22 Chapter 1 Box 1.2. Clinical reports William is 13 months old. His parents have concerns regarding his development. They observe that William displays limited interest in social interaction with them, does not smile at them or does not respond when spoken to. Furthermore, William is a notably quiet infant, making no babbling sounds. Parents note that these behaviors differ from their experience with their first child, prompting them to express their concerns to the preventive care physician at the well-baby clinic. The preventive care physician considers William to be still very young and opts to monitor his development. A follow-up appointment is scheduled in three months. Amir, who is 24 months old, accompanies his parents to the well-baby clinic for a routine check-up. During the visit, the preventive care nurse observes that Amir is not speaking and avoids making eye contact. Additionally, the nurse notices certain hand mannerisms that she perceives to be atypical. She communicates her concerns to Amir’s parents. Amir’s parents react surprised. While they share the nurse’s concern about Amir’s language development, they do not fully recognize and share the other observations the nurse mentions. Amir’s parents agree with a referral to a speech therapist. Emma is a 30 month old girl who visits kindergarten. Over time, the staff starts noticing some behaviors that stand out to them. For instance, when her parents drop her off, Emma walks into the kindergarten without waving goodbye. Once inside, she prefers playing alone in a corner with her dolls. If another child attempts to join her play, Emma shows visible distress and is difficult to console. The staff also noticed that Emma does not respond to her name being called and exhibits a fascination with turning lights on and off. Upon discussing these behaviors with her parents, they acknowledge observing similar behaviors at home. Concerned about Emma’s development, her parents conduct independent research on the internet, leading them to suspect that Emma may have autism. They decide to discuss these concerns during the upcoming well-baby clinic visit.
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