Development

QUESTION:

Dear Dr Dunlop,

My daughter is almost 11 weeks old (born at 37+6 via emergency c-section due to decreasing HR during contractions).

She did not start social smiling until about 8 weeks and despite a lot of attention and encouragement it seems like a lot of work to get her to smile. Some days I can’t get a smile at all. She otherwise makes very good eye contact and is babbling. My husband’s sister has autism.

Should I be concerned? Thanks.

QUESTION:

Dear Dr Dunlop,

I have a 23 month old boy who weighs 13kg, and is approximately 86cm tall. I have some concerns about him developmentally and in regards to his food intake.

Developmentally, he is making progress with speech, but has also lost a lot of words. So whilst he used to say hello and goodbye and had a range of animal sounds plus food request words, he hasn't used the social language for almost 8 months. He has a lot of food words (that I understand), but animal sounds, and social language are gone. He will only read the same set of books (this has been since day one - hates all other books to the point he closes them and throws them, or walks away) - these books are Paw Patrol school reader books. When he talks to you, he doesn't make eye contact, but can do this during certain games/routines (such as he will look at you if he is trying to run away from a nappy change), but when he asks for cuddles/stories/tv/food etc, he doesn't look at my face.

He is very much a sensory seeker and I have concerns about pica with him as he his exploration of textures (sand, bark, dirt, playdough etc) has become more intense and worse - lately he is eating playdough, chalk, plaster of paris, plastic toys, ear plugs, obsessively licking a salt lamp, ate his poo the other day, eats the straws off his sippy cups (not just chews, actually consumes the chewed off pieces) – it’s getting crazy. He eats ALL day and poos frequently too - the poos are runny/mushy). Most days he will consume 2 weetbix, 2 eggs, fruit pouch, 4 sandwiches (2 sliced with no crust), 2 bowls of pasta, 420ml of formula, meat, water, biscuits, and other fruit. It is non-stop. He does have dairy and soy allergy/intolerances. He has had his tonsils and adenoids removed and has grommets.

In terms of activity - very fast - a bit of a runner in open spaces, great gross motor skills as he climbs EVERYTHING, balances, jumps, scooters etc. very independent player - like he will sometimes take my hand to join him, but then won’t engage with me while I sit with him. Hates singing unless it’s wheels on the bus. likes "round and round the garden" rhyme, if I do it on his back – won’t look at me. Should I be concerned? Or is this typical toddler stuff?

Should add that he has a sister with ASD. Neither of my children will engage with the other - he pushes her away if she attempts any interaction. He hits people’s faces when they are standing in his vicinity. If I hug him front on and look at him, he turns my head away from him or tries to push my head backward (so I’m looking up). In the last week he will sometimes watch what someone else is doing, but didn’t do this at all until a week ago and still doesn’t do it much. In his own little world. Never takes you to show you things, unless requesting food - so will take me to the fridge or pantry.

QUESTION:

Dear Dr Dunlop,

I have a 9.5 month old and when he walks holding on to someone he walks on his tippy toes, when he stands in one spot sometimes he is on his tippy toes or flat foot.

Is this normal? How do I help him stand flat foot?