I have worried about autism ever since my ultrasound showed that I was carrying a boy. At the time my knowledge of the subject was derived almost entirely from Dustin Hoffman’s portrayal of the disorder in Rain Man and an article published in The Globe and Mail a few years ago suggesting that the epidemic of autism in Silicon Valley was a result of natural selection gone awry. Autism is especially prevalent, it seems, in families that have more than their share of engineers, accountants, and computer programmers – professions that involve lining up numbers in orderly columns. With a degree in computer science (and a math-teacher father), hubby fits the profile all too well. The article came with a handy multiple-choice quiz: Test your Autism Quotient! Needless to say, hubby’s score was well above average. Logic is the very air my husband breathes; he is rational in the best possible sense – rational enough to recognize that feelings are facts, and that there is nothing so irrational as the expectation that others’ emotions (okay, my emotions) line up precisely with his objective tally of events.
When Bub had his MMR vaccination, I watched him anxiously for side effects, and breathed a sigh of relief when he was still the same old Bub – no rocking or flapping, no screaming at loud noises, no withdrawal into silence or avoidance of eye contact. Sure, he was a bit quirky, but in ways I was proud of: at eighteen months of age, he could play independently for thirty minutes at a time, innocently absorbed in a single task, like lining up cars in careful rows on his Little People garage, or putting together wooden puzzles, casually sorting and replacing the pieces with lightning rapidity. His grandfather would tease him by mixing and matching his toys, taking the pentagon from his Tupperware shape-sorter and throwing it into his Fisher-Price shape-sorting snail, a move that always prompted Bub to snatch the offending toy and put it back in its proper place. When we took him on car rides, Bub would keep track of our route, squealing in dismay if we took a wrong turn; he knew the way to church, to grandma’s house, to playgroup, instantly aware of any deviation from our usual course.
My concerns began to re-emerge around Chrismastime; Bub had just turned two and his language delay was becoming more noticeable: he had a vocabulary of over 100 words (well within the normal range), but almost all of those words were nouns. He could recite his alphabet and identify every animal on his Baby Einstein World Animals DVD, but he couldn’t ask for food when he was hungry or say "All done" when he was full. "How does he communicate his desires?" the speech therapist asked when I called to set up an appointment. "Does he use words, or gestures, or does he pull you around by the hand?" Um, none of the above? For the most part, Bub’s desires were focused within the range of things he could do on his own – he might push his food away when he didn’t want any more, or scream in frustration when the flaps on his lift-the-flap book wouldn’t lie flat, but he did not instinctively turn to his parents for help in those situations – if he wanted something done, he tried his best to do it himself.

When you have a son with a language delay, what you discover is that everybody knows of a boy who didn’t talk until he was four. These boys all, without exception, grew up to be doctors. So that’s encouraging. But no one seems to know how to determine which slow-talker will catch up to his peers, and which one will end up with a diagnosis. The last time I wrote about this issue, I was feeling pretty optimistic. Bub has changed enormously over the last six months. Not so long ago, I estimated that 75% of what came out of his mouth was memorized fragments of storybooks and song lyrics. He would snuggle up in bed with me, first thing in the morning, and whisper, "and on that farm he had a cow," or "Five, four, three, two, one – Blast off!" He would interrupt his play to shout, "Put me down, said the fish, this is no fun at all! Put me down, said the fish, I do not wish to fall!" These days he still belts out song lyrics, increasingly tunefully, but he saves that for when he’s supposed to be sleeping (winding up with a long, extended final note: "And – the – smile was on the crocoDIIIIILE!"). When he’s up and around, by contrast, he issues orders like a field marshal, complete with prepositional phrases: "Mama, lie down under the table! Orange juice in a cup, please!" (Some of these instructions are based on his wants and needs; others are based on the pure love of power.)
And yet every step has been won with deliberate, conscious effort. We’ve taught him to point, for instance, with endless walks around the neighbourhood ("Look! A basketball hoop! A fire hydrant! A bicycle!"). Hesitantly, with an open hand, he gestures towards the things he sees – but he doesn’t point like the Pie does, enthusiastically, joyfully, as if her very life force were pulsing down her arm and through the tip of her index finger. The way his brain functions is fascinating (to me), but atypical. His process of language acquisition, for instance, is upside-down: first he learns to pronounce the words – studying the shape of sentences with scientific detachment, examining how the syllables feel in his mouth – and only then does he begin to discover what those words mean. Finally, when he has used the words himself in a variety of contexts, he begins to understand what they mean when he hears them from others: he had been ordering me to stand up and sit down for weeks before he began to realize that when I say "Come here!" or "Shut the door!" those words are (a) directed at him, (b) designed to elicit a response, and (c) useful clues he can use to determine what, exactly, I want him to do. (I know he’s got it when he responds to such instructions by looking me in the eye and replying, in an off-hand tone, "No.")
The other day, Bub looked up from his Thomas magnets, which he was carefully placing on the railroad track, and asked, "How many birds do you want?" As I have discussed elsewhere, the Bub rarely asks questions, so I hazarded a response: "I would like, um, one bird?" He was unimpressed. "How many squirrels do you want? How many grapes do you want?" The following morning my day-care provider explained that she had been showing him Baby Einstein Numbers Nursery during diaper changes. Mystery solved. One of the bonus features shows a few items and asks, "How many [blank] do you see?" Bub has altered the phrase slightly, possibly because he so often hears the words "What do you want?" from his parents at mealtimes. He is fascinated by the construction of this phrase, substituting his own words to create new questions. "How many sisters do you want?" he asked last night, with a hint of mischief, and when I posed the question to him in return he replied, promptly, "Four." (When he asked how many brothers I wanted, I didn’t bother to turn the question back on him. I was too afraid of what I’d hear.) He doesn’t really understand these questions, but I hope that, having made the transition from the indicative to the imperative, he’s getting ready to make the leap into the interrogative.
I sometimes feel that the credit for his progress belongs largely to the Pie. Hers was the first name he ever used, long before "Mama" or "Daddy." (He uses those terms regularly now, but not always correctly. "Daddy, run away!" he’ll tell me, and when I don’t run off and hide, he’ll look up, palpably trying to remember, Which one are you again? Oh, yeah…right.) From his sister, he has learned the joys of interaction, the fun that can be had from chasing and being chased. He is still reluctant to join in at playgroups, preferring to find a toy and retire to a corner where he can play undisturbed. But at moms' group the other day, a couple of rowdy girls were horsing around, wearing foam chairs on their heads, and the Bub ran over, grinning from ear to ear, and darted in and out of the fray shouting, "Silly! Crazy!" I have no idea what we’ll be told when we take him to the screening clinic in September, but as I watched him laughing and playing – with other children! his age! – I had tears in my eyes.