I'm sure you are very worried about your step son. But before we are sure we can diagnose a child with autism--or any other disorder--it is very important to take many different steps to evaluate him. In this case, I have a couple of thoughts for you.

1. Having trouble toilet training a 3 year old boy is not diagnostic. Many boys don't use the toilet until 3 1/2 or 4-years.

2. He may be having trouble hearing certain pitches. Ear infections can cause hearing loss as can other things, and this may be why he doesn't hear or respond to his name.

3. Most 3-year olds like to do things on their own terms, this is part of learning independence. Some kids have the 'terrible threes', rather than the terrible twos.

You definitely should pay attention to your concern. But I'd begin with a visit to your pediatrician. If all medical issues are ruled out (including hearing loss), then a developmental evaluation might be in order to determine whether he shows signs of autism or another developmental delay. Take each step one at a time so you can rule things in and out in a way that will not be confusing. Keep a folder of reports and notes from all doctors, this will help you feel that you are doing everything you need to do to help your step son.

Good Wishes and Great Parenting,
Dr Susan Bartell
JustAsk Expert
www.drsusanbartell.com
Twitter @drsusanbartell
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