack of social reciprocity -Poor or absent joint attention -Limited or absent peer relationships
2. Qualitative impairments in communication -No language or reduced language (no alternative compensatory means used to communicate) -If language spoken, involves echolalia, difficulties in pragmatic language -Lack of appropriate imaginative play
3. Restricted patterns of behaviour, interests -Abnormal preoccupations, interests, and activities -Difficulties with change -Stereotyped mannerisms