When my twins, Aren and Gabriel, were twelve months old, I began noticing that Gabriel communicated much better than his brother. While Gabriel had met milestones such as pointing, clapping, and using a variety of speech sounds (but few words), Aren had not even tried to point or clap, and had few consonant sounds in his babbling. I mentioned my concerns to my pediatrician, who reassured me. "They were a bit premature," he said. "It's OK if one is a little behind the other. He'll catch up."
I wasn't so sure. During my first marriage, I had been a step-mother to a little girl who was eventually diagnosed with an autistic disorder (PDD-NOS). She also had not waved or pointed, and had babbled incoherently or repeated phrases over and over when she was a toddler. She, like Aren, enjoyed playing alone. I knew that Aren had several risk factors for autism, including being a twin and having a mother of "advanced maternal age" (I was thirty-nine when he was born).
A month later, Aren had a seizure in a busy restaurant, and then six more tonic seizures the next day. We spent the weekend in the hospital, where he underwent many tests. He had an IV placed in his head because they couldn't find any other veins big enough. He was doped up on phenobarbital. After the neurologist had ruled out other causes – meningitis, a brain tumor, and other scary possibilities – he said that Aren most likely suffered from epilepsy, and put him on Trileptol.
When we returned home and adjusted back to "normal", I continued to watch Aren's development. While he actually seemed to be more engaged with his environment after her went on the medication, his speech and communication did not improve. I discussed this again with his pediatrician, who suggested I have Aren assessed by the school district.
Over the course of two weeks, six professionals, including autism specialists, speech therapists, and child development specialists, visited our home and assessed Aren, for a total of almost five hours of observation, play, and tests. When they had finished, they met with me and my husband, and told us that Aren had significant speech delay, and most likely fell on the mild end of the autism spectrum.
While the news was difficult, it was also a relief. We knew that something was wrong, and we were going to do something about it. The school district developed an Early Childhood IEP for Aren. We now take him to speech and developmental therapy twice a week. These therapy sessions are helpful for Aren, but also for us, his parents. The therapists teach us how to interact with Aren to encourage him to communicate using sign language. They show us how to play with him so that he develops stronger social skills. In short, they are helping us "reach" our son in ways we couldn't before.
The therapists working with Aren have emphasized that identifying him so young (he's nineteen months old), and getting him therapy now will maximize his chances of overcoming his developmental delays and difficulties. If you suspect one or both of your twins may be significantly developmentally delayed, there is no harm in having them assessed by professionals. It can either give you peace of mind or help you move in a direction that will ultimately benefit your child. For information on your state's early childhood intervention services, see this website: National Dissemination Center for Children with Disabilities.
There are also resources available to those in Great Britain, Canada, and Australia. To find out more about your national and local resources, contact your local school, county, province, or state government office or website and ask about early childhood resources or resources for people with disabilities.