Q: My son is 2 years old. A month ago a paediatrician told us that he may have a mild form of PDD - Pervasive Development Disability. She suggested a test called CARS to confirm the above and recommended speech therapy. My son has a vocabulary of 3-4 words. He calls his father papa. He says mama when he is upset or wants something and dede when he is thrilled. He communicates in his own way and is a very expressive and happy child. He wants to be engaged in some kind of activity all the time. Earlier we thought he was hyperactive but over the past few months his activity level has reduced and has become more meaningful. He loves playing outdoors, and enjoys going to the park and walking on the grass. He wants to taste stones. Initially he used to eat mud. He loves to be bounced on the sofa or bed and jumps himself. He recognizes music and seems to remember advertisements and poems whenever played. He wants me to sing nursery rhymes to him with actions. If I say something funny, he laughs and touches my lips for it to be repeated. He is able to imitate certain gurgling noises. He is not afraid of strangers and loves to explore new surroundings. He recognizes hot and cold and always checks the temperature of the water before a bath. He likes to feel warm surfaces like a cup of tea or the sides of a refrigerator. He loves to stand in front of the A.C. or lie on a cold stone ground. He loves bathing (blows bubbles and plays in the water), and his legs being massaged. He hates it when his favourite toys are taken away from him but calms down when they are replaced by another toy. He hugs his friends when he meets them. He responds sometimes to his name. When left alone in a room, he plays by himself but not for long. He plays meaningfully, loves dragging cars, sound making toys fascinate him. He doesn't play with blocks or shapes. He listens to conversation on the phone and smiles. He sometimes utters sounds in response but not words. He sings his own songs whenever pleased. We are worried about his speech. What is PDD and CARS? How worried should we be?

A:What a wonderfully detailed observation of a lively and fun-loving child! It seems to me from your description, that you are doing everything right. Children start to speak at different ages. I know of one or two children from a multi-lingual home and environment who listened to everything and started speaking only when they could keep the languages apart. While most children start with one and two word utterances, there are some children who process everything in the brain and wait till they can speak full sentences. Since your son listens on the phone and follows all your speech, he has obviously no problem with hearing. He seems to be so creative as a person that submitting him to tests and getting labels to attach may not be the most suitable thing to do. I think that when he is in a group with other children his age, he will realise that he has to communicate through speech to be understood. Being in a play school or a play group could be good, provided it is a genuine play group and discipline and formal learning are not imposed on him. Within the home, you could encourage him to ask you when he wants anything. Perhaps you anticipate his needs, as most parents do. Try and encourage him to use words, but do this gradually and playfully. He seems ahead of others his age on many aspects. Give him large sheets of paper on which he can do finger-painting or draw with crayons. Or let him use the floor for scribbling with chalk. Expressing his energies in several ways may relax his reserve about talking. Anyway, give it another six months before worrying about testing him. Of course, expertise may be available from an aunt, a teacher, or a neighbour.