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My daughter
Lily (5.5.2015, 17:30)Hello Dr.
I have consulted with you here several times before, and would like to hear your opinion again. My daughter is going to be 2.5 years soon. I'm a bit at loss about her development, and was wondering if you can offer advice (sorry for the length). My daughter has a lot of strengths - she is very affectionate with us, seeks our attention, asks for hugs, wants to play. Her language is well-developed, she routinely speaks in 4-5 word sentences, and can speak in 7-8 word sentences sometimes. Cognitively she seems Ok, and in some ways, more developed than other toddlers - she understands basic counting, knows all the letters, does simple puzzles well, understands shapes, etc. She has mild hypotonia, but walks, runs, jumps, climbs, etc. Can indicate if something is bothering her, and communicates her wants and needs (e.g. if she wants to eat or drink, if she is in pain, etc.)
However, she also exhibits some concerning behaviors. She is not interested in playing with children her age (loves babies, and watches older children, but refuses to engage). When in daycare, she refuses to sit in circle, or at the lunch table, with other children. She may ignore the teachers when she asks her to join an activity. In addition, while her speech is well-developed, almost all her communication is in the forms of questions ("what's this", "who's that", etc.). She can be very repetitive in her speech, asking the same questions over and over again and making the same statements about her toys or what she sees ("e.g. this is a big, red car"). She has a lot of pretend play, especially involving animals and princesses, but it can even look "obsessive" at times. In addition, her eye contact is great with us, but not so great with other people. In general, she has a lot of difficulties forming new attachments with adults (e.g. is not attached to the teachers at day care or her nanny, even after a long time). She's only attached to me and her dad. We have been providing her with some supportive services (OT, mainly, even though she doesn't have any extreme sensory issues), but I'm not sure if what we're doing is right. The therapists are not sure either, say that they do see the social difficulties, but not sure if she is on the spectrum or just has some unidentified social delay.
What do you think? Have you seen children like that? I know that girls on the spectrum might have different symptoms than boys, do you think that's her issue? If so, what should we give her? ABA does not seem appropriate, as she is communicative, responds to requests, follows commands, etc. I'd appreciate any insight. Thanks!