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Psychological services for internationally adopted children
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Q: I have a referral of an 18 month old who was completely silent during our visits.
Are there tips for the prospective parent on distinguishing significant language delay as a possible symptom of autism or as simply an effect of being institutionalized?

A: First of all, an adoptive parent needs to understand that any institutionalized child will be behind on pretty much all developmental milestones. Speech and language development are especially vulnerable because of an obvious lack of mediation by adults in the institutions. So, the lack of any vocalizations or speech, taken separately, is not yet a sign of any specific problem at the age of 18 months.

Some other behaviors should be noticeable and accompany a lack of speech--these may indicate autistic features in an infant.
These behaviors include passivity, few gestures, a tendency to fixate on objects, reduced social interaction, and lack of facial expression. These signs may be attributed to many issues and delays, typical for orphanage children (institutional autism among them). The bottom line is, it's very difficult even for a professional to differentiate between some developmental delays, real autism and institutional autism. In such cases parents should collect as much information as possible and ask for a professional opinion.



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Last update on May 8, 2018