I have a wonderful niece (Lea Ann Thompson) who owns and manages a residence facility for autistic and other impaired young people in Salem, Oregon. Lea Ann and her husband Matt are full of good spirits and do-goodness, with two young sons of her own. Here, she asks a question that commonly arises out there in our modern world:

“I have a friend — and no it is not my boys — her son is about 18 months old and is exhibiting signs of autism. I don’t want to bring it up to her unless I have some kind of ‘to do list’ to offer. Because pointing out the obvious is just mean. As you may remember, I work with autistic kids in my home and also have on staff a teacher who works with special needs kids, and both of us are sure his twitches, tantrums, lack of speech, motor skills, hating to be touched, and overall extreme anxiety look a lot like autism. The other possible factor is that she drank one day of her pregnancy. Her doctor told her that he was pretty sure the baby was dead and she should prepare herself. She did so with a bottle of Merlot ( the doctor in question has since lost his license to practice). But 6 months later comes her son. My friend is a great mom — super smart and capable of following a program to help her son. Do you have any suggestions for early intervention? Or should I just keep my mouth shut and let some professional point it out to her?

Lea Ann, neither you nor I can expect to devise a course of action for helping her son. A professional should evaluate him, and help your friend understand whether or not and how he could be helped. Sometimes children develop language late, without much residual disadvantage. You might remember hearing that your uncle Mike (who is writing this blog) didn’t talk until he was three. As your grandmother put it, “I thought he was just stupid. Then he started talking, and hasn’t shut up, since!” Of course you and I know that my mom said this with a little laugh, a crooked smile, and a twinkle in her eye. Or at least that’s how I saw it!

The other characteristics you describe, in combination with the language delay, paint a more worrisome picture. I don’t think you should ever hesitate to tell a friend that she should think about seeing a professional who could help her evaluate how her son is doing. OF COURSE it takes sensitivity on your part. But if she understands that you really care about her and her son (which I know you do), she should be able to accept your advice. It will hopefully lead her to action.

It is difficult — and premature — to say much about a course of therapy without knowing more about this child, and 18 months is not the easiest age to make a crystal-clear judgment! If your friend does have the child evaluated, please communicate back with us, and I’ll try to respond — and ask our community to respond — about how we might help this mother and child.

An afterword: Alcohol poisoning can alter neurons, synaptic connections between neurons, and other elemental aspects of the development of a fetal brain. It’s not a good thing. If exposure was limited to a bottle of wine consumed in a period of despair, it was probably not a contributor to enduring problems in the child. But if heavy alcohol consumption extended across a period of days or weeks — the probability that it could contribute to later impairments in the child would be significantly higher.