Host: Language, by a year of age you would expect a kid to say how many words?
Henry Joseph Hasson: Well, by year of age children should be having their first few words. When you say language, it's not always necessarily words.
Host: Sound.
Henry Joseph Hasson: Well, not only for that, for example, pointing is really one of the first language that we see, that in children, they will point for what they want even before they are able to say words.
Host: So you call that expressive language?
Henry Joseph Hasson: Sure, that will be part of expressive language. Even babbling and cooing is the first starting of expressive language, and as using the hands is easier than controlling all the muscles in the mouth that it takes to say certain sounds and words. You can see children using their hands and gesturing as expressive language even before using their words.
Host: If a kid at four months of age doesn't make an eye contact, would there be a little bit of concern?
Henry Joseph Hasson: Sure. Definitely by four months of age they should be; at least with their mother, with the people that they are used to, should be making eye contact, and they should be following, specially something that's of interest to them.
Host: What about social smile, is that a little bit of concern?
Henry Joseph Hasson: Sure, that will be concerns.
Host: What would you expect a social smile that should be there in most babies?
Henry Joseph Hasson: It's early on, I mean, they really start smiling from one, two month of age, they will really start responding to their mother and being consoled by their mother.
Host: So in other words, if the kid is say 15 to 18 months and is really not expressively; by pointing direction, or with words, that sounds like another big red flag sometimes.
Henry Joseph Hasson: Yeah, that would be a red flag. There are all sorts of disorders that are associated with expressive language disorders. By expressive I mean, where they are saying enough as opposed to receptive, where they are understanding language, and it varies.
Host: Okay. Of course, if you don't think the kid was speaking, you would always make sure the kid had a hearing test.
Henry Joseph Hasson: It's always the first thing to do. There is a newborn hearing screen that's done when they are first born, but of course that's not very accurate. That's helpful, but if the child is not speaking, one of the first things you could do is check their hearing, because that's something that could be taken care of.
Host: There are ways of doing it that are reasonably accurate as the kids get older, but they should not just be taken to anybody; it should be someone specially trained in doing that with children.
Henry Joseph Hasson: Yes, of course.
Host: Because some of it is based on observations too, isn't it?
Henry Joseph Hasson: Right. I mean, some parents will come and say, oh, of course my child hears, I can tell that they hear, but hearing is very specific, and there are different frequencies that some babies can hear at and different frequencies that language is functioning at, and therefore all those frequencies need to be tested properly.
Host: So the kid doesn't have a social smile and doesn't speak, people are really worried about a term today, and the term is called autism. Now, you don't likely put that diagnosis on a kid in the young age, but you think about it a little bit, a kid that doesn't have a social smile and doesn't speak, but we don't say the kid is, we have concerns.
Henry Joseph Hasson: Right, early on to make the diagnosis however, if you start seeing that they don't have language and they don't have sociability and they are not interacting properly, its something that you definitely want to keep in the back of your minds, that you can keep following the kid closely, so that you can diagnose it as early as possible, because the sooner you diagnose the problem, the sooner you can start treating it properly.
Host: There is a term we used, language delay, which is not autism; some kids just speak later, and they are perfectly okay.
Henry Joseph Hasson: And a lot of that is hereditary and genetic, and sometimes if you into the family; the mother's family, the father's family, you can find that they have other learning disabilities or language disabilities as well.
Host: Now, if the kid is a two years old, no expressive language, virtually no eye contact with mother and father. Would you have a greater concern if you could possibly have this -- we are hearing in the news all the time, autism, is that a possibility?
Henry Joseph Hasson: Sure, it is possible, and its something we are going to look at, and we will look at all his social interactions, we will look at the way he plays, the way he interacts with his environment in general.
Host: What would make you be very suspicious, anything else that you would look at say, maybe this kid is doing something, no, this is it. What would make you suspicious?
Henry Joseph Hasson: Sure. The other thing that -- certain autism do is, someone has stereotypies, which are just repetitive movements such as hand clapping, or some children will be spitting on himself or banging. Others like doing repetitive behaviors such as flipping light switches, opening and closing the doors, cabinets, spitting on themselves, and a lot of them will prefer to be alone, not necessarily prefer to be with other children or interacting with other people. They don't play with their toys in the normal manner that children play with their toys.
For example, there is imaginative play, where the children will take two cars and roll them and crash them, and make traffic jams, and things like that. Children with autism may just line them up or stack them or bang them on their head or something like that.
Host: But even some of these kids who do all these things, when they are five years old, you don't know why, some of them end up being okay too. Is that true?
Henry Joseph Hasson: Yeah, I mean autism is a spectrum; its called autistic spectrum disorder. One of reasons today that there is a very wide spectrum that some children have some of these features and can do very well, while others have more of the features and have more of difficulty with social interaction and with language. Actually one of the biggest predictors of how well they will do as they develop is really their social interactions, because that's one of the most important things.
