DEAR ABBY: I'm concerned that my great-grandson may be autistic. He is 13 months old. He never laughs or giggles out loud, and his response when spoken to often is expressionless. However, he will occasionally smile slightly, is already walking and says a few words we can understand. He also is extremely hyperactive.
His parents appear oblivious to this behavior, and I wouldn't dare suggest that I may be seeing a problem. My question is: Do all pediatricians check for this at regular visits? My understanding is the earlier the detection, the better to start treatment. -- WORRIED GREAT-GRAMMY
DEAR GRAMMY: Pediatricians perform developmental screenings at each and every visit, and any delays out of the ordinary should be investigated further. Typical autistic features include social interaction difficulties and speech delay.
Autism is a difficult diagnosis to establish since many of the features aren't apparent at a young age. Most pediatricians will do an M-CHAT (Modified Checklist for Autism in Toddlers) at 18 months of age. If the M-CHAT reveals areas of concern, a full developmental assessment is recommended.
Because you are worried, you should bring your concerns up with the parents so they can discuss this with their pediatrician. That way the doctor can reassure the parents (and you) if your great-grandson is developing appropriately, or refer the child for a full developmental assessment if there is cause for concern because earlier detection is always better. You are wise for seeking advice for your concerns regarding the child, and I'm glad you wrote.