what were the clues?

Our son got early intervention, so early he got it without a formal diagnosis. We his parents were frankly shocked when he was diagnosed. So what tipped us off to get help?

In our son's case he did not progress very far in using words. He was 'speech delayed.' Neither I nor my wife thought of it as anything more that that.

He wouldn't use words but would point or (especially) grab your hand and pull you to what he wanted. Being parents, we of course did what we could to interpret and in a sense 'enable' him. We wanted to provide for his needs and although we did want him to 'use his words' we also did not want to create unneeded stress.

We raised the issues of his language use with his pediatrician perry early, iirc around the age of a year and a half... which was pretty amazing given that we had just had another child, purchased our first home and moved all within the space of a month. I have to give credit where it is due, my wife was the one who really picked upon his language issues and pushed to get him help.

Our pediatrician recommended speech therapy, which initially focused on building a functional vocabulary.

Our son very clearly understood a large number of words. His comprehension vocabulary was never at issue. We could ask him to perform tasks and he could do so without any excessive difficulty. He just would not use words to communicate.

It was also not as if he did not know how to speak, he just - as far as we could tell - would not speak.

We as parents of course had read to him 'religiously,' we tried to exemplify in our every interaction with him how to speak, how to have a back and forth, to use signs, pictures, photos rather than words if necessary.

And working with a therapist for 50 minutes a week, who helped guide our efforts at home, our son did make good progress adding to his vocabulary over a period of six months. Which is when we discovered other aspects associated with his use of language.

Echolalia: repeating phrases - repeating questions back before addressing them, repeating statements, repeating phrases from favorite books and repeating scripts from tv shows. This seemed a bit odd.

Another curious deficit was the seeming inability to have a conversation.

Our son could use his vocabulary to make known his wants and needs, but would not have a back and forth discussion. You could ask a question and if it was very concrete and direct you would get an appropriate response. But if you wanted to ask our son how his day was going or how he felt you would not get an appropriate response but rather a piece of 'script' - for example, reciting text from one of his favorite Curious George stories that we read to him or a song from 'Blues Clues.'

So as far as my wife and I could see, our son was making progress, building his vocabulary (as I documented weekly) starting to use words to communicate needs but still needed work on the pragmatics of speech, using the components of language properly to carry on what neurotypical people would consider a typical back-and-forth conversation...

...And then his speech therapist casually mentions at the end of one of his sessions that our son was autistic, in her opinion quite possibly with Asperger's syndrome.

B O O M !